Osteoarthritis of HipNCT02161484
Continuous Lumbar Plexus Block With and Without Parasacral Block in Patients Undergoing Total Hip Replacement
A study testing Continuous Lumbar Plexus Block, Parasacral Nerve Block and Ropivacine 0.2% in people with Osteoarthritis of Hip and Regional Anesthesia, run by Rita Merman at 1 site in United States.
Trial summary
The purpose of this research study is to evaluate the analgesic efficacy of adding a single shot parasacral (sciatic) nerve block to a continuous lumbar plexus block in patients undergoing total hip replacement. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Osteoarthritis of Hip, Regional Anesthesia, Other Acute Postoperative Pain
- What is being tested?
- Continuous Lumbar Plexus Block, Parasacral Nerve Block and Ropivacine 0.2%
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2014to 17 Jun 2014
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Subject has signed and dated an Informed Consent Form.
- Subject is classified as a ASA (American Society of Anesthesiologists) status I-III
- Subject is age 18- 75 years old.
- Subject is having primary total hip arthroplasty
- No contraindication to peripheral nerve catheter ( local infection or hypocoagulable state)
- Patient willing to receive spinal anesthesia as operative anesthesia
- No known drug allergies to study medications
- Patients not expected to receive therapeutic anticoagulation in the postoperative period.
Who cannot join
- Subject inability to provide adequate informed consent.
- Age younger than 18 years or older than 75 years
- Any contraindication to the placement of lumbar plexus catheter, including local infection, hypocoagulable state.
- ASA (American Society of Anesthesiologists) physical status of IV or greater
- Any chronic painful conditions
- Preoperative opioid use
- Coagulation abnormalities or patients who are expected to be on therapeutic anticoagulants postoperatively
Trial locations and contacts
1 site in 1 country.
United States1 site
UPMC Presbyterian Shadyside
Pittsburgh, Pennsylvania, 15232
About this study
Official title: A Prospective, Randomized, Blinded, Controlled Study Evaluating the Efficacy of Continuous Lumbar Plexus Block With and Without Parasacral Block in Patients Undergoing Total Hip Replacement
The purpose of this research study is to evaluate the analgesic efficacy of adding a single shot parasacral (sciatic) nerve block to a continuous lumbar plexus block in patients undergoing total hip replacement.
Read the detailed description
This prospective study is intended to assess the efficacy of placing a parasacral (sciatic) nerve block in addition to a lumbar plexus block for postoperative analgesia following total hip arthroplasty. Although the placement of a lumbar plexus block alone has become accepted as the standard of care at UPMC for postoperative analgesia following total hip arthroplasty, the addition of a parasacral (sciatic) nerve block may provide the advantage of blocking the superior gluteal nerve and nerve to the quadratus femoris which both supply small articular sensory branches to the posterior hip capsule.
- Conditions
- Osteoarthritis of Hip, Regional Anesthesia, Other Acute Postoperative Pain, Total Hip Arthroplasty, Peripheral Nerve Block, Lumbar Plexus Nerve Block
- Being tested
- Continuous Lumbar Plexus Block, Parasacral Nerve Block, Ropivacine 0.2%, Bupivacaine 0.0625%
- Keywords
- Peripheral Nerve Block, Total Hip Replacement
- Medical subject headings
- Osteoarthritis, Hip
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Continuous Lumbar Plexus BlockProcedure or surgery
Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn.
Parasacral Nerve BlockProcedure or surgery
Also called Sciatic Nerve Block
A single shot parasacral (sciatic) nerve block will then be place under the ultrasound guidance. Ropivacaine 0.2% 9 ml will be injected.
Ropivacine 0.2%Drug
Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm.
Bupivacaine 0.0625%Drug
In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn.
| Study group | Role | What they receive |
|---|---|---|
| Continuous Lumbar Plexus Block with Parasacral Nerve Block | Experimental | Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn.
