Peripheral Nerve Block in Patients With Painful Diabetic Polyneuropathy
Peripheral Nerve Block in Patients With Painful Diabetic Polyneuropathy: How Important is the Peripheral Signaling?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Both peripheral and central changes in the nervous system contribute to the development of painful diabetic neuropathy, but how these changes contribute to the pain generation remains yet to be fully understood.
The purpose of this study is to evaluate if a peripheral regional nerve block relieves spontaneous pain in painful diabetic polyneuropathy.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ellen L Schaldemose, MD
- Phone Number: +45 93501942
- Email: ells@clin.au.dk
Study Locations
-
-
Jutland
-
Aarhus N, Jutland, Denmark, 8200
- Recruiting
- Danish Pain Research Center, Aarhus University, Aarhus University Hospital
-
Contact:
- Ellen L Schaldemose, MD
- Phone Number: 93501942
- Email: ells@clin.au.dk
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aged 18 years or older.
- Probably diabetic neuropathy confirmed using the Toronto criteria in a "conservative manner", i.e. three out of three symptoms/signs of neuropathy must be present (sensory neuropathy symptoms, distal reduced sensibility, reduced ankle reflexes) 7.
- Definite or probable neuropathic pain for minimum the last 6 months
- Mean pain intensity at > 4 NRS the last week17.
Since we expect a large effect of the block it is not necessary to discontinue pain medication.
Exclusion Criteria:
- Other causes of pain in the same area or other pain that cannot be distinguished from the neuropathic pain.
- Unable to understand and speak Danish.
- Non-cooperative.
- Warfarin or other medication that contraindicate regional anesthesia.
- Infection in the injection area.
- Allergy to lidocaine.
- Pregnancy or lactating (fertile women must to show negative pregnancy test or use anticonception).
- Severe psychiatric disease e.g. severe depression during the last 6 months.
- Alcohol or drug abuse.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Isotonic saline
Nerve block
|
Nerve block
|
|
Active Comparator: Xylocaine
Nerve block
|
Nerve block
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Indication of pain relieved extremity
Time Frame: 30 minutes
|
Number of participants who indicated the leg with lidocaine as most pain relieved 30 minutes after block And number of participants who indicated the leg with saline as most pain relieved 30 minutes after block
|
30 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain intensity
Time Frame: 90 minutes
|
Intensity of spontaneous pain (Numeric Rating Scale (NRS) 0-10, 0=no pain 10=worst pain imaginable) 30, 45, 60 and 90 minutes after block
|
90 minutes
|
|
Hyperalgesia and allodynia
Time Frame: 90 minutes
|
Intensity of hyperalgesia and allodynia from -5 to 5 (-5 = no sensation, 0=normal sensation, 5=extremely intense sensation) to brush, pinprick, cold and warm at baseline and if there is registered any signs of hyperexcitability at baseline then 35, 60 and 90 minutes after nerve block.
|
90 minutes
|
|
Pain relief
Time Frame: 45 minutes
|
Pain relief at 45 minutes after block assessed using a 6-point scale compared to pain intensity at baseline.
(-1 = worse pain 0=no relief 1= little 2= moderate 3=good 4=complete)
|
45 minutes
|
|
Pain symptomps
Time Frame: 50 minutes
|
Intensity of neuropathic pain symptoms 50 minutes after nerve block Burning: NRS (0-10), 0=no burning 10=worst burning imaginable Squeezing: NRS (0-10), 0=no squeezing 10=worst squeezing imaginable Pressure: NRS (0-10), 0=no pressure 10=worst pressure imaginable Tingling: NRS (0-10), 0=no tingling 10=worst tingling imaginable
|
50 minutes
|
|
Distribution of evoked pain
Time Frame: 60 minutes
|
The distribution of any evoked pain to brush, pinprick, cold and warm before and 60 minutes after nerve block will be mapped using a filt pen and afterwards photographed.
|
60 minutes
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ellen L Schaldemose, MD, Danish Pain Research Center, Aarhus University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
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
- Nervous System Diseases
- Neurologic Manifestations
- Endocrine System Diseases
- Diabetes Complications
- Diabetes Mellitus
- Neuromuscular Diseases
- Neuralgia
- Peripheral Nervous System Diseases
- Pain
- Polyneuropathies
- Diabetic Neuropathies
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Arrhythmia Agents
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Sensory System Agents
- Anesthetics
- Membrane Transport Modulators
- Anesthetics, Local
- Voltage-Gated Sodium Channel Blockers
- Sodium Channel Blockers
- Lidocaine
Other Study ID Numbers
Other Study ID Numbers
- BPN2020
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
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