Trial Outcomes & Findings for Continuous Adductor Canal Nerve Blocks: Relative Effects of a Basal Infusion v. Hourly Bolus Doses (NCT NCT02219438)

NCT ID: NCT02219438

Last Updated: 2021-03-19

Results Overview

Evaluated in the seated position using transcutaneous electrical stimulation (TES) in the same manner as described throughout the anesthesia literature (this is a "gold standard" for regional anesthesia studies). EKG pads will be positioned over the proximal patella and quadriceps tendon 1 cm medial of midline and attached to a nerve stimulator. The current will be increased from 0 mA until the subject reports slight discomfort (or, up to a maximum of 80 mA), at which time the current is recorded as the TES value and the nerve stimulator turned off.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

24 participants

Primary outcome timeframe

After 8 h of infusion

Results posted on

2021-03-19

Participant Flow

This was a split-body study design, so while there were 24 human subjects involved; each had two treatments: one bolus and one basal. Therefore there were 24 sides receiving the "bolus" treatment and 24 sides receiving the "basal" treatment

Participant milestones

Participant milestones
Measure
Right Side Bolus, Left Side Basal
The right side received ropivacaine 0.2% administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses. Since it is a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as a continuous basal infusion (8 mL/h) for 8 hours total.
Right Side Basal, Left Side Bolus
The right side received ropivacaine 0.2% administration as a continuous basal infusion (8 mL/h) for 8 hours total. Since it was a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses.
Overall Study
STARTED
13
11
Overall Study
COMPLETED
13
11
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Right Side BOLUS and Left Side BASAL
n=13 Participants
The right side received ropivacaine 0.2% administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses. Since it is a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as a continuous basal infusion (8 mL/h) for 8 hours total.
Right Side BASAL and Left Side BOLUS
n=11 Participants
The right side received ropivacaine 0.2% administration as a continuous basal infusion (8 mL/h) for 8 hours total. Since it was a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses.
Total
n=24 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=13 Participants
0 Participants
n=11 Participants
0 Participants
n=24 Participants
Age, Categorical
Between 18 and 65 years
13 Participants
n=13 Participants
11 Participants
n=11 Participants
24 Participants
n=24 Participants
Age, Categorical
>=65 years
0 Participants
n=13 Participants
0 Participants
n=11 Participants
0 Participants
n=24 Participants
Sex: Female, Male
Female
10 Participants
n=13 Participants
7 Participants
n=11 Participants
17 Participants
n=24 Participants
Sex: Female, Male
Male
3 Participants
n=13 Participants
4 Participants
n=11 Participants
7 Participants
n=24 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
13 participants
n=13 Participants
11 participants
n=11 Participants
24 participants
n=24 Participants
Height
173 cm
STANDARD_DEVIATION 8 • n=13 Participants
175 cm
STANDARD_DEVIATION 10 • n=11 Participants
174 cm
STANDARD_DEVIATION 9 • n=24 Participants
Weight
74 kg
STANDARD_DEVIATION 12 • n=13 Participants
79 kg
STANDARD_DEVIATION 14 • n=11 Participants
76 kg
STANDARD_DEVIATION 13 • n=24 Participants
Dominant Leg was the RIGHT leg
13 participants
n=13 Participants
11 participants
n=11 Participants
24 participants
n=24 Participants

PRIMARY outcome

Timeframe: After 8 h of infusion

Evaluated in the seated position using transcutaneous electrical stimulation (TES) in the same manner as described throughout the anesthesia literature (this is a "gold standard" for regional anesthesia studies). EKG pads will be positioned over the proximal patella and quadriceps tendon 1 cm medial of midline and attached to a nerve stimulator. The current will be increased from 0 mA until the subject reports slight discomfort (or, up to a maximum of 80 mA), at which time the current is recorded as the TES value and the nerve stimulator turned off.

