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HealthyPhase 2NCT03222323

Perineural Dexmedetomidine for Ulnar Nerve Block.

A Phase 2 study testing Dexmedetomidine perineurally, Ropivacaine 5mg/ml and Ropivacaine 7.5mg/ml in people with Healthy, run by Zealand University Hospital at 1 site in Denmark.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this trial is to investigate if dexmedetomidine prolongs the duration of an ulnar nerve block. By using healthy volunteers the investigators can perform bilateral ulnar nerve blocks and thereby control for a systemic effect to clarify if the effect is actually peripheral or systemic. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
Dexmedetomidine perineurally, Ropivacaine 5mg/ml and Ropivacaine 7.5mg/ml
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
22 participants
Where
1 siteDenmark
Study dates
17 Jul 2017to 1 Apr 2018
Phase
Phase 2
Are there results?
None posted in the registry

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 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Participants must understand the protocol fully and sign the written in-formed consent.
  • ASA 1-2
  • BMI > 18 to < 30
  • For fertile women: safe contraceptives for the last month and a nega-tive urin HCG.

Who cannot join

  • Participants unable to cooperate in the trial.
  • Participants unable to speak or read Danish
  • Allergy to study medication.
  • Alcohol consumption >21 units for men and >14 for women per week
  • Daily intake of prescription painkillers within the last 4 weeks.
  • Over the counter painkillers during the last 48 hours.
Show all 11Show fewer
  • Neuromuscular defects or wounds on the arms or hands preventing test performance.
  • Diabetes Mellitus
  • 2. degree heart block
  • Sick sinus node.
  • For fertile women a positive urine HCG

Trial locations and contacts

1 site in 1 country.

Jakob H Andersen, M.D. contact

+4560610666

Jahea@regionsjaelland.dk

Ole Mathiesen, M.D. Ph.D. contact

omat@regionsjaelland.dk

Denmark1 site, 1 recruiting
  • Department of Anesthesiology Zealand University Hospital

    Køge, 4600

    Jakob H Andersen, MD, 004560610666, JAHEA@regionsjaelland.dk

    Jakob H Andersen, MD

    Recruiting

Other trials in Denmark

About this study

Official title: Does Perineural Dexmedetomidine Prolong the Duration of an Ulnar Nerve Block When Controlling for Possible Systemic Effects?

The aim of this trial is to investigate if dexmedetomidine prolongs the duration of an ulnar nerve block. By using healthy volunteers the investigators can perform bilateral ulnar nerve blocks and thereby control for a systemic effect to clarify if the effect is actually peripheral or systemic. The investigators hypothesis is that dexmedetomidine as an adjunct to a local anaesthetic prolongs the duration of a peripheral nerve block by a peripheral mechanism.

Read the detailed description

Background:

Efficient pain management promoting mobilization and convalescence is essential in an ideal perioperative course. Regional nerve blocks are a central element in postoperative regimes for many patients and it is therefore important that these nerve blocks are both long lasting and efficient. This trial will investigate whether it is possible to optimize the postoperative pain management when adding dexmedetomidine to the local anaesthetic ropivacaine in peripheral nerve blocks.

The prolonging effect of using dexmedetomidine as adjunct in peripheral nerve blocks have been investigated in several studies. However, it remains uncertain whether the effect is mediated by a systemic-, a peripheral- or a combined systemic/peripheral mechanism. In this trial the adjuvating effect of dexmedetomidine will be investigated using an ulnar nerve block.

Method:

The participants will attend two trial days.

On one trial day the volunteers will receive bilateral ulnar nerve blocks. In one arm they will receive the local anaesthetic ropivacaine 4ml 5mg/ml and placebo (saline) and in the other arm ropivacaine 4ml 5mg/ml and dexmedetomidine 100μg. The dexmedetomidine administered perineurally is absorbed and redistributed and will influence the two nerve blocks equally systemically. On the other trial day the participants will receive ropivacaine 4ml 5mg/ml and placebo (saline) and in the other arm ropivacaine 4ml 7.5mg/ml and placebo (saline). The allocation is blinded to volunteer and investigator.

In this setup we therefore have a perineural- and a systemic dexmedetomidine group and also a placebo group , and a group testing if higher doses of local anesthetics will prolong the duration of a nerve block.

The duration of the nerve block will be measured by 3 different tests: pinprick, temperature test (alcohol) and Pain during tonic heat stimulation. All tests are validated within pain research.

Conditions
Healthy
Being tested
Dexmedetomidine perineurally, Ropivacaine 5mg/ml, Ropivacaine 7.5mg/ml, Dexmedetomidine systemically, Isotonic saline
Keywords
volunteers

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dexmedetomidine perineurallyDrug

    Also called Dexdor

    Dexmedetomidine is added perineurally on one side and will influence the nerve block perineurally on this side. Dexmedetomidine is also absorbed and redistributed systemically and will influence the opposite ulnar nerve block systemically.

  • Ropivacaine 5mg/mlDrug

    Also called Naropine

    Ropivacaine is used in 5mg/ml in the perineural, systemic and placebo nerve blocks.

