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This pilot study will evaluate the latency of onset and duration of sensory-motor block in patients undergoing hand surgery. Patients will be randomized to receive nerve blocks of the distal forearm or of the distal and proximal forearm. Local anesthetic will be injected to anesthetise the median and ulnar nerves in the distal forearm (1-injection site group) or the median and ulnar nerves in the distal and proximal forearm (2-sequential injection sites group) to accomplish anesthesia for surgery on the hand.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lidocaine distal forearm | Active Comparator | Lidocaine 1% - Ultrasound-guided specific blocks of the DISTAL median and ulnar nerves with perineural injections of Lidocaine1%. Volume injected is 6 mL/nerve; 12 mL total. |
|
| Bupivacaine distal forearm | Active Comparator | Bupivacaine 0.5%-Ultrasound-guided specific blocks of the DISTAL median and ulnar nerves with perineural injections of Bupivacaine0.5%. Volume injected is 6 mL/nerve; 12 mL total. |
|
| Lidocaine distal and proximal forearm | Active Comparator | Lidocaine 1%- Ultrasound-guided specific blocks of the DISTAL and PROXIMAL median and ulnar nerves with perineural injections of Lidocaine 1%. Volume injected is 3 mL/nerve; 12 mL total |
|
| Bupivacaine distal and proximal forearm | Active Comparator | Bupivacaine 0.5%- Ultrasound-guided specific blocks of the DISTAL and PROXIMAL median and ulnar nerves with perineural injections of Bupivacaine 0.5 %. Volume injected is 3 mL/nerve; 12 mL total. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lidocaine | Drug | lidocaine 1%, distal ( ulnar and medial nerve): 6ml/nerve , 12m total |
|
| Measure | Description | Time Frame |
|---|---|---|
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 5-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 10-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 15-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 20-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative Numeric Rating Scale (NRS) | pain rating(numeric rating scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | screening Day0 (prior to the nerve block), post block, PACU arrival, Day0 evening, Day1 morning and evening, Day2 morning and evening, Day3 morning and evening, Day4, Day5, Day6, Day7 |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ziekenhuis Oost-Limburg | Genk | Limburg | B-3600 | Belgium |
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| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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| Bupivacaine | Drug | Bupivacaine 0.5%,distal ( ulnar and medial nerve): 6ml/nerve , 12m total |
|
| Lidocaine | Drug | lidocaine 1%, distal and proximal ( ulnar and medial nerve): 3ml/nerve , 12m total |
|
Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch.
| 25-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 30-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 45-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 60-minute beginning at the end of the last injection |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | Post Anesthesia Care Unit arrival |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 15-minute after Post Anesthesia Care Unit arrival |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | 30-minute after Post Anesthesia Care Unit arrival |
| onset of successful block and duration of sensory-motor blockade of the median and ulnar nerves | Block success is defined as full sensory block of the areas and muscles supplied by the median and ulnar nerves. Block failure is defined as absence of sensory blockade at 30 min in the median and ulnar nerve territories as assessed by pin-prick, cold and light touch. | Post Anesthesia Care Unit discharge |
| postoperative Numeric Rating Scale (NRS) |
pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) |
| post block |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Post Anesthesia Care Unit arrival |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 0 evening |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 1 morning |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 1 evening |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 2 morning |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 2 evening |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 3 morning |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 3 evening |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 4 |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 5 |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 6 |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 7 |
| postoperative Numeric Rating Scale (NRS) | pain rating( Numeric Rating Scale) at rest and with movement ( scale 0:no pain - 10:worst pain) | Day 30 |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |
| Aniline Compounds |
| D000588 | Amines |