- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04876989
The Comparison of Sympathetic Blockade of Stellate Ganglion Block and Thoracic Paravertebral Block
The Comparison of Sympathetic Blockade of Stellate Ganglion Block and Thoracic Paravertebral Block in Patients With Chronic Upper Extremity Neuropathic Pain: a Prospective Randomized and Comparative Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Well-trained pain physicians performs all US-guided stellate ganglion block(SGB)s or US-guided thoracic paravertebrl block(TPVB)s, who is not involved in evaluating study variables. Electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure.
For US-guided SGB, patients are supine positioned, and skin preparation on injection site is done with chlorohexidine. Procedure is conducted under ultrasound guidance at C6 level. 5 ml of 1% mepivacaine is injected for the SGB group. Syringes are prepared by one nurse who do not involved in other steps of this study.
For US-guided TPVB, patients are prone positioned, and skin preparation on injection site is done with chlorohexidine. Procedure is conducted under ultrasound guidance at T2 paravertebral space. 10 ml of 1% mepivacaine is injected for the TPVB group. Syringes are prepared by one nurse who do not involved in other steps of this study.
Temperature measurement is conducted 2 times (before US-guided SGB or TPVB and after 20 minutes) at both hands by one person who's not involved in other measuring in the study.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Seoul, Korea, Republic of
- Seoul National University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Clinical diagnosis of complex regional pain syndrome
- Clinical diagnosis of postherpetic neuralgia
- Clinical diagnosis of phantom limb pain
- Clinical diagnosis of chronic post-surgical pain
- Clinical diagnosis of post-traumatic pain syndrome
- Upper extremity pain lasting more than 3 months
Patients with a new or known diagnosis of chronic neuropathic pain lasting more than 3 months in the upper extremity
Exclusion Criteria:
- Refusal of a patient
- Any vascular disease in the upper extremities
- Previous history of thoracic sympathetic or stellate ganglion neurolysis (e.g. -thermocoagulation, radiofrequency neuromodulation, and/or chemical neurolysis)
- Coagulopathy
- Systemic infection or local infection at the needle injection site
- Major deformation at the level of the neck (radiotherapy, surgery, etc.)
- Known allergy to local anesthetics of amide type
- Inability to understand a numeric rating pain scale (cognitive dysfunction)
- Patients whose palm temperature on the ipsilateral side is ≥ 36.5℃ in the thermography before the procedure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: US-SGB
5 ml of 1% mepivacaine is injected for stellate ganglion block using the Ultrasound(US)-guided lateral approach at the sixth cervical vertebral level.
|
Well trained pain physician performs all the ultrasound(US)-guided stellate ganglion block(SGB)s, who is not involved in evaluating study variables.
Electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure.
For US-guided SGB, patients are supine positioned, and skin preparation on injection site is done with chlorohexidine.
Procedure is conducted under ultrasound guidance at C6 level.
5 ml of 1% mepivacaine is injected for the US-SGB group.
|
Active Comparator: US-TPVB
10 ml of 1% mepivacaine is injected for thoracic paravertebral block using the Ultrasound(US)-guided sagittal approach at the second thoracic paravertebral space.
|
Well trained pain physician performs all the ultrasound(US)-guided thoracic paravertebral block(SGB)s, who is not involved in evaluating study variables.
Electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure.
For US-guided TPVB, patients are prone positioned, and skin preparation on injection site is done with chlorohexidine.
Procedure is conducted under ultrasound guidance at T2 paravertebral space.
10 ml of 1% mepivacaine is injected for the US-TPVB group.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients reaching > 1.5°C rise of temperature in the ipsilateral hand compared to the contralateral hand
Time Frame: 20 minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Temperature is measured with a laser thermometer on the palmar aspect of 3 cm below from the middle finger.
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20 minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference of temperature change (°C) between ipsilateral hand and contralateral hand
Time Frame: 20 minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Temperature is measured with a laser thermometer on the palmar aspect of 3 cm below from the middle finger.
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20 minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Severity of pain
Time Frame: Time before block and 20 minutes and 1 week and 4weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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The severity of the pain will be evaluated before the block and 20 minutes, 1 week and 4 weeks after the block using an 11-pointed NRS (numerical rating scale) pain score.
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Time before block and 20 minutes and 1 week and 4weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Comparison of Korean version CISS(Cold Intolerance Symptom Severity) Questionnaire
Time Frame: Time before block and 4 weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Check the CISS before the procedure and 4 weeks after the procedure.
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Time before block and 4 weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Blood flow velocity measurement in upper extremity vessel(ipsilateral brachial artery) using ultrasound
Time Frame: Time before block and 20minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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The blood flow velocity in the ipsilateral brachial artery will be measured before the block and 20 minutes after the block using a Doppler mode ultrasound device.
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Time before block and 20minutes after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Patient global impression change (PGIC)
Time Frame: Time 20 minutes and 1 week and 4 weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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The PGIC will be evaluated 20 minutes, 1 week and 4 weeks after the block using a 5-point Likert scale.
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Time 20 minutes and 1 week and 4 weeks after US-guided thoracic paravertebral block or US-guided stellate ganglion block
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Youn Moon Jee, MD, PhD, Seoul National University Hospital
- Principal Investigator: Jeongsoo Kim, MD, SMG-SNU Boramae Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Postoperative Complications
- Pain
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Neuromuscular Diseases
- Peripheral Nervous System Diseases
- Autonomic Nervous System Diseases
- Perceptual Disorders
- Pain, Postoperative
- Neuralgia
- Complex Regional Pain Syndromes
- Reflex Sympathetic Dystrophy
- Phantom Limb
- Neuralgia, Postherpetic
Other Study ID Numbers
- 2102-183-120
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
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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