Interest in Clonidine in Association With Levobupivacaine Performing a Pudendal Block in Proctological Surgery.
NCT ID: NCT04530903
Last Updated: 2020-09-17
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
PHASE4
30 participants
INTERVENTIONAL
2020-09-09
2021-01-01
Brief Summary
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Post-operative pain resulting from proctological surgery is greater than 5 on the Visual Analog Scale (VAS) within the first 24 hours and it revives during the first defecation.
The ideal pain management procedures are based on the multimodal analgesia model, based in turn on the combination of products and / or techniques to improve the quality of analgesia, reduce the side effects linked to the use of opioids, reduce responses to surgical stress, reduce postoperative recovery and allow rapid rehabilitation of the patient.
The aim of our study is to investigate whether clonidine combined with levobupivacaine in the pudendal block reduce the total consumption of opioids in proctological surgery.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
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Group Clonidine
Group Clonidine will benefit from the pudendal block realised with 10 ml of 0.25% levobupivacaine and 75 µg of clonidine per side.
Clonidine
75 µg (0.5mL) per injection site
Levobupivacaine
0.25% (10 ml) per injection site
Control
Group Control will benefit from the pudendal block realised with 10 ml of 0.25% levobupivacaine per side; 0.5 ml of 0.9% NaCl will be added to each syringe to homogenise the volume in order to remain blind.
Levobupivacaine
0.25% (10 ml) per injection site
NaCl 0.9%
Nacl 0.9% (0.5ml) per injection site
Interventions
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Clonidine
75 µg (0.5mL) per injection site
Levobupivacaine
0.25% (10 ml) per injection site
NaCl 0.9%
Nacl 0.9% (0.5ml) per injection site
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Signature of informed consent
Exclusion Criteria
* Allergy to either local anaesthetics or clonidine;
* Local infectious pathologies (e.g. acute ano-perineal suppuration)
* Pregnancy
* Breastfeeding
* Severe bradyarrhythmia due to sinus node disease or second and third degree atrioventricular block
* Severe depressive condition
* Severe coronary artery disease
* Raynaud's disease
* Heart failure
* Obliterating thromboangiitis
* Epilepsy
* Spinal anesthesia
18 Years
ALL
No
Sponsors
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Centre Hospitalier Universitaire Saint Pierre
OTHER
Responsible Party
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Principal Investigators
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Panayota Kapessidou, MD,PhD
Role: STUDY_DIRECTOR
University Hospital Saint-Pierre (CHU Saint-Pierre), Université Libre de Bruxelles (ULB)
Myriam Suball, MD
Role: PRINCIPAL_INVESTIGATOR
University Hospital Saint-Pierre (CHU Saint-Pierre), Université Libre de Bruxelles (ULB)
Marzia Gambassi, MD
Role: PRINCIPAL_INVESTIGATOR
University Hospital Saint-Pierre (CHU Saint-Pierre), Université Libre de Bruxelles (ULB)
Locations
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University Hospital Saint-Pierre
Brussels, , Belgium
Countries
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Central Contacts
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Facility Contacts
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References
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Joshi GP. Multimodal analgesia techniques and postoperative rehabilitation. Anesthesiol Clin North Am. 2005 Mar;23(1):185-202. doi: 10.1016/j.atc.2004.11.010.
Ceulemans A, De Looze D, Van de Putte D, Stiers E, Coppens M. High post-operative pain scores despite multimodal analgesia in ambulatory anorectal surgery: a prospective cohort study. Acta Chir Belg. 2019 Aug;119(4):224-230. doi: 10.1080/00015458.2018.1500802. Epub 2018 Sep 7.
Joshi GP, Neugebauer EA; PROSPECT Collaboration. Evidence-based management of pain after haemorrhoidectomy surgery. Br J Surg. 2010 Aug;97(8):1155-68. doi: 10.1002/bjs.7161.
Comite douleur-anesthesie locoregionale et le comite des referentiels de la Sfar. [Formalized recommendations of experts 2008. Management of postoperative pain in adults and children]. Ann Fr Anesth Reanim. 2008 Dec;27(12):1035-41. doi: 10.1016/j.annfar.2008.10.002. Epub 2008 Nov 21. No abstract available. French.
