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| Name | Class |
|---|---|
| Research Institute of Medical Science, Daegu Catholic University | UNKNOWN |
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This study evaluates the effects of Horner's syndrome on cardiac autonomic nervous activity after interscalene brachial plexus block. Cardiac autonomic nervous activity and bilateral pupil diameters will be measured in a scotopic light condition, 30 minutes after interscalene brachial plexus block under ultrasound guidance and 15 minutes after the subsequent sitting position.
Stellate ganglia provide sympathetic fibers to the heart. Ipsilateral stellate ganglion block accompanied by interscalene brachial plexus block causes Horner's syndrome presenting with miosis, ptosis, and anhidrosis. The extent of Horner's syndrome can be represented by the difference in pupil diameter between bilateral eyes. Cardiac autonomic nervous activity affected by stellate ganglion block can be measured by calculation of heart rate variability parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interscalene brachial plexus block | Ultrasound-guided interscalene brachial plexus block with 25 ml to 30 ml of 0.75% ropivacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Interscalene brachial plexus block | Procedure | Under ultrasound guidance, the 5th to 7th cervical nerve roots are identified between anterior and middle scalene muscles and subsequently blocked. |
| Measure | Description | Time Frame |
|---|---|---|
| Post-sitting sympathetic nervous activity | Natural-log transformed low frequency power of heart rate variability calculated using R wave to R wave intervals obtained for 5 minutes between 10 and 15 minutes after the sitting position following interscalene brachial plexus block | 15 minutes after the sitting position following interscalene brachial plexus block |
| Measure | Description | Time Frame |
|---|---|---|
| Post-sitting ipsilateral pupil diameter | Ipsilateral pupil diameter measured under a mesopic condition 15 minutes after the sitting position following interscalene brachial plexus block | 15 minutes after the sitting position following interscalene brachial plexus block |
| Post-sitting contralateral pupil diameter |
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Inclusion Criteria:
Exclusion Criteria:
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Tertiary hospital
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| Name | Affiliation | Role |
|---|---|---|
| Jong Hae Kim, MD | Daegu Catholic University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Daegu Catholic University Medical Center | Daegu | 42472 | South Korea |
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| 0.75% ropivacaine | Drug | Placement of 25 to 30 ml of 0.75% ropivacaine around the 5th to 7th cervical nerve roots |
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Contralateral pupil diameter measured under a mesopic condition 15 minutes after the sitting position following interscalene brachial plexus block |
| 15 minutes after the sitting position following interscalene brachial plexus block |
| Post-anesthetic ipsilateral pupil diameter | Ipsilateral pupil diameter measured under a mesopic condition 30 minutes after interscalene brachial plexus block | 30 minutes after interscalene brachial plexus block |
| Post-anesthetic contralateral pupil diameter | Contralateral pupil diameter measured under a mesopic condition 30 minutes after interscalene brachial plexus block | 30 minutes after interscalene brachial plexus block |
| Pre-anesthetic ipsilateral pupil diameter | Ipsilateral pupil diameter measured under a mesopic condition 15 minutes after baseline acclimation | 15 minutes after baseline acclimation |
| Pre-anesthetic contralateral pupil diameter | Contralateral pupil diameter measured under a mesopic condition 15 minutes after baseline acclimation | 15 minutes after baseline acclimation |
| Post-sitting parasympathetic nervous activity | Natural-log transformed high frequency power of heart rate variability calculated using R wave to R wave intervals obtained for 5 minutes between 10 and 15 minutes after the sitting position following interscalene brachial plexus block | 15 minutes after the sitting position following interscalene brachial plexus block |
| Post-sitting sympathovagal balance | Low-to-high frequency power ratio of heart rate variability obtained for 5 minutes between 10 and 15 minutes after the sitting position following interscalene brachial plexus block | 15 minutes after the sitting position following interscalene brachial plexus block |
| Post-sitting overall variability of autonomic nervous system | Natural-log transformed total power of heart rate variability obtained for 5 minutes between 10 and 15 minutes after the sitting position following interscalene brachial plexus block | 15 minutes after the sitting position following interscalene brachial plexus block |
| Post-anesthetic sympathetic nervous activity | Natural-log transformed low frequency power of heart rate variability between 25 and 30 minutes after interscalene brachial plexus block | Between 25 and 30 minutes after interscalene brachial plexus block |
| Post-anesthetic parasympathetic nervous activity | Natural-log transformed high frequency power of heart rate variability between 25 and 30 minutes after interscalene brachial plexus block | Between 25 and 30 minutes after interscalene brachial plexus block |
| Post-anesthetic sympathovagal balance | Low-to-high frequency power ratio of heart rate variability between 25 and 30 minutes after interscalene brachial plexus block | Between 25 and 30 minutes after interscalene brachial plexus block |
| Post-anesthetic overall variability of autonomic nervous system | Natural-log transformed total power of heart rate variability between 25 and 30 minutes after interscalene brachial plexus block | Between 25 and 30 minutes after interscalene brachial plexus block |
| Pre-anesthetic sympathetic nervous activity | Natural-log transformed low frequency power of heart rate variability 15 minutes after baseline acclimation | 15 minutes after baseline acclimiation |
| Pre-anesthetic parasympathetic nervous activity | Natural-log transformed high frequency power of heart rate variability 15 minutes after baseline acclimation | 15 minutes after baseline acclimiation |
| Pre-anesthetic sympathovagal balance | Low-to-high frequency power ratio of heart rate variability 15 minutes after baseline acclimation | 15 minutes after baseline acclimiation |
| Pre-anesthetic overall variability of autonomic nervous system | Natural-log transformed total power of heart rate variability 15 minutes after baseline acclimation | 15 minutes after baseline acclimation |
| Sensory blockade | C5 to T1 dermatomal blockade of the shoulder graded from 0 to 2 (0 = no cold sensation, 1 = reduced cold sensation, and 2 = normal cold sensation) by applying ice to the shoulder | 30 minutes after interscalene brachial plexus block |
| Motor blockade | Motor blockade of the radial, ulnar, median, musculocutaneous, and axillary nerves graded from 0 to 2 (0 = no block 1 = partial block, and 2 = complete block) | 30 minutes after interscalene brachial plexus block |
| ID | Term |
|---|---|
| D006732 | Horner Syndrome |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D000096826 | Cavernous Sinus Syndromes |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D015877 | Miosis |
| D011681 | Pupil Disorders |
| D009461 | Neurologic Manifestations |
| D005128 | Eye Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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