- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01935648
Blood Levels of Local Anaesthetic in Knee Arthroplasty Using a Continuous Infusion Device (BLOCKS-II)
Blood Levels of Local Anaesthetic in Knee Arthroplasty: A Pharmacological Study of Ropivacaine Blood Levels During the Caledonian Technique for Knee Arthroplasty
The primary goal is to evaluate ropivacaine blood concentrations during and after local anaesthetic (ropivacaine) infiltration - the Caledonian technique - for total knee replacement surgery. The investigators plan to measure these levels by testing blood samples taken over a timed period.
This will allow us to confirm whether the current regimen of local anaesthetic use is within safe limits.
Study Overview
Detailed Description
Local anaesthetic (LA) toxicity may occur when the blood levels of a drug become particularly high. There is a need to confirm that the technique is safe to use. In addition, journal case reports may only describe serious side-effects of toxicity such as abnormal heart rhythms whilst more subtle clinical signs are rarely reported.
The investigators would like to study whether or not toxic levels may be approached in some patients or whether more subtle toxicity symptoms and signs are missed. For example, irregular heartbeat, low blood pressure or confusion/agitation.
Therefore, the investigators intend to study ropivacaine blood levels in patients receiving a total hip replacement in the Golden Jubilee National Hospital. A series of timed samples will be taken during the perioperative period. The anaesthesia and surgery will be performed as routine and no new treatment will be involved. Patient demographics, ropivacaine blood levels and clinical observations following LA administration will be collected.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Michael Gill, MBChB
- Phone Number: 5293 01419515000
- Email: Mike.Gill@gjnh.scot.nhs.uk
Study Locations
-
-
West Dunbartonshire
-
Clydebank, West Dunbartonshire, United Kingdom, G81 4dy
- Golden Jubilee National Hospital
-
Contact:
- Michael Gill, MBChB
- Phone Number: 5293 01419515000
- Email: Mike.Gill@gjnh.scot.nhs.uk
-
Principal Investigator:
- Michael Gill, MBChB
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Male or female patients greater than 65 years of age
Exclusion Criteria:
- Patients with a known sensitivity/allergy to ropivacaine or amide-type local anaesthetics
- Patients who are not suitable for the Caledonian technique
- Patients who refuse or are unable to give consent
- Patients undergoing bilateral hip replacements
- Patients with known heart, liver or kidney failure
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Ropivacaine
Injection of local anaesthetic (ropivacaine) into the knee joint following hip arthroplasty.
Total dose 200mls of 0.2% ropivacaine or 400mg at the time of surgery.
This will be followed by a continuous infusion of 10mls/hour 0.2% ropivacaine for the subsequent 24 hours.
|
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma levels of ropivacaine
Time Frame: Start of surgery until 24 hours postoperatively
|
Plasma levels of ropivacaine will be analysed to determine total and free levels. These will be taken following tourniquet release at the following time points: 5, 10, 15, 20, 25, 30 minutes then 1, 4, 12 and 24 hours. Note: Each patient will also have a baseline blood sample taken. |
Start of surgery until 24 hours postoperatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Vital signs of heart rate and blood pressure
Time Frame: Start of surgery until 24 hours postoperatively
|
Vital signs will be recorded (at each time point) when blood samples are taken.
|
Start of surgery until 24 hours postoperatively
|
Continuous 24 hour electrocardiograph monitoring
Time Frame: First 24 hours after surgery
|
Electrocardiograph data will be reported using analysis software to provide a summary of heart rhythm over the study period.
Both minor abnormalities (ectopic beats) and major abnormalities (loss of sinus rhythm, heart block) will be detected and reported.
|
First 24 hours after surgery
|
Symptoms of local anaesthetic toxicity
Time Frame: Start of surgery until 24 hours postoperatively
|
Patients will be specifically questioned (at each time point) on whether they have any of the following symptoms: Perioral tingling, dizziness, blurred vision, nausea |
Start of surgery until 24 hours postoperatively
|
Signs of local anaesthetic toxicity
Time Frame: Start of surgery until 24 hours postoperatively
|
Patients will be specifically assessed (at each time point) for the following signs: Confusion/agitation, (loss of consciousness, seizure activity, cardiac arrest) |
Start of surgery until 24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael Gill, MBChB, NHS Research Scotland
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 13/ANAES/02
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.
Clinical Trials on Osteoarthritis, Knee
-
LifeBridge HealthMicroPort Orthopedics Inc.; Rubin Institute for Advanced OrthopedicsRecruitingKnee Osteoarthritis | Osteoarthritis, Knee | Knee Pain Chronic | Arthropathy of Knee Joint | Knee Disease | Osteoarthritis Knees Both | Osteoarthritis Knee Left | Osteoarthritis Knee RightUnited States
-
University Hospital, Clermont-FerrandSanofiCompletedKnee Osteoarthritis (Knee OA)France
-
Joseph E. BroylesCompletedDegenerative Lesion of Articular Cartilage of Knee | Degeneration; Articular Cartilage, Knee | Unilateral Primary Osteoarthritis of Knee | Osteoarthritis Knee
-
Jiangsu XinChen-Techfields Pharma Co., LTD.Completed
-
The Hong Kong Polytechnic UniversityCompleted
-
Federal University of São PauloCompletedKNEE OSTEOARTHRITISBrazil
-
Novartis PharmaceuticalsRecruitingSymptomatic Knee OsteoarthritisUnited States, Spain, Hungary, Argentina, Germany, Slovakia, Czechia, Belgium, Romania
-
University of BathUniversity of Oxford; 3D Metal Printing Ltd; Versus ArthritisRecruitingMedial Knee OsteoarthritisUnited Kingdom
-
Max Biocare Pty. Ltd.Completed
Clinical Trials on Ropivacaine
-
Ziekenhuis Oost-LimburgNot yet recruitingAnesthesia | Hallux Valgus
-
University Health Network, TorontoUnknownPIB Versus CI Through a Popliteal Sciatic Nerve Catheter for Analgesia Following Major Ankle SurgeryPain, PostoperativeCanada
-
Northwestern UniversityCompletedPostoperative PainUnited States
-
Hospices Civils de LyonCompleted
-
Pusan National University HospitalCompletedHemodynamics | Epidural Anesthesia | Ropivacaine ConcentrationKorea, Republic of
-
Northwestern UniversityCompletedObesity | Postoperative Pain | PregnancyUnited States
-
Universiteit AntwerpenCompleted
-
San Gerardo HospitalIRCCS Policlinico S. Matteo; University of Milano Bicocca; Azienda L'ULSS 15... and other collaboratorsCompletedLaparoscopic CholecystectomyItaly
-
China Medical University, ChinaWithdrawn
-
China Medical University, ChinaCompleted