Effects of Control Scan for Presumed Difficult Epidural Infiltrations (ECHORACHIS) (ECHORACHIS)
Effects of Scan Control for Presumed Difficult Epidural Infiltrations: a Monocentric, Prospective, Randomized, Controlled, Simple Blind Trial
The aim of this care protocol is to study the effects of scan to help epidural infiltration realization, in presumed difficult patients suffering from sciatica.
These scans are already performed in our Rheumatology Department but our objective is to evaluate objectively its contribution for patients and doctors.
Epidural infiltration in young patients, with an easy anatomical identification, causes generally no technical difficulties, therefore this protocol will only include patients presumed to have a difficult infiltration, that means those aged more than 60, and/or with BMI > 30 and/or suffering from scoliosis.
This study concerns patients who are hospitalized in Rheumatology Department (Hospital of Nantes) for their first epidural infiltration for treatment-resistant lombosciatica.
Patient will be randomized at Day 0, before infiltration. This latter will be performed in accordance to current practice.
Tolerance data (pain and satisfaction) will be collected just after the infiltration and eventual complications will be reported within 48 hours after infiltration.
Following treatment of lombosciatic will be realized through hospitalization, as usual.
Scan is a safe, non invasive, painless and non radiating exam. It is the extension of the musculoskeletal clinical exam and it has already changed our rheumatology practices. The investigators hope at the end of this study, that results would confirm that scan can be a help in practice to perform epidural infiltrations.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Nantes, Francia, 44000
- University Hospital
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Major patients hospitalized in Rheumatology Department for performing their first epidural infiltration when sciatica is resistant to medical treatment.
- Inclusion of patients older than 60 years and / or BMI superior to 30 and / or scoliosis
Exclusion Criteria:
- Refusal to participate
- History of spinal surgery
- Anticoagulant or antiplatelet
- History of spinal malformations type spina bifida
- pregnancy
- Age<18
- Patients under guardianship
- Patients participating to another clinical trial (except non interventional trials)
- Patients unable to achieve the protocol, in the judgment of the investigator
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Comparador activo: Group " with scan prior to infiltration "
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Scan will be conducted by the operator performing the gesture.
He will examine the lumbar spine from L3 to S1, in longitudinal and cross sections and determine the best surgical approach.
This will be defined by the largest interspinous space or better visibility of the epidural space.
The depth of the epidural space will be noted.
The selected stage will be marked with a skin pen to facilitate its location thereafter
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Comparador de placebos: Group " without scan "
Patients will have a "dummy" lumber spine evaluation in order to put patients in blind conditions
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Visual analogue scale measuring the pain during infiltration
Periodo de tiempo: 10min after the infiltration
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To evaluate if scan prior to epidural infiltration could improve its tolerance
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10min after the infiltration
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Infiltration evaluation: procedure time between skin passage and release of the needle
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Infiltration evaluation: attempts number before correct positioning of needle
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Infiltration evaluation: number of puncture sites
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Infiltration evaluation: number of failures
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Infiltration tolerance : VAS for pain (graduating from 0 to 10)
Periodo de tiempo: 48 hours
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48 hours
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Infiltration tolerance : infiltration complications (headaches, pain at the puncture site, other)
Periodo de tiempo: 48 hours
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48 hours
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Distance skin- épidural space (mm) L3-L4, L4-L5 and L5-S1
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Minimal interspinous distance (mm) L3-L4, L4-L5 and L5-S1
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Epidural space visibility L3-L4, L4-L5 and L5-S1: 0 for " no visibility ", 1 for " mild ", 2 for " good "
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Epidural space accessibility L3-L4, L4-L5 and L5-S1 : 0 for " no visibility ", 1 for " mild ", 2 for " good "
Periodo de tiempo: 10min after the infiltration
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10min after the infiltration
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Benoît LE GOFF, Doctor, Nantes university hospital
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- RC13_0096
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