A single shot parasacral (sciatic) nerve block will then be place under the ultrasound guidance. Ropivacaine 0.2% 9 ml will be injected. Receives: Procedure: Continuous Lumbar Plexus Block; Procedure: Parasacral Nerve Block; Drug: Ropivacine 0.2%; Drug: Bupivacaine 0.0625% |
| Lumbar Plexus Nerve Block | Active comparator | Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn.
No sham/placebo parasacral (sciatic) blocks will be performed in this group. Receives: Procedure: Continuous Lumbar Plexus Block; Drug: Ropivacine 0.2%; Drug: Bupivacaine 0.0625% |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Rating Scale (NRS) Pain Assessment
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
Measured: 6 hours after the start of surgery
Numeric Rating Scale (NRS) Pain Assessment
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
Measured: 24 hours after the start of surgery
Numeric Rating Scale (NRS) Pain Assessment
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
Measured: 48 hours after the start of surgery
Secondary outcomes (5)
Number of Rescue Boluses Administered by Nurse (IV Dilaudid) Post Operatively
Measured: 48 hours after the start of the surgery
Amount of Oxycodone for the First 48 h Post Operatively
Including number of dose and mg).
Measured: 48 hours after the start of the surgery
Total Dilaudid or Opiate Equivalent Consumed (mg) Over 48 Hours Post Operatively
Measured: 48 hours after the start of the surgery
Number of Nerve Block Boluses (Bupivacaine) Administered by the Nurse Post Operatively
Measured: 48 hours after the start of the surgery
Total Amount of Local Anesthetic in 48 Hours Post Operatively
Combined amount of Bupivacaine Boluses + Continuous infusion in (cc)
Measured: 48 hours after the start of the surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2014 (estimated)
- Study startJan 2014
- Primary completion17 Jun 2014
- Study completion17 Jun 2014
Why it stopped: The computer is crushed and all data is lost (IT was not able to recover it. Last data was collected 6.17.14)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Osteoarthritis of HipStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 10 participants (actual)
Sponsor and investigators
- Lead sponsor
- Rita Merman
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Rita Merman, University of Pittsburgh
- Investigators
- Rita Merman, MD, Principal investigator, UPMC Presbyterian ShadysideJacques E. Chelly, MD, PhD, MBA, Study chair, UPMC Presbyterian Shadyside
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02161484
- Sponsor's protocol ID
- PRO13030184
- Status last verified
- Mar 2018
- First submitted
- 2 Jun 2014
- Last updated
- 29 Mar 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Ben-Ari AY, Joshi R, Uskova A, Chelly JE. Ultrasound localization of the sacral plexus using a parasacral approach. Anesth Analg. 2009 Jun;108(6):1977-80. doi: 10.1213/ane.0b013e3181a04d8e.
PubMed 19448235Ho AM, Karmakar MK. Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis. Can J Anaesth. 2002 Nov;49(9):946-50. doi: 10.1007/BF03016880.
PubMed 12419722Morris GF, Lang SA, Dust WN, Van der Wal M. The parasacral sciatic nerve block. Reg Anesth. 1997 May-Jun;22(3):223-8. doi: 10.1016/s1098-7339(06)80005-2.
PubMed 9168212Wiegel M, Gottschaldt U, Hennebach R, Hirschberg T, Reske A. Complications and adverse effects associated with continuous peripheral nerve blocks in orthopedic patients. Anesth Analg. 2007 Jun;104(6):1578-82, table of contents. doi: 10.1213/01.ane.0000261260.69083.f3.
PubMed 17513661Ilfeld BM, Mariano ER, Madison SJ, Loland VJ, Sandhu NS, Suresh PJ, Bishop ML, Kim TE, Donohue MC, Kulidjian AA, Ball ST. Continuous femoral versus posterior lumbar plexus nerve blocks for analgesia after hip arthroplasty: a randomized, controlled study. Anesth Analg. 2011 Oct;113(4):897-903. doi: 10.1213/ANE.0b013e318212495b. Epub 2011 Apr 5.
PubMed 21467563Marino J, Russo J, Kenny M, Herenstein R, Livote E, Chelly JE. Continuous lumbar plexus block for postoperative pain control after total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. 2009 Jan;91(1):29-37. doi: 10.2106/JBJS.H.00079.
