Anesthesia, Local, Ehlers-Danlos Syndrome
Conditions
Keywords
Ehlers-Danlos Syndrome, Local Anesthesia Resistance
Brief summary
Local anesthetic resistance is commonly reported by patients with EDS. However, there are no objective data on the occurrence of local anesthetic resistance in EDS patients and in healthy volunteers. We propose to collect such objective data on the frequency of drug resistance and whether any problems with local anesthesia are due to initial ineffectiveness or due to its effects dissipating too soon.
Detailed description
There was a prior large online questionnaire to better understand the issues around local anesthetic resistance. By November 2018, 933 EDS patients (total 1059 respondents) completed the survey, 99.2% of which had previously received local anesthetics. Among these patients, 88% reported that they have had a problem with local anesthetic injection not working adequately or properly, while only 54% of respondents without EDS reported a similar problem. These data suggests that local anesthetic resistance might be more prevalent in patients with EDS than in the general population. If these findings are true, then this might have significant implications for the appropriate management of these patients during minor surgery and dental procedures. This study aims to assess the frequency and related issues around local anesthetic resistance in EDS patients, including whether the problem is a lack of analgesia or a timing effect (short duration of action or delayed onset of action), and whether the problem relates only to some local anesthetics or whether there is a problem with the whole class of local anesthetics.
Interventions
DRUG0.9% Sodium Chloride Injection
All participants will be injected subcutaneously with a single 0.5ml dose
All participants will be injected subcutaneously with a single 0.5ml dose
DRUGBupivacaine Injection 0.5%
All participants will be injected subcutaneously with a single 0.5ml dose
Sponsors
University of Calgary
Vanderbilt University Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* EDS patients, clinically diagnosed hypermobile EDS based on 2017 criteria * EDS patients with genetically proven non-hypermobile EDS * Healthy participants, no EDS * Able and willing to provide informed consent
Exclusion criteria
* Known allergy to Lidocaine or Bupivacaine * Unable to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Delta Pain Scores Lidocaine at 5 min | 5 minutes post-injection | Difference between the pain score at the Lidocaine injection locations (compared to a control location) and the saline injection location (compared to a control location). The pain scale is .a 4 level scale from 0 (absent sensation), to 1 (dull pressure), to 2 (sharp but less than a control \[non-injected\] region) to 3 (same or worse than the control region). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delta Pain Scores Lidocaine at 30 min | 30 min | Difference between the pain score at the Lidocaine injection locations (compared to a control location) and the saline injection location (compared to a control location). The pain scale is .a 4 level scale from 0 (absent sensation), to 1 (dull pressure), to 2 (sharp but less than a control \[non-injected\] region) to 3 (same or worse than the control region). |
| Delta Pain Scores Bupivacaine at 5 min | 5 min | Difference between the pain score at the bupivacaine injection locations (compared to a control location) and the saline injection location (compared to a control location). The pain scale is .a 4 level scale from 0 (absent sensation), to 1 (dull pressure), to 2 (sharp but less than a control \[non-injected\] region) to 3 (same or worse than the control region). |
| Delta Pain Scores Bupivacaine at 30 min | 30 min | Difference between the pain score at the bupivacaine injection locations (compared to a control location) and the saline injection location (compared to a control location). The pain scale is .a 4 level scale from 0 (absent sensation), to 1 (dull pressure), to 2 (sharp but less than a control \[non-injected\] region) to 3 (same or worse than the control region). |
Countries
United States
Outcome results
None listed