Trial Outcomes & Findings for Optimizing Local Anesthetic Concentration for Continuous Popliteal-Sciatic Nerve Blocks (NCT NCT01898689)

NCT ID: NCT01898689

Last Updated: 2021-03-19

Results Overview

Electrocardiogram pads are placed on the lateral aspect of the plantar surface of the foot which is covered by the sciatic nerve distribution; and, the tolerance to cutaneous electrical current is obtained using a nerve stimulator. The current is increased from 0 mA until subjects detect the electrical current (up to a maximum of 80 mA), at which time the current is recorded and the nerve stimulator turned off.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

24 participants

Primary outcome timeframe

Hour 6

Results posted on

2021-03-19

Participant Flow

Participant milestones

Participant milestones
Measure
Right Side Ropivacaine 0.1%, Left Side Ropivacaine 0.4%
Ropivacaine 0.1% administered at 8 mL/h basal for 6 hours on the right side of the body while ropivacaine 0.4% administered at 2 mL/h basal for 6 hours on the left side of the body.
Right Side Ropivacaine 0.4%, Left Side Ropivacaine 0.1%
Ropivacaine 0.4% administered at 2 mL/h basal for 6 hours on the right side of the body while ropivacaine 0.1% administered at 8 mL/h basal for 6 hours on the left side of the body.
Overall Study
STARTED
10
14
Overall Study
COMPLETED
10
14
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Optimizing Local Anesthetic Concentration for Continuous Popliteal-Sciatic Nerve Blocks

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Right Side: Ropivacaine 0.1%
n=10 Participants
Bilateral sciatic perineural catheters were inserted and ropivacaine infused as a basal infusion through both for 6 hours. The right side of the body received 0.1% at 8 mL/h and the left side of the body received 0.4% at 2 mL/h.
Right Side: Ropivacaine 0.4%
n=14 Participants
Bilateral sciatic perineural catheters were inserted and ropivacaine infused as a basal infusion through both for 6 hours. The right side of the body received 0.4% at 2 mL/h and the left side of the body received 0.1% at 8 mL/h.
Total
n=24 Participants
Total of all reporting groups
Age, Categorical
Age · <=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Age · Between 18 and 65 years
10 Participants
n=93 Participants
14 Participants
n=4 Participants
24 Participants
n=27 Participants
Age, Categorical
Age · >=65 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Sex: Female, Male
Female
2 Participants
n=93 Participants
7 Participants
n=4 Participants
9 Participants
n=27 Participants
Sex: Female, Male
Male
8 Participants
n=93 Participants
7 Participants
n=4 Participants
15 Participants
n=27 Participants
Region of Enrollment
United States
10 Participants
n=93 Participants
14 Participants
n=4 Participants
24 Participants
n=27 Participants
Height
175 cm
STANDARD_DEVIATION 11 • n=93 Participants
175 cm
STANDARD_DEVIATION 11 • n=4 Participants
175 cm
STANDARD_DEVIATION 11 • n=27 Participants
Weight
87.0 kg
STANDARD_DEVIATION 15.3 • n=93 Participants
79.2 kg
STANDARD_DEVIATION 16.1 • n=4 Participants
81.0 kg
STANDARD_DEVIATION 17.0 • n=27 Participants
Body Mass Index
27.0 kg/m^2
STANDARD_DEVIATION 3.6 • n=93 Participants
26.3 kg/m^2
STANDARD_DEVIATION 5.0 • n=4 Participants
26.6 kg/m^2
STANDARD_DEVIATION 4.4 • n=27 Participants

PRIMARY outcome

Timeframe: Hour 6

Population: Since this was a split-body study, we included each individual who received the treatment. Since each of the 24 subjects received each of the treatments, the overall number of participants analyzed was 24 for each of the treatments. For this reason, the Total number of subjects appears to be '48', when in fact it was 48 treated sides.

Electrocardiogram pads are placed on the lateral aspect of the plantar surface of the foot which is covered by the sciatic nerve distribution; and, the tolerance to cutaneous electrical current is obtained using a nerve stimulator. The current is increased from 0 mA until subjects detect the electrical current (up to a maximum of 80 mA), at which time the current is recorded and the nerve stimulator turned off.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.1% at 8 mL/h and the left side received 0.4% at 2 mL/h.
Ropivacaine 0.4%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.4% at 2 mL/h and the left side received 0.1% at 8 mL/h.
Maximum Tolerance to Transcutaneous Electrical Stimulation
27.0 mA (milliamperes)
Standard Deviation 20.2
26.9 mA (milliamperes)
Standard Deviation 20.4

SECONDARY outcome

Timeframe: baseline, Hours 1-14 (except 6 which was the primary outcome) and Hour 22

Population: Since this was a split-body study, we included each individual who received the treatment. Since each of the 24 subjects received each of the treatments, the overall number of participants analyzed was 24 for each of the treatments. For this reason, the Total number of subjects appears to be '48', when in fact it was 48 treated sides.