  • Ropivacaine 7.5mg/mlDrug

    Also called Naropine

    In the high dose ropivacaine group a ropivacaine concentration of 7.5mg/ml is used.

  • Dexmedetomidine systemicallyDrug

    Also called dexdor

    Dexmedetomidine administered perineurally on one side is absorbed and redistributed systemically and will influence the opposite ulnar nerve block systemically.

  • Isotonic salineDrug

    Also called Placebo

    placebo (saline) is administered perineurally in all but the perineural group.

Study groups in NCT03222323
Study groupRoleWhat they receive
Perineural dexmedetomidineExperimentalUlnar nerve block 4ml ropivacaine 5mg/ml + 1ml 100ug/ml dexmedetomidine perineurally
Receives: Drug: Dexmedetomidine perineurally; Drug: Ropivacaine 5mg/ml
Systemic dexmedetomidineActive comparatorUlnar nerve block 4ml ropivacaine 5mg/ml + 1ml isotonic saline (placebo) perineurally + 100ug dexmedetomidine systemically (absorbed and redistributed from the opposite ulnar nerve block)
Receives: Drug: Ropivacaine 5mg/ml; Drug: Dexmedetomidine systemically; Drug: Isotonic saline
PlaceboPlacebo comparatorUlnar nerve block 4ml ropivacaine 5mg/ml + 1ml isotonic saline (placebo) perineurally
Receives: Drug: Ropivacaine 5mg/ml; Drug: Isotonic saline
High dose RopivacaineActive comparatorUlnar nerve block 4ml ropivacaine 7.5mg/ml + 1ml isotonic saline (placebo) perineurally
Receives: Drug: Ropivacaine 7.5mg/ml; Drug: Isotonic saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference in duration of sensory nerve block assessed by mechanical discrimination (pinprick) between perineural dexmedetomidine and placebo

    Duration of sensory nerve block measured by mechanical discrimination (pinprick) defined as time from block performance (removal of the needle) until the needle feels sharp again.

    Measured: 0-36 hours

  2. Difference in duration of sensory nerve block assessed by mechanical discrimination (pinprick) between systemic dexmedetomidine and placebo

    Duration of sensory nerve block measured by mechanical discrimination (pinprick) defined as time from block performance (removal of the needle) until the needle feels sharp again.

    Measured: 0-36 hours

  3. Difference in duration of sensory nerve block assessed by mechanical discrimination (pinprick) between systemic dexmedetomidine and perineural dexmedetomidine

    Duration of sensory nerve block measured by mechanical discrimination (pinprick) defined as time from block performance (removal of the needle) until the needle feels sharp again.

    Measured: 0-36 hours

Secondary outcomes (17)
  1. Difference in duration of sensory nerve block assessed by mechanical discrimination (pinprick) between high dose ropivacaine and placebo

    Duration of sensory nerve block measured by mechanical discrimination (pinprick) defined as time from block performance (removal of the needle) until the needle feels sharp again.

    Measured: 0-36 hours

  2. Difference in duration of sensory nerve block assessed by temperature discrimination between perineural dexmedetomidine and placebo

    Duration of sensory nerve block measured by temperature discrimination defined as time from block performance (removal of the needle) until the stimulation with an alcohol swab feels cold again.

    Measured: 0-36 hours

  3. Difference in duration of sensory nerve block assessed by temperature discrimination between systemic dexmedetomidine and placebo

    Duration of sensory nerve block measured by temperature discrimination defined as time from block performance (removal of the needle) until the stimulation with an alcohol swab feels cold again.

    Measured: 0-36 hours

  4. Difference in duration of sensory nerve block assessed by temperature discrimination between systemic dexmedetomidine and perineural dexmedetomidine

    Duration of sensory nerve block measured by temperature discrimination defined as time from block performance (removal of the needle) until the stimulation with an alcohol swab feels cold again.

    Measured: 0-36 hours

  5. Difference in duration of sensory nerve block assessed by temperature discrimination between high dose ropivacaine and placebo

    Duration of sensory nerve block measured by temperature discrimination defined as time from block performance (removal of the needle) until the stimulation with an alcohol swab feels cold again.

    Measured: 0-36 hours

  6. Difference in duration of sensory nerve block assessed by pain during tonic heat stimulation between perineural dexmedetomidine and placebo

    Duration of sensory nerve block measured by pain during tonic heat stimulation defined as time from block performance (removal of the needle) until a thermode heated to 45C for 30 seconds elicits a painful response again (VAS>0)

    Measured: 0-36 hours

  7. Difference in duration of sensory nerve block assessed by pain during tonic heat stimulation between systemic dexmedetomidine and placebo

    Duration of sensory nerve block measured by pain during tonic heat stimulation defined as time from block performance (removal of the needle) until a thermode heated to 45C for 30 seconds elicits a painful response again (VAS>0)

    Measured: 0-36 hours

  8. Difference in duration of sensory nerve block assessed by pain during tonic heat stimulation between perineural dexmedetomidine and systemic dexmedetomidine

