- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05083702
Ultrasound Versus Fluoroscopy Guided Superior Hypogastric Plexus Block in Cancer Bladder Patients
Ultrasound Versus Fluoroscopic Guided Superior Hypogastric Plexus Block in Cancer Bladder: A Randomized Controlled Trial
Study Overview
Status
Conditions
Detailed Description
Aim of the study:
To compare Fluoroscopic guided transdiscal superior hypogastric block and Ultrasound guided superior hypogastric block regarding their efficacy to control pelvic pain and
Statistical analysis:
Data will be described as mean ±SD or as frequencies (number of cases) and percentages when appropriate. Comparison of numerical variables between two study groups will be carried out using parametric and non-parametric t- tests for independent samples. Within group comparison of numerical variables was carried out using repeated measures ANOVA. P values of less than 0.05 will be statistically significant. All statistical calculations are performed using statistical package for the social sciences (SPSS, version 23 for Microsoft Windows; SPSS Inc., Chicago, Illinois, USA)
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Asmaa khalil, A.lecturer
- Phone Number: 01009468049
- Email: sosoelsayed1177@yahoo.com
Study Contact Backup
- Name: Khaled Mostafa, Professor
- Phone Number: 01011505033
- Email: K24mostafa@hotmail.com
Study Locations
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-
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Cairo, Egypt
- Recruiting
- National Cancer Institute
-
Contact:
- Asmaa Khalil, A.lecturer
- Phone Number: 01009468049
- Email: sosoelsayed11@yahoo.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 20 years.
- Patients with advanced stage cancer bladder.
- Patient with severe pain (VAS) 7 or more .
- Patients don't receive any strong opioids for pain at least 2 weeks
Exclusion Criteria:
- Patient refusal.
- Local infection at the puncture site.
- Coagulopathy.
- Cognitive disorders.
- Unstable cardiovascular disease.
- History of psychiatric disorders.
- History of drug abuse.
- Patients allergic to medication used.
- Patients with any contraindications to drugs and dye used.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Fluoroscopy-guided superior hypogastric plexus block transdiscal approach
fluroscopy guided superior hypogastric plexus block transdiscal approach for chronic pain treatment in cancer bladder VAS score and morphine consumption are measured before and after 1 day , 1 month , 3 monthes
|
Patient lies prone, L5-S1 interspace identified under fluoroscopy, the skin is prepared and sterile drapes are placed after local anesthetic infiltration of the skin the subcutaneous tissue with 2% lidocaine a 20 guage, 15 cm needle with short bevel is inserted at the center of L5- S1 interlaminar space under anteroposterior fluoroscopic vision.
The needle is then advanced toward the intervertebral disc.
After confirmation, the needle is advanced through the intervertebral disc until it exists at its anterior surface confirmed by administration of 4 ml of soluble contrast media in both lateral and anteroposterior fluoroscopic view.
Neurolysis is performed with 8 ml 8 % phenol solution.
After neurolysis, 0.5 ml of saline is given to avoid the deposition of phenol within the intervertebral disc material.
While withdrawing, the needle cephazoline 50 mg in 1 ml is injected into the disc.
Other Names:
|
ACTIVE_COMPARATOR: ultrasound-guided superior hypogastric plexus block
ultrasound guided superior hypogastric plexus block in treatment of chronic pain in cancer badder VAS score and morphine consumption are measured before and after 1 day , 1 month , 3 monthes
|
Patients are placed in the supine position and after sterilization, the low-frequency curved probe is used in the longitudinal axis to visualize the aortic bifurcation and is identified using a longitudinal Ultra-Sound (Phillips Healthcare, Andover, Massachusetts, US).
Next, the probe is placed deeply transverse till aorta end and bifurcation seen of iliac vessels once seen we enter out of plane and inject.as it lies in front the vertebral body of the L5 vertebra.
Local infiltration with 1% lidocaine is obtained at port of entry 1-1.5 inches below the umbilicus.
A 15-cm, 22-G Chiba needle is inserted (out-of-plane) and advanced by avoiding vascular structures until contact with the L5-body.
The needle will be withdrawan the 1-2 mm and inject 8 ml 8% phenol in saline.
Finally, 0.5 ml of lidocaine is injected during Chiba needle removal
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Visual analogue scale (VAS) score
Time Frame: Three months after the procedure
|
Pain Intensity measured by Visual analogue scale score16 (A 100 mm horizontal line version is used with 2 ends left end means no pain and right end means the worst pain. VAS will be recorded before and after the procedure, at the first day, after 1 month and after 3 months. |
Three months after the procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The amount of daily morphine consumption
Time Frame: Three months after the procedure
|
Daily morphine or other drugs consumption according to WHO ladder after the procedure. This will be recorded before and after the procedure, at the first day, after 1 month and after 3 months. |
Three months after the procedure
|
Patient functional capacity
Time Frame: Three months after the procedure
|
Patient functional capacity (is evaluated using Eastern cooperative oncology group "ECOG" scoring (0=fully active, 1= able to perform light effort, 2= in bed <50% of the day 3=in bed >50% of the day, 4=bed ridden). This will be recorded before and after the procedure, at the first day, after 1 month and after 3 months. |
Three months after the procedure
|
Quality of life
Time Frame: Three months after the procedure
|
Patient quality of life SF-36 19 (consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. This will be recorded before and after the procedure, at the first day, after 1 month and after 3 months. |
Three months after the procedure
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Complications
Time Frame: Three months after the procedure
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Any complications will be detected: back pain, bleeding, infection, L5 root injury with paresthesia or motor weakness, and visceral or vascular injuries.
|
Three months after the procedure
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Khaled Mostafa, National Cancer Institute (NCI)
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ANTICIPATED)
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
Other Study ID Numbers
- AP2103-30101R
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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