Outcome measures

Outcome measures
Measure
BOLUS
n=24 Participants
The right side received ropivacaine 0.2% administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses. Since it is a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as a continuous basal infusion (8 mL/h) for 8 hours total.
BASAL
n=24 Participants
The right side received ropivacaine 0.2% administration as a continuous basal infusion (8 mL/h) for 8 hours total. Since it was a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses.
Tolerance to Cutaneous Electrical Current
26.6 mA
Standard Deviation 12.1
27.1 mA
Standard Deviation 14.5

SECONDARY outcome

Timeframe: baseline through Hour 14 (except Hour 8 which is the primary outcome) and then again at Hour 22

Evaluated in the seated position using transcutaneous electrical stimulation (TES) in the same manner as described throughout the anesthesia literature (this is a "gold standard" for regional anesthesia studies). EKG pads will be positioned over the proximal patella and quadriceps tendon 1 cm medial of midline and attached to a nerve stimulator. The current will be increased from 0 mA until the subject reports slight discomfort (or, up to a maximum of 80 mA), at which time the current is recorded as the TES value and the nerve stimulator turned off.

Outcome measures

Outcome measures
Measure
BOLUS
n=24 Participants
The right side received ropivacaine 0.2% administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses. Since it is a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as a continuous basal infusion (8 mL/h) for 8 hours total.
BASAL
n=24 Participants
The right side received ropivacaine 0.2% administration as a continuous basal infusion (8 mL/h) for 8 hours total. Since it was a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses.
Tolerance to Transcutaneous Electrical Current
Baseline
26.7 mA (milliamperes)
Standard Deviation 7.6
26.6 mA (milliamperes)
Standard Deviation 7.2
Tolerance to Transcutaneous Electrical Current
Hour 1
26.8 mA (milliamperes)
Standard Deviation 8.8
24.7 mA (milliamperes)
Standard Deviation 7.8
Tolerance to Transcutaneous Electrical Current
Hour 2
27.9 mA (milliamperes)
Standard Deviation 9.0
27.4 mA (milliamperes)
Standard Deviation 8.2
Tolerance to Transcutaneous Electrical Current
Hour 3
27.8 mA (milliamperes)
Standard Deviation 9.6
29.7 mA (milliamperes)
Standard Deviation 13.3
Tolerance to Transcutaneous Electrical Current
Hour 4
30.0 mA (milliamperes)
Standard Deviation 14.0
29.7 mA (milliamperes)
Standard Deviation 14.6
Tolerance to Transcutaneous Electrical Current
Hour 5
29.5 mA (milliamperes)
Standard Deviation 13.7
30.1 mA (milliamperes)
Standard Deviation 14.5
Tolerance to Transcutaneous Electrical Current
Hour 6
29.0 mA (milliamperes)
Standard Deviation 14.0
29.0 mA (milliamperes)
Standard Deviation 14.8
Tolerance to Transcutaneous Electrical Current
Hour 7
26.8 mA (milliamperes)
Standard Deviation 12.1
25.9 mA (milliamperes)
Standard Deviation 11.3
Tolerance to Transcutaneous Electrical Current
Hour 9
22.7 mA (milliamperes)
Standard Deviation 8.8
24.3 mA (milliamperes)
Standard Deviation 10.6
Tolerance to Transcutaneous Electrical Current
Hour 10
22.6 mA (milliamperes)
Standard Deviation 8.6
24.9 mA (milliamperes)
Standard Deviation 10.5
Tolerance to Transcutaneous Electrical Current
Hour 11
21.1 mA (milliamperes)
Standard Deviation 8.4
25.0 mA (milliamperes)
Standard Deviation 12.1
Tolerance to Transcutaneous Electrical Current
Hour 12
21.3 mA (milliamperes)
Standard Deviation 7.8
24.6 mA (milliamperes)
Standard Deviation 12.7
Tolerance to Transcutaneous Electrical Current
Hour 13
21.2 mA (milliamperes)
Standard Deviation 7.4
23.2 mA (milliamperes)
Standard Deviation 9.4
Tolerance to Transcutaneous Electrical Current
Hour 14
21.1 mA (milliamperes)
Standard Deviation 7.9
22.3 mA (milliamperes)
Standard Deviation 8.8
Tolerance to Transcutaneous Electrical Current
Hour 22
24.1 mA (milliamperes)
Standard Deviation 8.8
24.5 mA (milliamperes)
Standard Deviation 9.0

