Distance for Interscalene Block

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01568463
Recruitment Status : Completed
First Posted : April 2, 2012
Last Update Posted : January 10, 2018
Information provided by (Responsible Party):
University Health Network, Toronto

Brief Summary:
Patients experience significant postoperative pain following shoulder surgery, Single shot interscalene block is used in ambulatory shoulder surgery for its advantages that include significant reduction in acute pain and analgesic requirements, prolonged time to first analgesic request, decreased incidence of nausea, as well as earlier hospital discharge.The process of nerve block requires several needle passes, with each of them being at risk of causing nerve injury either by direct trauma or intraneural injection even with the use of the ultrasound. These facts raised concerns and several authors stated that maybe the anesthesiologists should be more careful, keep a safe distance from the nerve, and inject the local anesthetics into fascial planes containing the nerve and not attempt to place the needle in close proximity to the nerve. This study is designed to determine the maximal effective distance away from the nerve for the injection to be effective.

Condition or disease
Regional Anesthesia Inter Scalene Block Post Operative Analgesia

Study Type : Observational
Actual Enrollment : 25 participants
Observational Model: Other
Time Perspective: Prospective
Official Title: What is the Maximal Effective Distance for Interscalene Block?
Actual Study Start Date : February 2012
Actual Primary Completion Date : January 24, 2013
Actual Study Completion Date : March 26, 2014

Primary Outcome Measures :
  1. Success of the inter-scalene block at 20 minutes after injection at a specific distance of the needle tip from the outer sheeth of the nerve [ Time Frame: 20 mins ]

Secondary Outcome Measures :
  1. The onset time of sensory and motor block [ Time Frame: the block success will be assessed for each patient every 5 min for 20 mins in the block room beginning when the needle exits the skin ]
  2. The proportion of inadequate and failed blocks. [ Time Frame: the block success will be assessed for each patient every 5 min for 20 mins in the block room beginning when the needle exits the skin ]
  3. The duration of block, defined as the time from the completion of block performance to the time of the request for the first postoperative analgesic. [ Time Frame: during the first 24 hours post operative ]
  4. The amount of pain and level of satisfaction, [ Time Frame: every 30 minutes starting at post anesthesia care unit admission till 120 minutes ]
  5. The presence of a Claude-Bernard-Horner Syndrome [ Time Frame: up to 24 hours post operative ]
  6. The presence of hoarseness. [ Time Frame: up to 24 hours post operative ]
  7. The presence of other complications such as hematoma, infection, pneumothorax. [ Time Frame: up to 24 hours post operative and 7 days post op ]

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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients undergoing shoulder surgery (shoulder arthroscopy or open shoulder surgery)

Inclusion Criteria:

  • ASA physical status I-III
  • 18-85 years of age, inclusive
  • surgery less than 3 hours

Exclusion Criteria:

  • contraindications to brachial plexus block (e.g., allergy to local anesthetics, coagulopathy, malignancy or infection in the area)
  • existing neurological deficit in the area to be blocked
  • pregnancy
  • history of neck surgery or radiotherapy
  • severe respiratory disease
  • inability to understand the informed consent and demands of the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01568463

Canada, Ontario
Toronto Western Hospital
Toronto, Ontario, Canada, M5T 2S8
Sponsors and Collaborators
University Health Network, Toronto
Principal Investigator: Richard Brull, MD, FRCPC University of Toronto

Responsible Party: University Health Network, Toronto Identifier: NCT01568463     History of Changes
Other Study ID Numbers: 11-0806-A
First Posted: April 2, 2012    Key Record Dates
Last Update Posted: January 10, 2018
Last Verified: January 2018

Keywords provided by University Health Network, Toronto:
Inter-scalene Block
Regional Anesthesia
shoulder surgeries