Continuous Infusions vs Scheduled Bolus Infusions
A Prospective Comparison of Pain and Analgesia in Patients With Continuous Peripheral Nerve Block Catheters Using Continuous Infusion or Scheduled Bolus Infusion
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Regional anesthetic techniques are an integral part to many anesthetic approaches, providing both intraoperative and postoperative anesthesia and analgesia. Regional anesthesia peripheral nerve blocks have been shown to reduce postoperative pain and improve measures such as opioid requirements and readiness for discharge. By using a catheter technique for continuous peripheral nerve blocks, analgesia can be extended well into post-operative days 2 and 3, further extending these benefits. Historically these catheters have implemented a continuous dosing regimen of local anesthetic, but increasingly there is evidence of improved analgesic outcomes without adverse effects by using a scheduled bolus dosing regimen. Many institutions have implemented this new protocol for catheter dosing. The beneficial effect of scheduled bolus dosing has not been studied in all blocks and all surgical procedures.
The study will consist of three independent arms, each designed to evaluate a different nerve block site: interscalene, adductor canal, and infraclavicular. A total of 60 patients will be enrolled in each arm.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Aaron J Deng, BS
- Phone Number: 408-914-5494
- Email: adeng1@stanford.edu
Study Locations
-
-
California
-
Stanford, California, United States, 94305
- Recruiting
- Stanford University
-
Contact:
- Archana Verma
-
Principal Investigator:
- Jean Louis-Horn, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients presenting for nerve block catheters for post-operative analgesia
- ASA physical status I, II, or III.
Exclusion Criteria:
- Pregnancy
- Incarceration
- Age <18
- BMI >35
- Pre-operative opioid use >30 mg morphine equivalents per day
- Inability to communicate with investigators by telephone
- Pre-existing neuropathy of the operative extremity.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Continuous Infusion
Local anesthetic medication (Ropivacaine 0.2%) is provided at a continuous basal rate.
|
Patient will be given a continuous infusion of local anesthetic.
Other Names:
Patient will be given a scheduled intermittent bolus of local anesthetic.
Other Names:
|
|
Active Comparator: Intermittent Bolus Infusion
Local anesthetic medication (Ropivacaine 0.2%) is provided in scheduled, intermittent boluses.
|
Patient will be given a continuous infusion of local anesthetic.
Other Names:
Patient will be given a scheduled intermittent bolus of local anesthetic.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Post-surgical pain
Time Frame: Post-operative day 0, 1, and 2
|
Pain scores will be collected using a Numeric Rating Scale (NRS) from 0-10, where 0 is the lowest and 10 is the highest pain level.
|
Post-operative day 0, 1, and 2
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Opioid consumption
Time Frame: Post-operative day 0, 1, and 2
|
The amount of opioid analgesics (converted to total morphine milligram equivalents) taken by patients will be recorded.
|
Post-operative day 0, 1, and 2
|
|
Local anesthetic use
Time Frame: Post-operative day 1 and 2
|
The amount of supplemental local anesthetic boluses self-administered by patients will be recorded (in mL).
|
Post-operative day 1 and 2
|
|
Quality of recovery
Time Frame: Post-operative day 1 and 2
|
Quality of recovery will be assessed using a Quality of Recovery (QoR-15) questionnaire.
The QoR15 scores range from 0 to 150, where 0 is poor recovery and 150 is excellent recovery.
|
Post-operative day 1 and 2
|
|
Evidence of diaphragmatic paralysis
Time Frame: Post-operative day 1 and 2
|
Ability to breathe will be assessed as a part of QoR-15 questionnaire on 11-point scale, where 0 is never being able to breathe easily and 10 is always being able to breathe easily.
|
Post-operative day 1 and 2
|
|
Patient satisfaction
Time Frame: Post-operative day 1 and 2
|
Patients will be asked to assess their satisfaction with pain management (Yes/No).
|
Post-operative day 1 and 2
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jean Louis-Horn, MD, Stanford University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 41434
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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