SECONDARY outcome

Timeframe: Baseline and then every hour through Hour 14, as well as Hour 22

Strength of the quadriceps muscle was assessed by measurement of maximum voluntary isometric contraction. In the sitting position, without using accessory muscle groups, subjects performed maximum forceful knee extension against an electromechanical dynamometer (MicroFET2, Lafayette Instrument Company, Lafeyette, IN). The subject sat at the side of the bed with their legs dangling. The device was placed against the anterior tibia just above the malleoli between the subject and a nonelastic 5 cm-wide fabric band that was affixed to the gurney to stabilize the dynamometer during flexing of the quadriceps femoris muscle. Subjects were instructed to come to maximum force of knee extension over 2 seconds, hold this force for 5 seconds, and then relax. The maximum force was recorded, and results are reported relative to the pre-infusion baseline measurement (i.e., percent of baseline).

Outcome measures

Outcome measures
Measure
BOLUS
n=24 Participants
The right side received ropivacaine 0.2% administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses. Since it is a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as a continuous basal infusion (8 mL/h) for 8 hours total.
BASAL
n=24 Participants
The right side received ropivacaine 0.2% administration as a continuous basal infusion (8 mL/h) for 8 hours total. Since it was a split body study, the left side of the body of these participants received ropivacaine 0.2% perineural administration as repeated 8 mL bolus doses starting at time point 0 and given hourly for 7 additional doses.
Maximum Voluntary Isometric Contraction of the Quadriceps
Baseline
188 percentage of baseline MVIC
Standard Deviation 65
188 percentage of baseline MVIC
Standard Deviation 78
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 1
84 percentage of baseline MVIC
Standard Deviation 27
88 percentage of baseline MVIC
Standard Deviation 36
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 2
89 percentage of baseline MVIC
Standard Deviation 21
87 percentage of baseline MVIC
Standard Deviation 30
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 3
95 percentage of baseline MVIC
Standard Deviation 25
93 percentage of baseline MVIC
Standard Deviation 32
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 4
92 percentage of baseline MVIC
Standard Deviation 34
87 percentage of baseline MVIC
Standard Deviation 31
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 5
95 percentage of baseline MVIC
Standard Deviation 38
90 percentage of baseline MVIC
Standard Deviation 29
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 6
88 percentage of baseline MVIC
Standard Deviation 34
93 percentage of baseline MVIC
Standard Deviation 91
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 7
85 percentage of baseline MVIC
Standard Deviation 35
92 percentage of baseline MVIC
Standard Deviation 29
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 8
88 percentage of baseline MVIC
Standard Deviation 31
94 percentage of baseline MVIC
Standard Deviation 32
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 9
86 percentage of baseline MVIC
Standard Deviation 30
87 percentage of baseline MVIC
Standard Deviation 30
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 10
89 percentage of baseline MVIC
Standard Deviation 36
90 percentage of baseline MVIC
Standard Deviation 32
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 11
89 percentage of baseline MVIC
Standard Deviation 36
87 percentage of baseline MVIC
Standard Deviation 30
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 12
87 percentage of baseline MVIC
Standard Deviation 35
84 percentage of baseline MVIC
Standard Deviation 29
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 13
84 percentage of baseline MVIC
Standard Deviation 32
89 percentage of baseline MVIC
Standard Deviation 31
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 14
85 percentage of baseline MVIC
Standard Deviation 30
88 percentage of baseline MVIC
Standard Deviation 29
Maximum Voluntary Isometric Contraction of the Quadriceps
Hour 22
114 percentage of baseline MVIC
Standard Deviation 35
119 percentage of baseline MVIC
Standard Deviation 39

Adverse Events

Bolus

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

Basal

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

UCSD

Phone: (619) 543-5560

Results disclosure agreements

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