    Duration of sensory nerve block measured by pain during tonic heat stimulation defined as time from block performance (removal of the needle) until a thermode heated to 45C for 30 seconds elicits a painful response again (VAS>0)

    Measured: 0-36 hours

  9. Difference in duration of sensory nerve block assessed by pain during tonic heat stimulation between high dose ropivacaine and placebo

    Duration of sensory nerve block measured by pain during tonic heat stimulation defined as time from block performance (removal of the needle) until a thermode heated to 45C for 30 seconds elicits a painful response again (VAS>0)

    Measured: 0-36 hours

  10. Difference in duration of motor nerve block assessed by maximum voluntary isometric contraction between perineural dexmedetomidine and placebo

    Duration of motor nerve block measured by maximum voluntary isometric contraction is defined as time from block performance (removal of the needle) until fifth finger abduction maximal voluntary isometric contraction (MVIC) > 75% of baseline value, or the participant indicates return of normal motor funktion.

    Measured: 0-36 hours

  11. Difference in duration of motor nerve block assessed by maximum voluntary isometric contraction between systemic dexmedetomidine and placebo

    Duration of motor nerve block measured by maximum voluntary isometric contraction is defined as time from block performance (removal of the needle) until fifth finger abduction maximal voluntary isometric contraction (MVIC) > 75% of baseline value, or the participant indicates return of normal motor funktion.

    Measured: 0-36 hours

  12. Difference in duration of motor nerve block assessed by maximum voluntary isometric contraction between systemic dexmedetomidine and perineural dexmedetomidine

    Duration of motor nerve block meassured by maximum voluntary isometric contraction is defined as time from block performance (removal of the needle) until fifth finger abduction maximal voluntary isometric contraction (MVIC) > 75% of baseline value, or the participant indicates return of normal motor funktion.

    Measured: 0-36 hours

  13. Difference in duration of motor nerve block assessed by maximum voluntary isometric contraction between high dose ropivacaine and placebo

    Duration of motor nerve block measured by maximum voluntary isometric contraction is defined as time from block performance (removal of the needle) until fifth finger abduction maximal voluntary isometric contraction (MVIC) > 75% of baseline value, or the participant indicates return of normal motor funktion.

    Measured: 0-36 hours

  14. Difference in onset of sensory nerve block assessed by mechanical discrimination (pinprick) between perineural dexmedetomidine and placebo

    Onset of sensory nerve block assessed by mechanical discrimination (pinprick) is defined as time from block performance (removal of the needle) until the needle stops feeling sharp.

    Measured: 0-36 hours

  15. Difference in onset of sensory nerve block assessed by mechanical discrimination (pinprick) between systemic dexmedetomidine and placebo

    Onset of sensory nerve block assessed by mechanical discrimination (pinprick) is defined as time from block performance (removal of the needle) until the needle stops feeling sharp.

    Measured: 0-36 hours

  16. Difference in onset of sensory nerve block assessed by mechanical discrimination (pinprick) between perineural dexmedetomidine and systemic dexmedetomidine

    Onset of sensory nerve block assessed by mechanical discrimination (pinprick) is defined as time from block performance (removal of the needle) until the needle stops feeling sharp.

    Measured: 0-36 hours

  17. Difference in onset of sensory nerve block assessed by mechanical discrimination (pinprick) between high dose ropivacaine and placebo

    Onset of sensory nerve block assessed by mechanical discrimination (pinprick) is defined as time from block performance (removal of the needle) until the needle stops feeling sharp.

    Measured: 0-36 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jul 2017
  2. Study start17 Jul 2017
  3. Primary completion1 Jan 2018 (estimated)
  4. Study completion1 Apr 2018 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The participants will attend two trial days and receive two treatments on each trial days
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
22 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03222323
Sponsor's protocol ID
REG-158-2016
Other IDs
2016-004883-20, 2016
Status last verified
Jul 2017
First submitted
17 Jul 2017
Last updated
31 Jul 2017
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Andersen JH, Jaeger P, Grevstad U, Estrup S, Geisler A, Vilhelmsen F, Dahl JB, Laier GH, Ilfeld BM, Mathiesen O. Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. Reg Anesth Pain Med. 2019 Mar;44(3):333-340. doi: 10.1136/rapm-2018-100089. Epub 2019 Jan 23.

    PubMed 30679332

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dexmedetomidine perineurally, Ropivacaine 5mg/ml and Ropivacaine 7.5mg/ml in people with Healthy, run by Zealand University Hospital at 1 site in Denmark.

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 4 inclusion and 11 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: status not confirmed, as of the sponsor's last update on 31 Jul 2017. 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 Denmark. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Jakob H Andersen, M.D. (+4560610666, Jahea@regionsjaelland.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference in duration of sensory nerve block assessed by mechanical discrimination (pinprick) between perineural dexmedetomidine and placebo (time frame: 0-36 hours). 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 NCT03222323, which also lists 1 linked publication.

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 31 Jul 2017.

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