Clinical Trial Results:
The effect of subsartorial saphenous block on postoperative pain following major ankle and hind foot surgery
Summary
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EudraCT number |
2016-000608-27 |
Trial protocol |
DK |
Global end of trial date |
28 Feb 2017
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Results information
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Results version number |
v1(current) |
This version publication date |
23 Jan 2018
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First version publication date |
23 Jan 2018
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
ProtokolSB2
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02697955 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Aarhus University Hospital
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Sponsor organisation address |
Nørrebrogade 44, Aarhus C, Denmark, 8000
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Public contact |
Sponsor: Thomas Fichtner Bendtsen, Aarhus University Hospital
Department of Anesthesiology and Intensive Care Medicine, +45 51542997, tfb@dadlnet.dk
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Scientific contact |
Sponsor: Thomas Fichtner Bendtsen, Aarhus University Hospital
Department of Anesthesiology and Intensive Care Medicine, +45 51542997, tfb@dadlnet.dk
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
25 Jun 2017
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
28 Feb 2017
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Global end of trial reached? |
Yes
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Global end of trial date |
28 Feb 2017
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The main objective was to conduct a prospective, randomized, controlled, double-blinded trial to compare saphenous nerve block with bupivacaine-epinephrine vs. placebo to investigate the effect of a saphenous block as a supplement to sciatic nerve block after major ankle surgery. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery.
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Protection of trial subjects |
The study was monitored by the Good Clinical Practice Unit at Aarhus and Aalborg University Hospitals
In this study all patients received a sciatic nerve block according to the standard treatment at the department. The patients were randomized to active or placebo saphenous nerve block, but the observation period ended when the patient reported significant clinical pain (NRS > 3), and the patient immediately received a rescue saphenous nerve block.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
21 Jun 2016
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Denmark: 18
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Worldwide total number of subjects |
18
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EEA total number of subjects |
18
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
7
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From 65 to 84 years |
11
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85 years and over |
0
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Recruitment
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Recruitment details |
The first patient was enrolled 21 June 2016, and the last patient was enrolled and completed 28 February 2017. All patients were enrolled at the foot and ankle surgery section at the Department of Orthopedic Surgery, Aarhus University Hospital, Denmark. | |||||||||
Pre-assignment
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Screening details |
44 patients were screened. Reasons for primary exclusion: - Operation type not included (n=6) - Logistical reasons (n=6) - Daily intake of opioids (n=3) - Inability to cooperate (n=2) - Neuropathy/reduced sensation (n=5) - Charcot-Marie-Tooth disease (n=1) - Severe co-morbidity (n=3) | |||||||||
Period 1
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Period 1 title |
Overall trial (overall period)
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Is this the baseline period? |
Yes | |||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||
Roles blinded |
Subject, Investigator, Data analyst, Assessor | |||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Active | |||||||||
Arm description |
Saphenous nerve block in the femoral triangle with 10 mL 0.5 % bupivacaine with 1:200,000 epinephrine | |||||||||
Arm type |
Experimental | |||||||||
Investigational medicinal product name |
Bupivacaine-epinephrine
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Investigational medicinal product code |
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Other name |
Marcaine-adrenaline
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Perineural use
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Dosage and administration details |
Single-injection saphenous nerve block with 10 ml Marcaine-adrenaline.
1 ml Marcaine-adrenaline contains 5 mg bupivacainehydrochloride and 5 micrograms adrenaline as tartrate.
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Arm title
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Placebo | |||||||||
Arm description |
Saphenous nerve block in the femoral triangle with 10 mL saline | |||||||||
Arm type |
Placebo | |||||||||
Investigational medicinal product name |
Sodium chloride 0.9 %
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Perineural use
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Dosage and administration details |
Single-injection saphenous nerve block with 10 ml Sodium chloride 0.9 %
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Baseline characteristics reporting groups
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Reporting group title |
Active
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Reporting group description |
Saphenous nerve block in the femoral triangle with 10 mL 0.5 % bupivacaine with 1:200,000 epinephrine | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Saphenous nerve block in the femoral triangle with 10 mL saline | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Active
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Reporting group description |
Saphenous nerve block in the femoral triangle with 10 mL 0.5 % bupivacaine with 1:200,000 epinephrine | ||
Reporting group title |
Placebo
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Reporting group description |
Saphenous nerve block in the femoral triangle with 10 mL saline |
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End point title |
Number of patients experiencing significant clinical pain (NRS > 3) | |||||||||||||||
End point description |
Significant clinical pain at rest is defined as NRS > 3 at any time during the observation period
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End point type |
Primary
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End point timeframe |
Patients were observed postoperatively until NRS > 3 or up until 120 minutes after the end of surgery. Pain scores were evaluated at: Arrival at PACU and 30, 45, 60, 75, 90, 105 and 120 min after the end of surgery
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Statistical analysis title |
Fischer’s exact test | |||||||||||||||
Comparison groups |
Active v Placebo
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Number of subjects included in analysis |
18
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Analysis specification |
Pre-specified
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Analysis type |
superiority | |||||||||||||||
P-value |
= 0.003 | |||||||||||||||
Method |
Fisher exact | |||||||||||||||
Confidence interval |
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End point title |
The maximal reported pain score (NRS) during the observation period | ||||||||||||
End point description |
NRS = numerical rating scale 0-10
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End point type |
Secondary
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End point timeframe |
Patients were observed postoperatively until NRS > 3 or up until 120 minutes after the end of surgery. Pain scores (NRS) were evaluated at: Arrival at PACU and 30, 45, 60, 75, 90, 105 and 120 min after the end of surgery.
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Statistical analysis title |
Mann-Whitney test | ||||||||||||
Comparison groups |
Placebo v Active
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Number of subjects included in analysis |
18
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.001 | ||||||||||||
Method |
Wilcoxon (Mann-Whitney) | ||||||||||||
Confidence interval |
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End point title |
Sensory testing of the infrapatellar branch | ||||||||||||||||||
End point description |
The sensory test was performed as a pinprick test with a neuropen applying a standardized pressure of 40 g. The infrapatellar branch of the saphenous nerve was tested at the midpoint of a line connecting the medial femoral condyle and the tibial tuberosity. Sensation to pinprick was graded on a 3 point scale: 0 = no sensation, 1 = reduced sensation and 2 = normal sensation to pinprick compared to the contralateral side.
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End point type |
Secondary
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End point timeframe |
Baseline test and at the time when the patient reported NRS > 3 during the observation period. In case of NRS ≤ 3 during the entire observation period, sensory testing was conducted at t = 120 min
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No statistical analyses for this end point |
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Adverse events information [1]
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Timeframe for reporting adverse events |
Reporting period: 21 Jun 2016 until 28 Feb 2017.
Each patient was observed for adverse events from study treatment was given (randomized saphenous nerve block) and until the end of the observation period (maximum 120 min after the end of surgery)
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Assessment type |
Non-systematic | |||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||
Dictionary version |
10.0
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Reporting groups
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Reporting group title |
Active
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Reporting group description |
- | |||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
- | |||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||
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Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: No non-serious adverse events were observed in this trial. The study was small with only 18 patients. The trial period was of very short duration, and the study intervention very similar to the normal standard treatment. |
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |