Use of Pre-Emptive Pudendal Nerve Block for Pelvic Reconstructive Surgery
A Randomized Controlled Trial of Use of Pre-emptive Pudendal Nerve Block for Pelvic Reconstructive Surgery
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljerad beskrivning
Subjects will have a through physical exam with evolution of the pelvis support using the POP-Q (pelvic organ prolapse quantification) system. All subjects will need to sign informed consent pre-approved by the IRB. The subjects, surgeons, and anesthesiologist will all be blinded to the injected material. The OR Scrub nurse will given the envelope at the start of each case and asked to draw the material into a syringe. All subjects will receive general anesthesia. Subjects will be randomized to receive preemptive pudendal nerve blockade with 10 ml of 0 .5 % Bupivacaine with epinephrine or normal saline to each side. The allocation schedule is computer generated using random-numbers table concealed in opaque envelops. Once the patient receives general anesthesia she will be positioned appropriately in dorsal lithotomy with padded Allan stir ups. 10 ml of Bupivacaine will be injected on either side using the Iowa trumpet pudendal needle drive to direct and guide appropriate position. Aspiration was attempted for every injection to decrease the chance of intravascular infusion.
At the completion of the surgery the subjects will be brought to the PACU for care. Patients are assessed immediately upon arrival to the PACU. The patients are asked their pain level using the VAS pain scale/ modified surgical pain scale at hours 1 and 2 post op. All patients are given a prescription for Vicoprofen 7.5/200mg at their pre-op visit and asked to have it filled prior to their surgery. Patients have the option to go home the same day of surgery as long as their pain is well controlled and they are clinically stable for discharge. Continued pain management and pain scale assessment will be done at 4 hours, and post op day 1 and 2. A medication log will be kept for 2 weeks post op, detailing the number of pain medications taken during that period.
Studietyp
Studietyp
Fas
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
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-
New York
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New York, New York, Förenta staterna, 10029
- Icahn School of Medicine at Mount Sinai
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-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- The ability to read and understand English
- Be at least 18 years old
- Symptomatic Stage 2 prolapse
Exclusion Criteria:
- Intolerance to local anesthetics or narcotics
- History of major psychiatric disorder or chronic pain syndrome
- History of substance abuse or current narcotic use
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Stödjande vård
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Aktiv komparator: pudendal block
preemptive pudendal nerve blockade with 10 ml of 0 .5 % Bupivacaine with epinephrine.
10 ml of Bupivacaine will be injected on either side using the pudendal nerve block tray.
|
preemptive pudendal nerve blockade with 10 ml of 0 .5 % Bupivacaine with epinephrine.
Andra namn:
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Placebo-jämförare: no pudendal block
Saline
|
preemptive pudendal nerve blockade with 10 ml of normal saline to each side
Andra namn:
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Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
VAS pain scale
Tidsram: up to 2 weeks
|
up to 2 weeks
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
post operative analgesic consumption
Tidsram: up to 2 weeks
|
up to 2 weeks
|
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adverse effect of the pudendal block
Tidsram: up to 2 weeks
|
up to 2 weeks
|
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Length of hospital stay
Tidsram: up to 2 weeks
|
up to 2 weeks
|
|
Medical or surgical complications
Tidsram: up to 2 weeks
|
up to 2 weeks
|
Samarbetspartners och utredare
Sponsor
Sponsor
Utredare
Utredare
- Huvudutredare: Mamta Mamik, MD, Icahn School of Medicine at Mount Sinai
Publikationer och användbara länkar
Allmänna publikationer
- Ke RW, Portera SG, Bagous W, Lincoln SR. A randomized, double-blinded trial of preemptive analgesia in laparoscopy. Obstet Gynecol. 1998 Dec;92(6):972-5. doi: 10.1016/s0029-7844(98)00303-2.
- Katz J, Kavanagh BP, Sandler AN, Nierenberg H, Boylan JF, Friedlander M, Shaw BF. Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology. 1992 Sep;77(3):439-46. doi: 10.1097/00000542-199209000-00006.
- Schierup L, Schmidt JF, Torp Jensen A, Rye BA. Pudendal block in vaginal deliveries. Mepivacaine with and without epinephrine. Acta Obstet Gynecol Scand. 1988;67(3):195-7. doi: 10.3109/00016348809004200.
Studieavstämningsdatum
Studera stora datum
Studiestart
Studiestart
Primärt slutförande (Faktisk)
Primärt slutförande
Avslutad studie (Faktisk)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
Andra studie-ID-nummer
- GCO 13-1190
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