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IRCT20181128041783N1 IRCT 2019-01-19 Mashhad University of Medical Sciences Comparison of Obturator nerve block and Femoral nerve block with spinal anesthesia for analgesia after elective knee arthroscopy Comparison of Obturator nerve block and Femoral nerve block with spinal anesthesia for analgesia after elective knee arthroscopy 2018-04-22 anticipated 72 Complete https://irct.ir/trial/35723 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Random Software, Blinding description: This is a double-blind interventional study (a study is one in which neither the nurse who is in charge of measuring the NRS nor the statistisian know about used analgesia method), all patients in Imam Reza hospital that are candidates for knee arthroscopy can be enrolled in this study after signing the contest form. N/A Comparison of obturator nerve block and femoral nerve block with spinal anesthesia in analgesia after elective knee arthroscopy. Intervention 1: 1 Intervention group: For the obturator nerve block, the patient's hip should be placed in the abduction and the external rotational position. The ultrasound probe will be placed in the medial segment of the inguinal groove. After detecting the pectinose muscle, the probe head spins 40 to 50 degrees towards the cranial to reveal the hyperecho structure in the posterolateral pectinose (the lower edge of the upper rhomus pubis).Then, in the fascia space between the two muscles of Abductor Longus and the Abductor Brevis anterior branches, and between the abductor brevis and Abdactor magnus, the posterior branch of the obturator nerve is characterized by ultrasound and a stimulator of the nerve with a 0.5mA and proper stimulation of the contraction of the abductor muscles. Linear probe with a frequency of 10 MHz is used for this purpose and the block is performed out of plane. In the vicinity of each anterior and posterior branches of the obturator nerve 5 cc lidocaine 2% with 0.5 cc bicarbonate and 25 micrograms of fentanyl and then 3 cc marcaine 0.5% with epinephrine 1/200000 is injected to increase block length. For the femoral block, after the preparation of the probe area, ultrasound is placed in the ligament of the inguinal lining. The lateral to the femoral artery and the sub facia Iliaka, the femoral nerve is targeted with the help of a nerve stimulus needle and in-plane ultrasound guidance. After a 0.5 mA quadriceps shrinkage, 10 cc lidocaine 2% with 1 cc bicarbonate and 50 micrograms fentanyl and then 6 cc marcaine 0.5% with epinephrine 1/200000 are injected to increase the block length. Intervention 2: 2 Intervention group: To perform the spinal anesthesia, the patient is placed in setting position. In L4-L5 space, in the midline, with needle number 25, the needle is perpendicular to the Dora axis, after inserting the needle into the subarachnoid space, the needle is 90 degrees Rotate counterclockwise and inject 15 mg of marcaine 0.5% with 25 μg of fentanyl. After the anesthesia, the surface of the block is checked with a pinprick test to ensure that the level of the block reaches l3, which is a suitable level for performing orthoscopy. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is No more information.
public Mokarram Dori Mehrdad
Imam Reza hospital, Ebne sina Ave
Mashhad Iran (Islamic Republic of) 9137913316 +98 38022713 mokarramdm@mums.ac.ir Mashhad University of Medical Sciences scientific Mokarram Dori Mehrdad
Imam Reza hospital, Ebme sina Ave
Mashhad Iran (Islamic Republic of) 9137913316 +98 51 3802 2713 mokarramdm@mums.ac.ir Mashhad University of Medical Sciences Iran (Islamic Republic of) Aged 18 to 50 years Classification of American Society of Anesthesiology (ASA-1) Non-sensitivity to local anesthetic drugs BMI less than 30 patient satisfaction. 18 years 50 years Both Having coagulation disorders Infection in the injection site Having nerve disorders at the foot of the site Other Other 1 Intervention group: For the obturator nerve block, the patient's hip should be placed in the abduction and the external rotational position. The ultrasound probe will be placed in the medial segment of the inguinal groove. After detecting the pectinose muscle, the probe head spins 40 to 50 degrees towards the cranial to reveal the hyperecho structure in the posterolateral pectinose (the lower edge of the upper rhomus pubis).Then, in the fascia space between the two muscles of Abductor Longus and the Abductor Brevis anterior branches, and between the abductor brevis and Abdactor magnus, the posterior branch of the obturator nerve is characterized by ultrasound and a stimulator of the nerve with a 0.5mA and proper stimulation of the contraction of the abductor muscles. Linear probe with a frequency of 10 MHz is used for this purpose and the block is performed out of plane. In the vicinity of each anterior and posterior branches of the obturator nerve 5 cc lidocaine 2% with 0.5 cc bicarbonate and 25 micrograms of fentanyl and then 3 cc marcaine 0.5% with epinephrine 1/200000 is injected to increase block length. For the femoral block, after the preparation of the probe area, ultrasound is placed in the ligament of the inguinal lining. The lateral to the femoral artery and the sub facia Iliaka, the femoral nerve is targeted with the help of a nerve stimulus needle and in-plane ultrasound guidance. After a 0.5 mA quadriceps shrinkage, 10 cc lidocaine 2% with 1 cc bicarbonate and 50 micrograms fentanyl and then 6 cc marcaine 0.5% with epinephrine 1/200000 are injected to increase the block length. 2 Intervention group: To perform the spinal anesthesia, the patient is placed in setting position. In L4-L5 space, in the midline, with needle number 25, the needle is perpendicular to the Dora axis, after inserting the needle into the subarachnoid space, the needle is 90 degrees Rotate counterclockwise and inject 15 mg of marcaine 0.5% with 25 μg of fentanyl. After the anesthesia, the surface of the block is checked with a pinprick test to ensure that the level of the block reaches l3, which is a suitable level for performing orthoscopy. Severity of pain after surgery. Timepoint: The severity of pain in the recovery at 3, 6, 12 and 24 hours after surgery. Method of measurement: Numeric pain rating scale. Mashhad University of Medical Sciences Approved 2018-10-15 Ethics committee of Mashhad University of Medical Sciences No170, 36th Jalal Al-e-Ahmad Blv, Mashhad Razavi Khorasan Iran (Islamic Republic of)