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Trial registered on ANZCTR
Registration number
ACTRN12615000482561
Ethics application status
Approved
Date submitted
29/04/2015
Date registered
15/05/2015
Date last updated
24/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Does Saphenous Nerve Block in Hamstring Anterior Cruciate Ligament Reconstruction Affect Postoperative Pain? A Randomised Controlled Trial
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Scientific title
Effect of saphenous nerve block versus no block on patient perception of pain in patients undergoing ACL reconstruction with ipsilateral hamstring autograft
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Secondary ID [1]
286611
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nil
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Universal Trial Number (UTN)
U1111-1168-8534
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Trial acronym
ACL block study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
ACL reconstruction
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Condition category
Condition code
Anaesthesiology
295170
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0
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Pain management
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Surgery
295240
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Saphenous nerve block for patients undergoing ACL reconstruction with hamstring autograft. This involves 15cc 0.5% Ropivacaine (75mg) with an ultrasound guided approach picking a spot 10 cm above the patella, after general anaesthesia.
Both groups will receive multimodal analgesia. This includes IV paracetamol 1g 20min before the end of the case, and Parecoxib 40mg IV during the case. Surgeons will infiltrate hamstring site and knee joint with Ropivacaine 2mg/kg and 10mg of Morphine into the knee joint (intra-articular).
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Intervention code [1]
291738
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Treatment: Drugs
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Comparator / control treatment
No saphenous nerve block for patients undergoing ACL reconstruction with hamstring autograft.
Both groups will receive multimodal analgesia. This includes IV paracetamol 1g 20min before the end of the case, and Parecoxib 40mg IV during the case. Surgeons will infiltrate hamstring site and knee joint with Ropivacaine 2mg/kg and 10mg of Morphine into the knee joint (intra-articular).
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Control group
Active
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Outcomes
Primary outcome [1]
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Post-operative pain assessed using a visual analogue scale.
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Assessment method [1]
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Timepoint [1]
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Immediate Post surgery, 4 hours post surgery, 8 hours post surgery, 24 hours post surgery
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Secondary outcome [1]
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Opiate use will be measured based on anaesthetic perioperative record and medication chart.
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Assessment method [1]
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Timepoint [1]
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First 24 hours post surgery while patient is an inpatient.
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Eligibility
Key inclusion criteria
All patients undergoing ACL reconstruction with ipsilateral hamstring autograft at our practice.
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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
a. Previous ligamentous ipsilateral knee surgery
b. Concurrent surgery on contralateral limb
c. Any other graft use
d. Lack of adequate English as this would inhibit VAS score
e. Allergy or contraindication to Tramadol, Morphine, Fentanyl, Parecoxib, Ropivacaine, Postop NSAIDS, Paracetamol
f. Neurological disease involving peripheral nerves
g. Chronic pain issues
h. Drug addiction or tolerance with analgesics
i. Age less than 16
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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)
All patients undergoing ACL reconstruction at Unisports with hamstring autograft will be given the option to enrol.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation is via computer generated random number list. Concealment of allocation is established by using sealed numbered envelopes allocated only when patients have signed the consent to enter the trial. The anaesthetist then opens the envelope prior to treatment.
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Masking / blinding
Open (masking not 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
Efficacy
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Statistical methods / analysis
Statistical power was calculated based on previous similar studies. To detect a difference of 2 in visual analogue scale with 80% power and 0.05 beta value, we require 20 patients in each group. We are aiming for 30 patients in each group to achieve 90% power.
VAS scores and opiate consumption will be compared between control and intervention group, after performing normal distribution test on the data. Linear regression analysis will be performed to look for correlation between outcomes and patient baseline characteristics.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
22/05/2015
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Actual
22/05/2015
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Date of last participant enrolment
Anticipated
30/11/2015
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Actual
30/11/2015
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Date of last data collection
Anticipated
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Actual
2/02/2016
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Sample size
Target
60
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Accrual to date
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Final
60
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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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Commercial sector/Industry
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Name [1]
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Unisports Ltd. Please note that this is a group of surgeons that are carrying out the study. It is not a commercial entity.
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Address [1]
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71 Merton Road, Auckland, New Zealand, 1743
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Country [1]
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New Zealand
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Primary sponsor type
Commercial sector/Industry
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Name
Unisports Ltd
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Address
71 Merton Road
Auckland 1743
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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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none
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Address [1]
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none
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Country [1]
289859
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central HDEC
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Ethics committee address [1]
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PO BOX 5013 Wellington 6011
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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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28/04/2015
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Ethics approval number [1]
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15/CEN/38
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Summary
Brief summary
Reconstruction of anterior cruciate ligament (ACL) of the knee is a common procedure. Perioperative analgesia for ACL reconstruction using hamstring autograft can be achieved with multimodal analgesia +/- addition of nerve block. Saphenous nerve block is commonly used in our practice for patients undergoing ACL reconstruction. Performing a saphenous nerve block adds cost, time and complications (overall rare) to the overall procedure with a perceived benefit of reduced opiate requirement and increased patient comfort. The benefit of saphenous nerve block for hamstring autograft ACL reconstruction has not been established in the literature. We hypothesize that saphenous nerve block in ACL reconstruction with hamstring autograft does not improve patient comfort.
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Trial website
none
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Trial related presentations / publications
None, in the process of writing a manuscript
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Public notes
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Contacts
Principal investigator
Name
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Mr Ritwik Kejriwal
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Address
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Unisports
71 Merton Rd
Auckland 1743
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Country
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New Zealand
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Phone
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+64 21 620586
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ritwik Kejriwal
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Address
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Unisports
71 Merton Rd
Auckland 1743
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Country
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New Zealand
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Phone
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+6421620586
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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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Ritwik Kejriwal
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Address
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Unisports
71 Merton Rd
Auckland 1743
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Country
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New Zealand
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Phone
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+64 21620586
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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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