Post-operative Pain, Upper-extremity Surgery
Conditions
Keywords
Pain, surgery, catheter, nerve block, supraclavicular, infraclavicular, UCSD, moderate-to-severe pain, Supraclavicular catheter, Infraclavicular catheter
Brief summary
This research study is to determine if the insertion site of a perineural catheter or tiny tube placed next to the nerves that go to the part of the body (hand or arm) having surgery, affects the amount of pain relief that is experienced after surgery. Catheters will be placed in either the supraclavicular or infraclavicular location.
Detailed description
To determine if a particular perineural local anesthetic catheter location (supraclavicular or infraclavicular) will maximize postoperative analgesia, minimize oral opioid requirements, minimize sleep disturbances resulting from postoperative pain, and maximize patient satisfaction.
Interventions
PROCEDURESupraclavicular vs. Infraclavicular ropivicaine infusion
Patients will be randomized to one of two groups: nerve blocks in the supraclavicular location or the infraclavicular location. Following surgery the patient will be called by study staff to assess pain scores, sleep disturbances, infusion side effects, feeling in fingers and other study outcomes.
Sponsors
University of California, San Diego
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age or older * unilateral, upper (at or distal to the elbow) extremity orthopedic surgery with moderate-to-severe postoperative pain expected * patients already agree to and want a continuous brachial plexus block for postoperative analgesia
Exclusion criteria
* patients who have difficulty understanding the study protocol or caring for the infusion pump/catheter system * patients who have any known contraindication to study medications * insulin-dependent diabetes mellitus * neuropathy of any etiology in the affected extremity * contraindication to regional blockade (e.g. clotting deficiency) * any known acute or chronic hepatic or renal insufficiency or failure * any incision site outside of the catheter-effected area * chronic opioid use * history of opioid abuse * obesity * pregnancy * incarceration * inability to communicate with the investigators and hospital staff
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Surgical pain as measured on a 0-10 scale where 0=no pain and 10=worst imaginable pain. The values for the two different catheter locations will be compared to see which site is optimal for catheter placement. | 3 days |
Secondary
| Measure | Time frame |
|---|---|
| Sleeping disturbances (difficulty sleeping and awakenings due to pain) as reported to the study staff. | 3 days |
| Infusion side effects (shortness of breath) as reported to study staff. | 3 day |
| Opioids consumed by patient each day after surgery as reported to study staff. | 3 days |
| Sensory and motor deficits (ability to move fingers and numbness of fingers) as reported to study staff. | 3 days |
| Catheter site discomfort, leakage at catheter site, and catheter related pain on the 0-10 rating scale, where 0=no pain and 10=worst imaginable pain, as reported to study staff during phone calls. | 3 days |
| Satisfaction with pain control as measured on a 0-10 scale where 0=very unsatisfied and 10=very satisfied, as reported to study staff at time of daily phone calls | 3 days |
Countries
United States
Outcome results
None listed