Optimization of Catheter Insertion Site for Continuous Peripheral Nerve Blocks

University of California San Diego

Status and phase: Completed; Phase 4

Conditions: Post-operative Pain; Upper-extremity Surgery

Treatments: Procedure: Supraclavicular vs. Infraclavicular ropivicaine infusion

Study type: Interventional

Funder types: Other

Identifiers

NCT00876746

Supra / Infra Catheters

Details and patient eligibility

About

This research study is to determine if the insertion site of a perineural catheter or tiny tube placed next to the nerves that go to the part of the body (hand or arm) having surgery, affects the amount of pain relief that is experienced after surgery. Catheters will be placed in either the supraclavicular or infraclavicular location.

Full description

To determine if a particular perineural local anesthetic catheter location (supraclavicular or infraclavicular) will maximize postoperative analgesia, minimize oral opioid requirements, minimize sleep disturbances resulting from postoperative pain, and maximize patient satisfaction.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years of age or older
• unilateral, upper (at or distal to the elbow) extremity orthopedic surgery with moderate-to-severe postoperative pain expected
• patients already agree to and want a continuous brachial plexus block for postoperative analgesia

Exclusion criteria

• patients who have difficulty understanding the study protocol or caring for the infusion pump/catheter system
• patients who have any known contraindication to study medications
• insulin-dependent diabetes mellitus
• neuropathy of any etiology in the affected extremity
• contraindication to regional blockade (e.g. clotting deficiency)
• any known acute or chronic hepatic or renal insufficiency or failure
• any incision site outside of the catheter-effected area
• chronic opioid use
• history of opioid abuse
• obesity
• pregnancy
• incarceration
• inability to communicate with the investigators and hospital staff

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

1. Supraclavicular

Active Comparator group

Description:

Patients will be randomized to placement of a nerve block in the supraclavicular position. After the catheter has been placed, sensory and motor deficit will be assessed and following surgery, for the next three days, the patient will be contacted by research staff to assess pain scores and other outcome measures.

Treatment:

Procedure: Supraclavicular vs. Infraclavicular ropivicaine infusion

2. Infraclavicular

Active Comparator group

Description:

Patients will be randomized to placement of a nerve block in the infraclavicular position. After the catheter has been placed, sensory and motor deficit will be assessed and following surgery, for the next three days, the patient will be contacted by research staff to assess pain scores and other outcome measures.

Treatment:

Procedure: Supraclavicular vs. Infraclavicular ropivicaine infusion