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Trial registered on ANZCTR
Registration number
ACTRN12617001378314
Ethics application status
Approved
Date submitted
14/09/2017
Date registered
28/09/2017
Date last updated
6/05/2019
Date data sharing statement initially provided
6/05/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Adding hyaluronic acid to pudendal nerve blocks for treatment of pudendal neuralgia
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Scientific title
Randomised cross-over trial assessing the efficacy of adding hyaluronic acid to local anaesthetic in pudendal nerve blocks in the treatment of pudendal neuralgia
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Secondary ID [1]
292889
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None
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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:
Pudendal neuralgia
304735
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Condition category
Condition code
Anaesthesiology
304052
304052
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0
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Pain management
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Neurological
304212
304212
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0
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Other neurological disorders
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Renal and Urogenital
304213
304213
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is a randomised cross-over trial looking at the efficacy of adding hyaluronic acid to local anaesthetic when performing pudendal nerve blocks for the treatment of pudendal neuralgia.
Medication;
- levobupivicaine 0.5% 3ml
- 3ml hyaluronic acid 1% OR 3ml placebo gel
- deep tissue neural block performed via a transgluteal approach under x-ray guidance
- two treatments
- treatments consist of either a unilateral or bilateral block (depending on patient symptoms) and are performed on two occasions with a 3 month wash out period between
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Intervention code [1]
299126
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Treatment: Drugs
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Comparator / control treatment
Hyaluronic acid is a glycosaminoglycan present within the body and is thought to improve analgesia by restoration of the extracellular matrix. It is available in commercial preparations eg Juvaderm. In our study it will be compounded in a concentration of 1% and appears as a gel solution. 3ml of solution will be used for each nerve block.
The control arm will receive an identical gel solution that does not contain hyaluronic acid.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Pain relief using BPI-SF
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Assessment method [1]
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Timepoint [1]
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1, 6 and 12 weeks post treatment
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Secondary outcome [1]
338808
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Pain interference with function using BPI-SF
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Assessment method [1]
338808
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Timepoint [1]
338808
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1, 6 and 12 weeks post treatment
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Secondary outcome [2]
338809
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Change in analgesia use according to patient self report questionnaire
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Assessment method [2]
338809
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Timepoint [2]
338809
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12 weeks after treatment
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Eligibility
Key inclusion criteria
Clinical diagnosis of pudendal neuralgia
No previous pudendal nerve block
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Minimum age
16
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
Previous pudendal nerve block
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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)
Allocation will occur after enrolment.
It will be performed by the pharmacy compounding the solutions and not available to other study staff.
Randomisation will be by numbered opaque envelopes and involve stratification for gender and blocking to ensure even numbers.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted blocking will be performed using computer software with stratification according to gender.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Students t-test to compare pain scores pre and post procedure at time slots of 1, 6 and 12 weeks and 6 months after trial completion.
The issue of multiple comparisons will be taken into consideration during the analysis.
Similar analysis of pain interference.
Descriptive statistics will be used for changes in analgesic use.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
8/01/2018
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Actual
23/05/2018
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Date of last participant enrolment
Anticipated
30/06/2020
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Actual
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Date of last data collection
Anticipated
31/12/2020
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Actual
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Sample size
Target
103
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Accrual to date
35
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
9030
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Prince of Wales Private Hospital - Randwick
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Recruitment postcode(s) [1]
17510
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2031 - Randwick
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Funding & Sponsors
Funding source category [1]
297519
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Other
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Name [1]
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Women's Health and Research Institute of Australia (WHRIA)
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Address [1]
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Level 12, 97-99 Bathurst St Sydney NSW 2000
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Country [1]
297519
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Australia
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Primary sponsor type
Other
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Name
WHRIA
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Address
Level 12, 97-99 Bathurst St Sydney NSW 2000
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Country
Australia
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Secondary sponsor category [1]
296526
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None
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Name [1]
296526
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Address [1]
296526
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Country [1]
296526
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298618
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Belberry
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Ethics committee address [1]
298618
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129 Glen Osmond Road Eastwood South Australia 5063
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Ethics committee country [1]
298618
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Australia
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Date submitted for ethics approval [1]
298618
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02/10/2017
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Approval date [1]
298618
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09/03/2018
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Ethics approval number [1]
298618
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Summary
Brief summary
This study is a randomised cross-over trial assessing the efficacy of the addition of hyaluronic acid (HA) to levobupivicane in pudendal nerve blockade as a treatment for pudendal neuralgia. Previous studies have demonstrated that application of local anaesthetic along the path of the pudendal nerve results in the onset of numbness and a reduction in symptoms. This result is however, most often limited from a few hours to a few days . Recent studies have suggested that the addition of hyaluronic acid to the local anaesthetic blockade can result in improved and prolonged analgesia. AIM; to determine whether the addition of hyaluronic acid to local anaesthetic results in improved post-blockade pain scores, change in medication use and change in pain interference in daily activities. MATERIALS AND METHODS; This is a triple-blind randomised cross-over study in which each participant will receive two pudendal nerve blocks 3 months apart one of which will contain hyaluronic acid + levobupivicaine and the other placebo + levobupivicaine. Assessment of symptoms and effect on function will be via use of The Brief pain inventory – short form. We will also assess analgesia use pre and post blockade. RESULTS; Differences in pain and function scores pre and post blockade will be assessed using the students t-test with adjustments made for multiple comparisons. We will also use descriptive statistics to review any changes in medication use. CONCLUSION; if our null hypothesis is true we would expect to see no difference between HA acid and placebo. However, if the HA is effective then we would hope to see improved pain scores, decreased pain interference with life and potentially decreased medication use.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
2758
2758
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/AnzctrAttachments/373651-ApprovalLetter-HREC2017-09-690.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
77662
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Dr Lauren Kite
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Address
77662
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Women's health and research institute of Australia
Level 12, 97-99 Bathurst St Sydney NSW 2000
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Country
77662
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Australia
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Phone
77662
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+61419160667
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Fax
77662
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Email
77662
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[email protected]
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Contact person for public queries
Name
77663
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Lauren Kite
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Address
77663
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Women's health and research institute of Australia
Level 12, 97-99 Bathurst St Sydney NSW 2000
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Country
77663
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Australia
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Phone
77663
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1300 722206
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Fax
77663
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Email
77663
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[email protected]
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Contact person for scientific queries
Name
77664
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Lauren Kite
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Address
77664
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Women's health and research institute of Australia
Level 12, 97-99 Bathurst St Sydney NSW 2000
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Country
77664
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Australia
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Phone
77664
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+61419160667
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Fax
77664
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Email
77664
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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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