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Trial registered on ANZCTR
Registration number
ACTRN12618001884291
Ethics application status
Approved
Date submitted
13/11/2018
Date registered
20/11/2018
Date last updated
5/03/2019
Date data sharing statement initially provided
20/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Better ways of pain management in adults with hip fractures
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Scientific title
Neck Of Femur fracture pain management with ultrasound-guided single bolus versus repeated bolus Fascia Iliaca CatheterS in the Emergency Department: a double-blind, randomized controlled trial. (NOF-FICSED)
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Secondary ID [1]
296095
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None
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Universal Trial Number (UTN)
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Trial acronym
NOF-FICSED
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hip Fracture Pain Management
309674
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Cognitive Impairment
309675
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Condition category
Condition code
Emergency medicine
308477
308477
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0
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Other emergency care
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Surgery
309103
309103
0
0
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Other surgery
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Anaesthesiology
309104
309104
0
0
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Pain management
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Injuries and Accidents
309137
309137
0
0
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Fractures
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Neurological
309138
309138
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Single vs repeated bolus fascia iliaca (FICB) nerve blocks from emergency department to surgery.
Arm 1: 40ml 0.2% Ropivacaine through a FICB catheter followed by 2hrly 20ml 0.2% Ropivacaine through the same FICB catheter until surgery. This duration maybe anywhere from 6 - 48 hours.
Arm 2: 40ml 0.2% Ropivacaine through a FICB catheter followed by 2hrly 20ml 0.9% saline through the same FICB catheter until surgery. This duration maybe anywhere from 6 - 48 hours.
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Intervention code [1]
312436
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Treatment: Drugs
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Comparator / control treatment
Arm 2: 40ml 0.2% Ropivacaine through a FICB catheter and 2hrly 0.9% saline until surgery
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Control group
Active
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Outcomes
Primary outcome [1]
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Behavioural pain score (Pain in Advanced Dementia)
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Assessment method [1]
307457
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Timepoint [1]
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Pre-operation pain scores at 16 hours from emergency presentation (primary timepoint)
Other pain score timepoints will be as follows:
Every hour from emergency presentation for first 4 hours
Every 2 hours from hours 4-8
Every 4 hours from hours 8 until time to surgery.
Time to surgery duration may range from 6-48 hours with the average being 23 hours. Pain scores will be compared across multiple timepoints where applicable.
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Secondary outcome [1]
351970
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Pain Scale (verbal response scale 1-10)
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Assessment method [1]
351970
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Timepoint [1]
351970
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Pre-operation pain scores at 16 hours from emergency presentation (secondary timepoint)
Other pain score timepoints will be as follows:
Every hour from emergency presentation for first 4 hours
Every 2 hours from hours 4-8
Every 4 hours from hours 8 until time to surgery.
Time to surgery duration may range from 6-48 hours with the average being 23 hours. Pain scores will be compared across multiple timepoints where applicable.
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Secondary outcome [2]
353894
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Total Opioid use (Study-specific analysis)
- Total Opioid use will be standardised to IV Morphine using the ANZFPM pain calculator, then divided by each patients weight (kg) and standardised to a 24 hour time period to allow appropriate comparison.
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Assessment method [2]
353894
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Timepoint [2]
353894
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Total IV Morphine over entire duration (from 6-48 hours) standardised to amount/24 hours.
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Secondary outcome [3]
353895
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Delirium incidence (CAM Scores) - single incidence
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Assessment method [3]
353895
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Timepoint [3]
353895
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Pre-operative time period. Duration may last from 6-48hours depending on surgical planning.
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Eligibility
Key inclusion criteria
Adults over the age of 50 years with a radiologically-proven neck of femur fracture and ability to consent
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Minimum age
50
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
Interhospital transfers,
Refusal of consent,
Individuals with weights less than 50kg, Local site infection,
Allergies to local anaesthetics,
Liver failure,
Dangerous or combative patients,
Altered anatomy (such as past femoral bypass),
Unwell patients requiring immediate resuscitation
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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)
Identical drug treatment bags provided by Ropivacaine supplier
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be via a permuted block of varying block size code generated by a validated computer program
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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
Parallel
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Other design features
Block Stratification for Fracture Type and for Cognitive Status
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2019
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Actual
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Date of last participant enrolment
Anticipated
1/07/2020
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Actual
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Date of last data collection
Anticipated
1/09/2020
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Actual
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Sample size
Target
122
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
12393
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The Townsville Hospital - Douglas
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Recruitment hospital [2]
13303
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Mackay Base Hospital - Mackay
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Recruitment hospital [3]
13304
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Bundaberg Hospital - Bundaberg
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Recruitment postcode(s) [1]
24660
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4814 - Douglas
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Recruitment postcode(s) [2]
25877
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4740 - Mackay
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Recruitment postcode(s) [3]
25878
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4670 - Bundaberg
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Funding & Sponsors
Funding source category [1]
300683
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Hospital
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Name [1]
300683
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Townsville Hospital
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Address [1]
300683
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100 Angus Smith Drive Douglas QLD, 4814
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Country [1]
300683
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Australia
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Primary sponsor type
Hospital
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Name
Townsville Hospital
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Address
100 Angus Smith Drive Douglas QLD, 4814
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Country
Australia
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Secondary sponsor category [1]
300780
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None
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Name [1]
300780
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Address [1]
300780
0
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Country [1]
300780
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301465
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Townsville Hospital and Health Service Human Research Ethics Committee [EC00183]
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Ethics committee address [1]
301465
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100 Angus Smith Drive QLD 4814
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Ethics committee country [1]
301465
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Australia
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Date submitted for ethics approval [1]
301465
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22/08/2018
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Approval date [1]
301465
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31/10/2018
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Ethics approval number [1]
301465
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HREC/2018/QTHS/44969
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Summary
Brief summary
The purpose of this study is to compare ultrasound guided repeat fascia iliaca blocks delivered through a catheter to ultrasound guided single blocks delivered through a catheter with a saline control in emergency department hip fracture patients. The outcomes measured will be behavioural pain scores, verbal pain scores, opioid use, and incidence of delirium. Further a health economic component will analyse cost effectiveness of both interventions. We predict based on the literature and a pilot study that repeated boluses will be less painful, use less opioids, and have decreased incidences of delirium.
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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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Dr Michael Polischuk
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Address
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Townsville Hospital and Health Service
100 Angus Smith Drive, Douglas QLD 4814
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Country
87102
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Australia
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Phone
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+61 7 44331111
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Fax
87102
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Email
87102
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[email protected]
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Contact person for public queries
Name
87103
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Michael Polischuk
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Address
87103
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Townsville Hospital and Health Service
100 Angus Smith Drive, Douglas QLD 4814
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Country
87103
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Australia
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Phone
87103
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+61 7 44331111
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Fax
87103
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Email
87103
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[email protected]
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Contact person for scientific queries
Name
87104
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Michael Polischuk
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Address
87104
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Townsville Hospital and Health Service
100 Angus Smith Drive, Douglas QLD 4814
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Country
87104
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Australia
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Phone
87104
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+61 7 44331111
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Fax
87104
0
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Email
87104
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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)?
Undecided
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No/undecided IPD sharing reason/comment
IPD data will likely be available to aid in reproducibility and comparison from other groups. Data released will not include confidential identifiable information.
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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
Source
Title
Year of Publication
DOI
Dimensions AI
Emergency Department Femoral Nerve Blocks and 1-Year Mortality in Fragility Hip Fractures
2019
https://doi.org/10.1177/2151459319893894
N.B. These documents automatically identified may not have been verified by the study sponsor.
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