Leg Amputation and Continuous Sciatic Nerve Block (CAPDAF)
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Purpose
Analgesia following leg amputation is based on morphine administration. For elderly patients of ASA physical status 2 or 3, morphine sparing is possible when perinervous block techniques are used. Phantom limb pain complicates leg amputation in 50 to 80% of cases. Prevention of these pains has been studied in various clinical trials but the interest of perinervous block technique remains to be evaluated.
The purpose of the study is to evaluate the benefit of perioperative locoregional analgesia by ropivacaine via a popliteal sciatic catheter on intravenous morphine consumption during the 72 first postoperative hours following leg (below knee) amputation The study will be randomized, double blinded, controlled clinical trial and 84 patients undergoing leg amputation (below knee) will be included Patients will be divided into 2 groups: one group of patients who will benefit perioperative locoregional analgesia by ropivacaine via a popliteal sciatic catheter and morphine for analgesia and the other one who will benefit placebo through the catheter and morphine.
The investigators will evaluate the efficacy of the continuous popliteal sciatic nerve block in postoperative analgesia after leg amputation and prove the efficacy of a perioperative analgesia by continuous popliteal sciatic nerve block to prevent phantom limb pain after leg amputation in patients of ASA physical status 2 or 3.
| Condition | Intervention | Phase |
|---|---|---|
|
Phantom Limb Leg Amputation |
Drug: ropivacaine/placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Continuous Popliteal Sciatic Nerve Block Interest in Postoperative Pain Management for Patients With Leg Amputation |
- Total intravenous morphine consumption [ Time Frame: during the first 72 postoperative hours following leg (below knee) amputation ] [ Designated as safety issue: No ]
- tolerance and adverse effects (myalgia, infection, adverse effects of local anaesthetics) of the popliteal sciatic catheter, in patients with ASA physical status 2 or 3 [ Time Frame: during the 72 first postoperative hours and on the 7th postoperative day ] [ Designated as safety issue: Yes ]
- tolerance and adverse effects of morphine during the protocol in the 2 groups of patients [ Time Frame: during the first 72 postoperative hours ] [ Designated as safety issue: Yes ]
- incidence of stump pain and phantom limb pain, time of outbreak, intensity (VAS), characteristics (French version of the McGill Pain Questionnaire and DN4 qu [ Time Frame: 1, 3, 6 and 12 months postoperative ] [ Designated as safety issue: No ]
- use of prosthesis [ Time Frame: 1, 3, 6 and 12 months postoperative ] [ Designated as safety issue: No ]
| Enrollment: | 6 |
| Study Start Date: | December 2006 |
| Study Completion Date: | December 2009 |
| Primary Completion Date: | April 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Continuous sciatic nerve bloc : ropivacaine infusion
|
Drug: ropivacaine/placebo
Continuous sciatic nerve bloc
|
|
Placebo Comparator: 2
Continuous sciatic nerve bloc : NaCl Infusion
|
Drug: ropivacaine/placebo
Continuous sciatic nerve bloc
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients scheduled for leg amputation following arteritis
- ASA score: 2-3
- Informed consent obtained from the patient
Exclusion Criteria:
- Patients involved in another clinical trial
- Post-infection OR post traumatic leg amputation
- Blood coagulation disorders
- Local anesthetic, morphine, or paracetamol allergy
- Local inflammatory signs
- Pregnant or breastfeeding women
- Patients with protective supervision
Contacts and Locations| France | |
| Département d'anesthésie réanimation I, Hopital Pellegrin, CHU de Bordeaux | |
| Bordeaux, France, 33076 | |
| Principal Investigator: | Karine NOUETTE GAULAIN, Dr | University Hospital, Bordeaux, France |
| Study Chair: | Antoine BENARD, Dr | university hospital, Bordeaux, France |
More Information
No publications provided
| Responsible Party: | Jean-Pierre LEROY / Clinical Research and Innovation Director, University Hospital, Bordeaux |
| ClinicalTrials.gov Identifier: | NCT00427947 History of Changes |
| Other Study ID Numbers: | 9440-05, 2004-037 |
| Study First Received: | January 26, 2007 |
| Last Updated: | December 28, 2009 |
| Health Authority: | France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Keywords provided by University Hospital, Bordeaux:
|
phantom limb pain amputation anesthetics, local |
postoperative analgesia ropivacaine analgesia |
Additional relevant MeSH terms:
|
Phantom Limb Perceptual Disorders Neurobehavioral Manifestations Neurologic Manifestations Nervous System Diseases Signs and Symptoms Ropivacaine Anesthetics, Local |
Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 18, 2013