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Trial registered on ANZCTR
Registration number
ACTRN12609000689279
Ethics application status
Approved
Date submitted
6/08/2009
Date registered
12/08/2009
Date last updated
29/11/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Fascia Iliaca Block with and without ultrasound for knee surgery.
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Scientific title
Fascia Iliaca Block with and without ultrasound for knee surgery.
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Secondary ID [1]
273490
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FIBBUS
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Universal Trial Number (UTN)
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Trial acronym
FIBUS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fascia iliaca block
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Condition category
Condition code
Anaesthesiology
239772
239772
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After informed consent, patients will be assigned, by using a computer-generated block randomization, to either group 1 - ultrasound guided fascia iliaca block, or group 2 - fascia iliaca block with loss of resistance blind technique.
Patient will receive routine general anaesthetic for the operation as per the discretion of the anaesthetist. Allowable analgesics include alfentanil/ fentanyl for induction.
After the patient is asleep, Group 1 patient will then have a fascia iliaca block placed with ultrasound assistance. The fascia iliaca and the iliacus muscle are identified. An 18 gauge Touhy needle will be inserted under the fascia iliaca with ultrasound guidance. Group 2 patient will have the fascia iliaca block performed by anatomical landmark technique alone. The line from the anterior superior iliac spine and pubic tubercle is drawn. The insertion point is at the lateral 1/3 and medial 2/3 and 1cm caudad to the line drawn. Again an 18 gauge Tuohy needle will be inserted using 2-pop loss of resistance technique. All blocks will be performed by anaesthetists who are proficient at blocks without ultrasound, and who have been trained in the use of ultrasound for vascular access or other nerve blocks. The investigator will be present if required to provide guidance.
For both groups, a total of 0.5ml/kg 0.5% ropivacaine (maximum of 40ml) will be injected through the Tuohy needle in 5ml aliquots after negative aspiration.
Morphine can be administered during the operation as per the discretion of the anaesthetist. Non-steroidal anti-inflammatory drugs (NSAIDS) and tramadol will not be allowed intra-operatively or post-operatively for 48hours. Paracetamol will be given strictly 6-hourly (QID).
A morphine patient controlled analgesia pump will be commenced post-operatively. A blinded research nurse or investigator would then collect the data required from this study.
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Intervention code [1]
237090
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Treatment: Other
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Comparator / control treatment
Performing block with ultrasound guidance versus without ultrasound
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Control group
Active
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Outcomes
Primary outcome [1]
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24 hour cumulative morphine consumption from medical records - including anaesthetics charts and patient-controlled analgesic forms.
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Assessment method [1]
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Timepoint [1]
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24 hours post first dose of morphine administration
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Secondary outcome [1]
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pain scores - visual analogue score
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Assessment method [1]
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Timepoint [1]
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24 hours post first dose of morphine administration
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Secondary outcome [2]
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48 hours cumulative morphine consumption - from medical records including anaesthetics charts and patient-controlled analgesics charts.
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Assessment method [2]
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Timepoint [2]
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48 hours post first dose of morphine administration
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Secondary outcome [3]
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pain score - visual analogue score
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Assessment method [3]
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Timepoint [3]
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48 hours post first dose of morphine administration
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Secondary outcome [4]
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quality of recovery score using questionnaires.
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Assessment method [4]
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Timepoint [4]
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48 hours post first dose of morphine administration
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Eligibility
Key inclusion criteria
American Society of Anesthesiologists (ASA) physical status classification system 1, 2, or 3 who are scheduled for elective unilateral total knee replacement under general anaesthesia
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
patients who are unable to consent (patient’s refusal, non-English speaking or less than 18 years of age), pregnant and lactating patients, patients having spinal anaesthetic, patients having bilateral surgery or patients with drug allergy to ropivacaine, morphine or panadol.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patient identified in preadmission clinic, consented and computer randomised to the allocated group.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer generated block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
28/07/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Royal Melbourne Hospital
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Address [1]
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Grattan Street, Parkville, VIC 3050
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Melbourne Hospital
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Address
Grattan street, Parkville, VIC 3050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
236951
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Address [1]
236951
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Country [1]
236951
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Research and Ethics Committees (HREC) Melbourne Health
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Ethics committee address [1]
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Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
239592
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Approval date [1]
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15/07/2009
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Ethics approval number [1]
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HREC 2009.052
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Summary
Brief summary
The purpose of this project is to determine if using ultrasound when performing a nerve block improves the control of pain after surgery. The nerve block is called the fascia iliaca block, which is commonly performed for patients having total knee replacement to improve pain relief. Traditionally, the block is performed using a blind technique called the fascial click or loss of resistance technique. The anaesthetist inserts the needle usually near the groin area and feels for the clicks or the loss of resistance before injecting the local anaesthetic drug for pain relief. Recently, the use of ultrasound has become very popular when performing nerve block. Ultrasound allows the anaesthetist to visualize the structures underneath the skin before and during the insertion of the needle and injection of local anaesthetic. However, there is no information on whether using ultrasound to perform fascia iliaca block for total knee replacement improves the success of pain relief. This study is therefore designed to investigate if ultrasound improves block success and therefore reduces pain.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Irene Ng
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Address
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Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC 3050
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Country
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Australia
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Phone
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+61-3-93427540
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Irene Ng
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Address
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Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC 3050
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Country
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Australia
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Phone
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+61-3-93427540
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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