PubMed 19122076
Study at a glance
From the registry record, last updated by the sponsor on 29 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective, Randomized, Blinded, Controlled Study Evaluating the Efficacy of Continuous Lumbar Plexus Block With and Without Parasacral Block in Patients Undergoing Total Hip Replacement
- ClinicalTrials.gov ID
- NCT02161484
- Acronym / sponsor ID
- PRO13030184
- Conditions
- Osteoarthritis of Hip, Regional Anesthesia, Other Acute Postoperative Pain, Total Hip Arthroplasty, Peripheral Nerve Block, Lumbar Plexus Nerve Block
- Keywords
- Peripheral Nerve Block, Total Hip Replacement
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The computer is crushed and all data is lost (IT was not able to recover it. Last data was collected 6.17.14)
- Enrolment
- 10 participants (actual)
- Lead sponsor
- Rita MermanUniversity, hospital or other
- Study start
- Jan 2014
- Primary completion
- 17 Jun 2014 (actual)
- Study completion
- 17 Jun 2014 (actual)
- First posted
- 11 Jun 2014 (estimated)
- Results
- Posted 29 Mar 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this research study is to evaluate the analgesic efficacy of adding a single shot parasacral (sciatic) nerve block to a continuous lumbar plexus block in patients undergoing total hip replacement.
Detailed description
This prospective study is intended to assess the efficacy of placing a parasacral (sciatic) nerve block in addition to a lumbar plexus block for postoperative analgesia following total hip arthroplasty. Although the placement of a lumbar plexus block alone has become accepted as the standard of care at UPMC for postoperative analgesia following total hip arthroplasty, the addition of a parasacral (sciatic) nerve block may provide the advantage of blocking the superior gluteal nerve and nerve to the quadratus femoris which both supply small articular sensory branches to the posterior hip capsule.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Continuous Lumbar Plexus Block with Parasacral Nerve Block | Experimental | Procedure: Continuous Lumbar Plexus Block, Procedure: Parasacral Nerve Block, Drug: Ropivacine 0.2%, Drug: Bupivacaine 0.0625%Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn. A single shot parasacral (sciatic) nerve block will then be place under the ultrasound guidance. Ropivacaine 0.2% 9 ml will be injected. |
| Lumbar Plexus Nerve Block | Active comparator | Procedure: Continuous Lumbar Plexus Block, Drug: Ropivacine 0.2%, Drug: Bupivacaine 0.0625%Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn. No sham/placebo parasacral (sciatic) blocks will be performed in this group. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Subject has signed and dated an Informed Consent Form.
- Subject is classified as a ASA (American Society of Anesthesiologists) status I-III
- Subject is age 18- 75 years old.
- Subject is having primary total hip arthroplasty
- No contraindication to peripheral nerve catheter ( local infection or hypocoagulable state)
Key exclusion criteria (7 listed)
- Subject inability to provide adequate informed consent.
- Age younger than 18 years or older than 75 years
- Any contraindication to the placement of lumbar plexus catheter, including local infection, hypocoagulable state.
