Can the Femoral Nerve Block be Improved by Ultrasound Guidance?
Recruitment status was Not yet recruiting
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Purpose
Studies have suggested a link with effective pain relief and reduced illness and death in very unwell patients. This study will determine the most effective method of injecting local anaesthetic around the nerves which supply the hip joint. Local anaesthetic will be injected around the hips nerve supply using either ultrasound, loss of resistance or electrical nerve stimulator to guide the positioning of the needle on patients due for elective total hip replacement. The patient will then be observed for 30 minutes and the patient ability to move or feel the upper leg will recorded. A standard anaesthetic and a hip replacement operation will then be performed. Standard pain relief protocols will be used the operation and after the operation. After the operation we will record the amount of morphine used and how happy the patients have been with their treatment at 6 hours after the operation and at 24 hours after the operation. The first day the patient is able to walk on their new hip replacement will also be recorded.
| Condition | Intervention | Phase |
|---|---|---|
|
Pain |
Procedure: determination of method with highest efficacy (ultrasound or nerve stimulator) Procedure: nerve stimulator Procedure: loss of resistance |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Caregiver, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Can the Use of Ultrasound to Guide the Insertion of a Needle for an Anterior Psoas Compartment Nerve Block Increase Its Efficacy in Comparison to Traditional Techniques Utilising Loss of Resistance and Nerve Stimulation? |
- percentage of patients with effective regional analgesia [ Time Frame: Induction of anaesthesia ] [ Designated as safety issue: No ]
- hospital mortality [ Time Frame: 1months after operation ] [ Designated as safety issue: Yes ]
- sensory function in lateral cutaneous nerve [ Time Frame: 0mins, 10mins 20mins post insertion of local anaesthetic ] [ Designated as safety issue: No ]
- sensory function of femoral nerve [ Time Frame: 0mins, 10mins, 20mins after insertion of local anesthetic ] [ Designated as safety issue: No ]
- sensory function of obturator nerve [ Time Frame: 0mins, 10mins, 20mins after insertion of local anesthetic ] [ Designated as safety issue: No ]
- motor function of obturator nerve [ Time Frame: 0mins, 10mins and 20minutes after insrtion of local anesthetic ] [ Designated as safety issue: No ]
- motor function of femoral nerve [ Time Frame: 0mins,10mins and 20mins post insertion of local anesthetic ] [ Designated as safety issue: No ]
- acute mental test scores [ Time Frame: 6hours and 24 hours post operatively ] [ Designated as safety issue: No ]
- total morphine dose administered [ Time Frame: 6hours and 24 hours post operstively ] [ Designated as safety issue: No ]
- day first mobilise post operatively [ Time Frame: post operatively 0-10 days ] [ Designated as safety issue: No ]
- patient satisfaction scores [ Time Frame: 6 hours and 24hours post operatively ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 269 |
| Study Start Date: | July 2008 |
| Estimated Study Completion Date: | August 2010 |
| Estimated Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: loss of resistance
Anterior psoas compartment nerve block inserted using loss of resistance
|
Procedure: loss of resistance
Use of ultrasound to guide the insertion of anterior psoas compartment block
|
|
Active Comparator: nerve stimulator
Anterior psoas compartment nerve block inserted using nerve stimulator
|
Procedure: determination of method with highest efficacy (ultrasound or nerve stimulator)
Use of ultrasound to guide the insertion of anterior psoas compartment block
Procedure: nerve stimulator
The use of the nerve stimulator to guide insertion of the anterior psoas compartment block
|
|
Active Comparator: ultrasound
Anterior psoas compartment nerve block inserted using ultrasound
|
Procedure: determination of method with highest efficacy (ultrasound or nerve stimulator)
Use of ultrasound to guide the insertion of anterior psoas compartment block
|
Eligibility| Ages Eligible for Study: | 35 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Elective primary total hip arthroplasty under general anaesthesia
- ASA<=4
- Able to give informed consent
- Able to cooperate with sensory and motor testing of lower limb function
Exclusion Criteria:
- Abnormal clotting screen (coagulopathy) or thrombocytopenia (<100,000)
- Acute mental test score of <=7 at any time pre or post operatively
- Allergy to local anaesthetic
- Signs, symptoms or laboratory evidence of local infection or systemic sepsis
- No pre-existing neurological deficit (sensory or motor) affecting lower limb
- Patients with lower limb amputations
Contacts and Locations| Contact: Malcolm Watson, MBChB, MRCP, FRCA | 01412116291 | mwatson@doctors.org.uk |
| United Kingdom | |
| Gartnavel General hospital | Not yet recruiting |
| Glasgow, Lanarkshire, United Kingdom, G12 0YN | |
| Principal Investigator: Graham Hilditch, MB chB, FRCA | |
| Golden Jubilee hospital | Not yet recruiting |
| Glasgow, Lanarkshire, United Kingdom | |
| Principal Investigator: Micheal Higgins, MB chB, FRCA | |
| Glasgow Royal Infrimary | Not yet recruiting |
| Glasgow, Lanarkshire, United Kingdom, G4 | |
| Principal Investigator: Colin Rae, Mb chB, FRCA | |
| Royal alexandra hospital | Not yet recruiting |
| Paisley, Renfrewshire, United Kingdom, PA2 | |
| Principal Investigator: Paul Allcock, Mb ChB, FRCS | |
| Study Chair: | Malcolm watson, MB ChB FRCA | NHS greater glasgow and clyde health board |
More Information
No publications provided
| Responsible Party: | Dr Erica Packard, NHS Greater Glasgow and Clyde health board |
| ClinicalTrials.gov Identifier: | NCT00696150 History of Changes |
| Other Study ID Numbers: | ultrasound for hip # study-1, CSO reference CAF/07/05 |
| Study First Received: | June 9, 2008 |
| Last Updated: | June 11, 2008 |
| Health Authority: | United Kingdom: Department of Health |
Keywords provided by NHS Greater Glasgow and Clyde:
|
ultrasound hip pain |
ClinicalTrials.gov processed this record on May 19, 2013