Novikova N, Cluver C. Local anaesthetic nerve block for pain management in labour. Cochrane Database Syst Rev. 2012 Apr 18;2012(4):CD009200. doi: 10.1002/14651858.CD009200.pub2.
Vinson-Bonnet B.. Le bloc pudendal: technique d'analgésie postopératoire en chirurgie proctologique. Pelvi-Périnéologie 2007, 2(2):180-183.
Naja Z, Ziade MF, Lonnqvist PA. Nerve stimulator guided pudendal nerve block decreases posthemorrhoidectomy pain. Can J Anaesth. 2005 Jan;52(1):62-8. doi: 10.1007/BF03018582.
Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d'Athis F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999 Jul;91(1):8-15. doi: 10.1097/00000542-199907000-00006.
Imbelloni LE, Vieira EM, Gouveia MA, Netinho JG, Spirandelli LD, Cordeiro JA. Pudendal block with bupivacaine for postoperative pain relief. Dis Colon Rectum. 2007 Oct;50(10):1656-61. doi: 10.1007/s10350-007-0216-7.
De La Arena P.. Bloc pudendal sous échographie: faisabilité et efficacité peropératoire chez l'enfant. Annales Françaises d'Anesthésie et de Réanimation 2014; A398-A403.
Gaudet-Ferrand I, De La Arena P, Bringuier S, Raux O, Hertz L, Kalfa N, Sola C, Dadure C. Ultrasound-guided pudendal nerve block in children: A new technique of ultrasound-guided transperineal approach. Paediatr Anaesth. 2018 Jan;28(1):53-58. doi: 10.1111/pan.13286. Epub 2017 Dec 5.
Li A, Wei Z, Liu Y, Shi J, Ding H, Tang H, Zheng P, Gao Y, Feng S. Ropivacaine versus levobupivacaine in peripheral nerve block: A PRISMA-compliant meta-analysis of randomized controlled trials. Medicine (Baltimore). 2017 Apr;96(14):e6551. doi: 10.1097/MD.0000000000006551.
Malav K, Singariya G, Mohammed S, Kamal M, Sangwan P, Paliwal B. Comparison of 0.5% Ropivacaine and 0.5% Levobupivacaine for Sciatic Nerve Block Using Labat Approach in Foot and Ankle Surgery. Turk J Anaesthesiol Reanim. 2018 Feb;46(1):15-20. doi: 10.5152/TJAR.2017.03411. Epub 2017 Nov 27.
Brummett CM, Williams BA. Additives to local anesthetics for peripheral nerve blockade. Int Anesthesiol Clin. 2011 Fall;49(4):104-16. doi: 10.1097/AIA.0b013e31820e4a49.
Kirksey MA, Haskins SC, Cheng J, Liu SS. Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review. PLoS One. 2015 Sep 10;10(9):e0137312. doi: 10.1371/journal.pone.0137312. eCollection 2015.
Bernard JM, Macaire P. Dose-range effects of clonidine added to lidocaine for brachial plexus block. Anesthesiology. 1997 Aug;87(2):277-84. doi: 10.1097/00000542-199708000-00014.
Kelika P, Arun JM. Evaluation of clonidine as an adjuvant to brachial plexus block and its comparison with tramadol. J Anaesthesiol Clin Pharmacol. 2017 Apr-Jun;33(2):197-202. doi: 10.4103/joacp.JOACP_58_13.
Popping DM, Elia N, Marret E, Wenk M, Tramer MR. Clonidine as an adjuvant to local anesthetics for peripheral nerve and plexus blocks: a meta-analysis of randomized trials. Anesthesiology. 2009 Aug;111(2):406-15. doi: 10.1097/ALN.0b013e3181aae897.
McCartney CJ, Duggan E, Apatu E. Should we add clonidine to local anesthetic for peripheral nerve blockade? A qualitative systematic review of the literature. Reg Anesth Pain Med. 2007 Jul-Aug;32(4):330-8. doi: 10.1016/j.rapm.2007.02.010.
Other Identifiers
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B076202042809
Identifier Type: -
Identifier Source: org_study_id
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