Electrocardiogram pads are placed on the lateral aspect of the plantar surface of the foot which is covered by the sciatic nerve distribution; and, the tolerance to cutaneous electrical current is obtained using a nerve stimulator. The current is increased from 0 mA until subjects detect the electrical current (up to a maximum of 80 mA), at which time the current is recorded and the nerve stimulator turned off.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.1% at 8 mL/h and the left side received 0.4% at 2 mL/h.
Ropivacaine 0.4%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.4% at 2 mL/h and the left side received 0.1% at 8 mL/h.
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 11
23.5 mA (milliamperes)
Standard Error 2.5
24.3 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 12
25 mA (milliamperes)
Standard Error 2.5
22 mA (milliamperes)
Standard Error 2
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 13
19.5 mA (milliamperes)
Standard Error 1
21.2 mA (milliamperes)
Standard Error 1
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 14
23.5 mA (milliamperes)
Standard Error 2.5
21 mA (milliamperes)
Standard Error 2
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 22
17 mA (milliamperes)
Standard Error 1
17 mA (milliamperes)
Standard Error 1
Maximum Tolerance to Transcutaneous Electrical Stimulation
Baseline
23 mA (milliamperes)
Standard Error 2.5
22.5 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 1
19 mA (milliamperes)
Standard Error 1.5
20 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 2
18 mA (milliamperes)
Standard Error 1.2
19 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 3
20 mA (milliamperes)
Standard Error 2.5
20.4 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 4
25 mA (milliamperes)
Standard Error 3
21 mA (milliamperes)
Standard Error 2
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 5
25 mA (milliamperes)
Standard Error 2.5
24.5 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 7
27 mA (milliamperes)
Standard Error 2.5
26.5 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 8
27 mA (milliamperes)
Standard Error 2.5
27.5 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 9
23 mA (milliamperes)
Standard Error 2.5
23.5 mA (milliamperes)
Standard Error 2.5
Maximum Tolerance to Transcutaneous Electrical Stimulation
Hour 10
25 mA (milliamperes)
Standard Error 2.5
24.5 mA (milliamperes)
Standard Error 2.5

SECONDARY outcome

Timeframe: baseline, Hours 1-14 and Hour 22

Population: Since this was a split-body study, we included each individual who received the treatment. Since each of the 24 subjects received each of the treatments, the overall number of participants analyzed was 24 for each of the treatments. For this reason, the Total number of subjects appears to be '48', when in fact it was 48 treated sides.

Muscle strength was evaluated with an isometric force electromechanical dynamometer (MicroFET2, Lafayette Instrument Company, Lafayette, IN) to measure the force produced during a MVIC during plantar flexion. The dynamometer was placed against the bed's foot board (immobile) and the subjects asked to take 2 seconds to come to maximum effort plantar flexing, maintaining this effort for 5 seconds, and then relaxing. The measurements immediately prior to perineural ropivacaine administration were designated as baseline measurements, and all subsequent measurements expressed as a percentage of the pre-infusion baseline.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.1% at 8 mL/h and the left side received 0.4% at 2 mL/h.
Ropivacaine 0.4%
n=24 Participants
Bilateral sciatic perineural catheters are inserted and ropivacaine is infused as a basal infusion for 6 hours. The right side received 0.4% at 2 mL/h and the left side received 0.1% at 8 mL/h.
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Baseline
100 percentage change from baseline MVIC
Standard Error 0
100 percentage change from baseline MVIC
Standard Error 0
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 1
90 percentage change from baseline MVIC
Standard Error 1.2
98 percentage change from baseline MVIC
Standard Error 1.5
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 2
8.1 percentage change from baseline MVIC
Standard Error 1.2
8.1 percentage change from baseline MVIC
Standard Error 1.2
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 3
81.5 percentage change from baseline MVIC
Standard Error 1.5
81.0 percentage change from baseline MVIC
Standard Error 1.5
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 4
71.0 percentage change from baseline MVIC
Standard Error 1.0
71.5 percentage change from baseline MVIC
Standard Error 1.0
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 5
66 percentage change from baseline MVIC
Standard Error 4.9
57 percentage change from baseline MVIC
Standard Error 1
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 6
57 percentage change from baseline MVIC
Standard Error 1.4
56 percentage change from baseline MVIC
Standard Error 1.4
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 7
58 percentage change from baseline MVIC
Standard Error 1
57 percentage change from baseline MVIC
Standard Error 1
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 8
61 percentage change from baseline MVIC
Standard Error 2.5
63 percentage change from baseline MVIC
Standard Error 2.5
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 9
67 percentage change from baseline MVIC
Standard Error 2.1
68 percentage change from baseline MVIC
Standard Error 2
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 10
68 percentage change from baseline MVIC
Standard Error 2
66 percentage change from baseline MVIC
Standard Error 2
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 11
70 percentage change from baseline MVIC
Standard Error 1.0
67 percentage change from baseline MVIC
Standard Error 1
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 12
72 percentage change from baseline MVIC
Standard Error 2.5
78.5 percentage change from baseline MVIC
Standard Error 2.5
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 13
80 percentage change from baseline MVIC
Standard Error 2.5
70 percentage change from baseline MVIC
Standard Error 2.5
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 14
78 percentage change from baseline MVIC
Standard Error 3
78 percentage change from baseline MVIC
Standard Error 3
Percent of Maximum Voluntary Isometric Contraction Baseline (Quadriceps Femoris)
Hour 22
96 percentage change from baseline MVIC
Standard Error 0.8
97 percentage change from baseline MVIC
Standard Error 1.1

Adverse Events

Ropivacaine 0.1%

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Ropivacaine 0.4%

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Brian Ilfeld

UC San Diego

Phone: (858) 444-5949

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place