Nerve Block of the Proximal Interphalangeal Joints PIPs in Rheumatoid Arthritis (RA) Patients: a Prospective Pilot Study

Sohag University

Status: Completed

Conditions: Rheumatoid Arthritis

Treatments: Drug: Nerve block; Drug: Saline injection

Study type: Interventional

Funder types: Other

Identifiers

NCT04130178

4/10/2019

Details and patient eligibility

About

Researchers will include 83 rheumatoid arthritis patients (either early or established) diagnosed after 2010 ACR/EULAR criteria with bilateral hand arthritis aged 18 or above. Nerve block to the neural bundle of the 2nd and 3rd PIPs will be done to one hand (the dominant in half of the participants and the non-dominant in the remaining). The other hand will be used as a control and injected subcutaneously with saline. Half ml of Bupivacaine will be injected through a 27G needle at the level of the volar proximal digital crease of the 2nd and 3rd PIP. The needle will be directed alternatively toward the two pedicles on both sides.

PIPs of the 2nd and 3rd fingers in both hands will be examined EULAR-OMERACT scoring system at 0, 2 weeks, and 2 months intervals. Visual analog scale (VAS) for each hand will be used at the same intervals. There are no certain conditions for medications and all the patients were using sDMARDS.

Full description

PIPs of the 2nd and 3rd fingers at the control group will be injected with .5 mL of saline on each joint through a 27G needle.

Enrollment: 48 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Rheumatoid arthritis patient according to ACR/EULAR criteria
• age >18
• bilateral hand affection

Exclusion criteria

• peripheral neuropathy
• other chronic arthritis
• patient who did mastectomy or any other hand operation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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48 participants in 2 patient groups, including a placebo group

Bupivacine injected

Active Comparator group

Description:

Half ml of Bupivicaine hydrochloride .5% (Marcaine, Pfizer) was injected through a 27G needle at the level of the volar proximal digital crease of the 2nd and 3rd PIP on each side of the selected joint.

Treatment:

Drug: Nerve block

Control group

Placebo Comparator group

Description:

Saline was injected subcutaneously in the 2nd and 3rd PIP on each side of the selected joint.

Treatment:

Drug: Saline injection