Ultrasound Description of the Sciatic Nerve - Full Text View

Purpose

Sciatic nerve blocks are frequently used for anesthesia or analgesia for surgery of the lower legs. Currently, if ultrasound is used to find the sciatic nerve, the leg must be raised to locate the nerve with the ultrasound probe on the back of the thigh. In pediatric surgery, the patients are anesthetized (asleep) before the block is given. It is difficult for one person to administer the sciatic nerve block using this method. We would like to identify the sciatic nerve using ultrasound on the side of the thigh and its location to the adjacent structures.

Condition	Intervention
Sciatic Nerve AH Peripheral Nerves US	Other: Observation of the Sciatic Nerve

MedlinePlus related topics:

Anatomy Anesthesia Ultrasound

U.S. FDA Resources

Study Type:	Observational
Study Design:	Case-Only, Prospective

Official Title:	Anatomical Description of the Sciatic Nerve Via a Lateral Mid-Thigh Approach Using Ultrasound

Further study details as provided by Children's Hospital of Philadelphia:

Primary Outcome Measures:

The primary objective is to describe the appearance of the sciatic nerve and its location in relation to adjacent anatomic structures using ultrasound from the lateral mid-thigh position. [ Time Frame: 10 minutes ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

A secondary objective is to describe correlations between any of the measured variables and the patient's mid-thigh circumference or weight. [ Time Frame: 10 minutes ] [ Designated as safety issue: No ]

Biospecimen Retention: None Retained

Biospecimen Description:

Estimated Enrollment:	40
Study Start Date:	April 2008
Estimated Study Completion Date:	June 2009
Estimated Primary Completion Date:	April 2009 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
1 Pediatric Patients of ages 11-17	Other: Observation of the Sciatic Nerve Ultrasound will be used to determine the location of the Sciatic Nerve using a lateral mid-thigh approach.

Detailed Description:

The sciatic nerve block is frequently used for anesthesia or analgesia for surgery of the lower extremities. Ultrasound-guided sciatic nerve blocks performed at the lateral mid-femoral level have been successfully described with subjects in the supine position and the lower limb elevated in order to accommodate the ultrasound probe against the posterior aspect of the thigh. In the pediatric setting in which nerve blocks are commonly performed with the patient anesthetized rather than awake, we find this technique to be unwieldy as a single-operator technique. Using a more ergonomic approach that has not been previously described, we plan to identify and describe the sciatic nerve with the ultrasound positioned against the lateral aspect of the thigh. We hope to describe the appearance of the sciatic nerve and its location in relation to adjacent anatomic structures using this modified approach.

This a prospective cross-sectional study of 40 pediatric subjects 11-17 years of age. Three ultrasound images of the sciatic nerve will be obtained via the lateral mid-thigh approach in 40 pediatric patients scheduled to undergo sciatic nerve block - the first image prior to placement of the block, the second after the nerve is located by the stimulating needle and the third after the injection of local anesthetic.

Eligibility

Ages Eligible for Study:	11 Years to 17 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

Pediatric patients

Criteria

Inclusion Criteria:

Males or females 11 to 17 years old.
Patients undergoing lower extremity surgery who are scheduled to have a sciatic nerve block as part of the anesthetic.
Parental/guardian permission (verbal consent) and child assent. Note: if you record ANY PHI, you will need to obtain written consent since HIPAA requires written authorization for use of PHI.

Exclusion Criteria:

None

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00663715

Contacts


Contact: George Liu, MD	1-267-426-5894	liug@email.chop.edu

Contact: Arjunan Ganesh, MD	1-215-590-1623	ganesha@email.chop.edu

Locations


United States, Pennsylvania
	The Children's Hospital Of Philadelphia	Recruiting
	Philadelphia, Pennsylvania, United States, 19104
	Contact: Arjunan Ganesh, MBBS 215-590-1623 ganesha@email.chop.edu
	Contact: George Liu, MD 267-426-5891 liug@email.chop.edu
	Principal Investigator: Arjunan Ganesh, MD

Sponsors and Collaborators

Children's Hospital of Philadelphia

Children's Anesthesiology Associates, Ltd.

Investigators


Principal Investigator:	Arjunan Ganesh, MD	Children's Hospital of Philadelphia

More Information

Publications:

Karmakar MK, Kwok WH, Ho AM, Tsang K, Chui PT, Gin T. Ultrasound-guided sciatic nerve block: description of a new approach at the subgluteal space. Br J Anaesth. 2007 Mar;98(3):390-5.

Responsible Party:	The Children's Hospital Of Philadelphia ( Arjunan Ganesh, MD )
Study ID Numbers:	2008-02-5808
First Received:	April 18, 2008
Last Updated:	April 18, 2008
ClinicalTrials.gov Identifier:	NCT00663715
Health Authority:	United States: Food and Drug Administration

Keywords provided by Children's Hospital of Philadelphia:

Sciatic Nerve

Peripheral Nerve Block

Lower extremity surgery

Local Anesthesia

Ultrasound guided nerve blocks

ClinicalTrials.gov processed this record on September 05, 2008

Sponsors and Collaborators:	Children's Hospital of Philadelphia Children's Anesthesiology Associates, Ltd.
Information provided by:	Children's Hospital of Philadelphia
ClinicalTrials.gov Identifier:	NCT00663715