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Trial registered on ANZCTR
Registration number
ACTRN12610000749000
Ethics application status
Approved
Date submitted
6/09/2010
Date registered
8/09/2010
Date last updated
14/05/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Single Injection Infraclavicular vs. Distal Peripheral Nerve Block for Wrist and Hand Surgery
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Scientific title
Single Injection Infraclavicular vs. Distal Peripheral Nerve Block for Wrist and Hand Surgery to Compare Patient Satisfaction
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Secondary ID [1]
252652
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No secondary ID
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Analgesia after wrist and hand surgery
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Condition category
Condition code
Anaesthesiology
258309
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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
Distal Peripheral Nerve Block Group: A preoperative (30 mins prior to surgery) one-off ultrasound guided block of the radial (at distal humerus), median and ulnar nerves (at the forearm level) will be performed using 3x 6 ml of ropivacaine 0.5%.Patients will also receive an ultrasound-guided infraclavicular injection of lignocaine 1.5% 30 ml with adrenaline 1/200,000 40 mins prior to surgery to cover torniquet pain.
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Intervention code [1]
257148
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Treatment: Drugs
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Intervention code [2]
257161
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Treatment: Surgery
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Comparator / control treatment
Infraclavicular Group:
A preoperative one-off ultrasound guided block of the infraclavicular brachial plexus will be performed: following standard intravascular injection precautions, 30 ml 20:10 ropivacaine 0.75%: lignocaine 2% with adrenaline 1/200,000 will be injected posterior to the axillary artery.
The duration/frequency of this treatment is the same as the intervention arm with the only difference being the site where the block is administered.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patient satisfaction as assessed by patient questionnaire using a simple 11-point numerical rating satisfaction scale.
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Assessment method [1]
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Timepoint [1]
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24 hours postoperatively.
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Secondary outcome [1]
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Postoperative pain as assessed by patient questionnaire and 11-point numerical rating pain scale.
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Assessment method [1]
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Timepoint [1]
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24-hrs post operatively
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Secondary outcome [2]
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Arm numbness/weakness as assessed by questionnaire and 11-point numerical rating numbness/weakness scale.
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Assessment method [2]
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Timepoint [2]
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24-hrs postoperatively
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Secondary outcome [3]
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Surgical anaesthesia success as assessed by the primary surgeon (patient interrogation)
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Assessment method [3]
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Timepoint [3]
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1-2 hrs after block placement
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Secondary outcome [4]
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Procedural pain using simple 11-point numerical rating pain scale.
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Assessment method [4]
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Timepoint [4]
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At the time of block placement (patient interrogation)
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Eligibility
Key inclusion criteria
Patients requiring surgical anaesthesia for hand or wrist surgery under the care of the principal and co-investigators.
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Minimum age
16
Years
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Maximum age
80
Years
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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
Exclusion criteria will include patient refusal for brachial plexus block, known neuropathy involving the arm undergoing surgery and known allergy to amide local anaesthetic drugs.
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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)
Initial invitation to participate in the study will occur one week prior to surgery, where patients will be contacted by a research assistant and invited to participate. Written informed consent will be obtained from all patients. Assignment of the patient to one of the 2 groups will be delivered in sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computerised random number generator will be used to assign the patient to one of the 2 groups.
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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
Phase 4
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Type of endpoint/s
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
15/09/2010
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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
180
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NZ Lottery Grants Board
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Address [1]
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P O Box 805 Wellington 6140
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Michael Fredrickson
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Address
Anaesthesia Institute P O Box 109 199 Newmarket Auckland 1149
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Y Regional Ethics Commitee
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Ethics committee address [1]
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P O Box 1031 Hamilton Waikato Mail Centre 3240
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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08/07/2010
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Ethics approval number [1]
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NTY/10/EXP/056
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Summary
Brief summary
Brachial plexus block is a commonly performed anaesthetic/analgesic technique for elective wrist and hand surgery. Traditionally, long acting local anaesthetic is used which provides 12-15 hours potent postoperative analgesia; however, some patients experience dissatisfaction from the inevitable proximal limb paralysis. The recent availability in the operating room of portable ultrasound equipment has made it very feasible to block, at the level of the forearm, the individual nerves supplying the wrist and hand. This enables the provision of potent analgesia but without proximal extremity motor weakness. A potential disadvantage of this approach, however, is that the duration of blockade may be shorter. The 2 approaches are to be compared in a prospective randomised manner with patient satisfaction as the primary outcome.
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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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Dr Michael Fredrickson
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Address
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Anaesthesia Institute
P O Box 109 199
Newmarket
Auckland 1149
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Country
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New Zealand
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Phone
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+64 9 522 1117
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Fax
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+64 9 522 1127
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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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Dr Michael Fredrickson
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Address
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Anaesthesia Institute
P O Box 109 199
Newmarket
Auckland 1149
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Country
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New Zealand
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Phone
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+64 9 522 1117
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Fax
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+64 9 522 1127
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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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