An interventional study of ultrasonographic diaphragmatic assessment in Anesthesia, sponsored by Nova Scotia Health Authority. Completed at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-04-06.
Sponsored by Nova Scotia Health Authority · Not applicable, Interventional, and Treatment
The investigators plan to determine the onset time and incidence of hemidiaphragmatic paresis (HDP) with a double injection supraclavicular nerve block in patients presenting for upper extremity surgery below the elbow.
The hypothesis is HDP following supraclavicular brachial plexus block occurs with-in 15 minutes of block performance and is not associated with subjective dyspnea.
This study will be an observational trial to assess the onset time and incidence of hemidiaphragmatic paresis in patients who undergo the double injection ultrasound-guided supraclavicular block. Diaphragmatic dysfunction will be determined by intercostal diaphragm thickening measured using ultrasound. The available image will be saved.
Patients having below the elbow surgery will be be approached by someone from the research team for consent and possible inclusion in the study. This will be done in the anesthesia preoperative assessment clinic, or in the pre-op area on the day of surgery (if a patient was not seen in clinic).
A baseline ultrasonographic diaphragmatic assessment will be completed. Study participants will then receive supraclavicular brachial plexus block as per standard of care. Ultrasonographic diaphragmatic assessment and dyspnea score (using modified Borg dyspnea scale) will be performed every 5 minutes for 30 minutes, or until the patient is transferred to the operating room, whatever comes first. Patients will also undergo an ultrasonographic diaphragmatic assessment and dyspnea score in the recovery room after their surgery.
Nova Scotia Health Authority is the lead sponsor of 264 studies on the registry; 80 are open to participants now.
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Exclusion Criteria:
Diagnostic Test: ultrasonographic diaphragmatic assessment
Diaphragmatic dysfunction will be determined by intercostal diaphragm thickening. The available image will be saved. Diaphragmatic motion assessments will be conducted on the side to be blocked both at baseline, and then every 5 minutes until patient leaves for operating room or 30 minutes (whatever is earlier).
Frequency of hemi-diaphragmatic paresis
Number of participants in which hemi-diaphragmatic paresis is detected using ultrasound measurement of diaphragmatic thickening
Time frame: Relative change in ultrasound assessment of diaphragmatic thickening (Baseline vs 30 min after supraclavicular block)
Onset time of hemi-diaphragmatic paresis
The average time at which hemi-diaphragmatic paresis is detected using ultrasound measurement of diaphragmatic thickening
Time frame: Baseline, 5, 10, 15, 20, 25, and 30 minutes after block
The correlation of subjective dyspnea
Using the modified Borg dyspnea scale ranging from 0 (no breathlessness at all to 10 (maximal breathlessness)
Time frame: Baseline, 5, 10, 15, 20, 25, and 30 minutes after block
Incidence of HDP after surgical procedure under supraclavicular brachial plexus block (in post recovery unit).
Based upon sonographic assessment
Time frame: Post-operatively up to 24 hours
This study is completed, as verified in Apr 2020. You cannot join it, but the record below documents what was studied.
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