- ASA (American Society of Anesthesiologists) physical status of IV or greater
- Any chronic painful conditions
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Continuous Lumbar Plexus BlockLumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn. | Procedure or surgery | Continuous Lumbar Plexus Block with Parasacral Nerve Block, Lumbar Plexus Nerve Block |
| Parasacral Nerve BlockAlso: Sciatic Nerve BlockA single shot parasacral (sciatic) nerve block will then be place under the ultrasound guidance. Ropivacaine 0.2% 9 ml will be injected. | Procedure or surgery | Continuous Lumbar Plexus Block with Parasacral Nerve Block |
| Ropivacine 0.2%Lumbar plexus nerve block placement and activation: After subcutaneous infiltration of local anesthetic, 20 mL of Ropivacaine 0.2% will be injected; the catheter will be introduced for 5 cm past the needle tip and secured with steri strips and tegaderm. | Drug | Continuous Lumbar Plexus Block with Parasacral Nerve Block, Lumbar Plexus Nerve Block |
| Bupivacaine 0.0625%In PACU, the catheter will be connected to a pump of 0.0625% bupivacaine at 5 - 10 mL per hour at the discretion of the Acute Interventional Perioperative Pain Service (AIPPS). Additional 5mL boluses of 0.0625% bupivacaine will be given on demand once per hour prn. | Drug | Continuous Lumbar Plexus Block with Parasacral Nerve Block, Lumbar Plexus Nerve Block |
Primary outcome
Numeric Rating Scale (NRS) Pain Assessment
Time frame: 6 hours after the start of surgery
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
Numeric Rating Scale (NRS) Pain Assessment
Time frame: 24 hours after the start of surgery
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
Numeric Rating Scale (NRS) Pain Assessment
Time frame: 48 hours after the start of surgery
Postoperative pain assessments using a 11-point numerical rating during physical therapy and at rest. This pain scale ranges from 0, being no pain at all, up to 10 being the worst pain ever experience.
5 secondary outcomes
Number of Rescue Boluses Administered by Nurse (IV Dilaudid) Post Operatively
Time frame: 48 hours after the start of the surgery
Amount of Oxycodone for the First 48 h Post Operatively
Time frame: 48 hours after the start of the surgery
Total Dilaudid or Opiate Equivalent Consumed (mg) Over 48 Hours Post Operatively
Time frame: 48 hours after the start of the surgery
Number of Nerve Block Boluses (Bupivacaine) Administered by the Nurse Post Operatively
Time frame: 48 hours after the start of the surgery
Total Amount of Local Anesthetic in 48 Hours Post Operatively
Time frame: 48 hours after the start of the surgery
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Mar 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 19448235Ben-Ari AY, Joshi R, Uskova A, Chelly JE. Ultrasound localization of the sacral plexus using a parasacral approach. Anesth Analg. 2009 Jun;108(6):1977-80. doi: 10.1213/ane.0b013e3181a04d8e.
- Background: PubMed 12419722Ho AM, Karmakar MK. Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis. Can J Anaesth. 2002 Nov;49(9):946-50. doi: 10.1007/BF03016880.
- Background: PubMed 9168212Morris GF, Lang SA, Dust WN, Van der Wal M. The parasacral sciatic nerve block. Reg Anesth. 1997 May-Jun;22(3):223-8. doi: 10.1016/s1098-7339(06)80005-2.
- Background: PubMed 17513661Wiegel M, Gottschaldt U, Hennebach R, Hirschberg T, Reske A. Complications and adverse effects associated with continuous peripheral nerve blocks in orthopedic patients. Anesth Analg. 2007 Jun;104(6):1578-82, table of contents. doi: 10.1213/01.ane.0000261260.69083.f3.
- Background: PubMed 21467563Ilfeld BM, Mariano ER, Madison SJ, Loland VJ, Sandhu NS, Suresh PJ, Bishop ML, Kim TE, Donohue MC, Kulidjian AA, Ball ST. Continuous femoral versus posterior lumbar plexus nerve blocks for analgesia after hip arthroplasty: a randomized, controlled study. Anesth Analg. 2011 Oct;113(4):897-903. doi: 10.1213/ANE.0b013e318212495b. Epub 2011 Apr 5.
- Background: PubMed 19122076Marino J, Russo J, Kenny M, Herenstein R, Livote E, Chelly JE. Continuous lumbar plexus block for postoperative pain control after total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. 2009 Jan;91(1):29-37. doi: 10.2106/JBJS.H.00079.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Rita Merman, MD principal investigator
UPMC Presbyterian Shadyside
Jacques E. Chelly, MD, PhD, MBA study chair
UPMC Presbyterian Shadyside
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Continuous Lumbar Plexus Block, Parasacral Nerve Block and Ropivacine 0.2% in people with Osteoarthritis of Hip and Regional Anesthesia, run by Rita Merman at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 29 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Mar 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Rating Scale (NRS) Pain Assessment (time frame: 6 hours after the start of surgery). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02161484, which also lists 6 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Mar 2018.