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Effect of DrugNCT04729842

Comparison Between Bupivacaine and Ropivacaine in Patients Undergoing Forearm Surgeries Under Brachial Plexus Block

A study testing Axillary Brachial plexus block in people with Effect of Drug, run by Assam Medical College.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This prospective comparative randomized study was done to compare Bupivacaine and Ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block. The study compares the onset and duration of sensory block, onset and duration of motor block and duration of analgesia between these two drugs. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Effect of Drug
What is being tested?
Axillary Brachial plexus block
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
No sites listed yet
Study dates
1 Jul 2016to 1 Jun 2017
Phase
Interventional
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 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Patients with ASA classes I and II who gave consent and were candidates for elective forearm surgeries.

Who cannot join

  • Any allergic reactions to ropivacaine, bupivacaine and lignocaine.
  • All patients with hypertension, cardiac, hepatic or renal diseases.
  • Pregnant women, drug abusers and psychiatric patients.
  • Patient who had an anatomical or vascular abnormality in the upper extremity.
  • Bleeding diathesis.
  • Local infection of the axilla.
  • Patient refusal.

About this study

Official title: Comparison Between Bupivacaine and Ropivacaine in Patients Undergoing Forearm Surgeries Under Axillary Brachial Plexus Block: A Prospective Comparative Randomized Study

This prospective comparative randomized study was done to compare Bupivacaine and Ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block. The study compares the onset and duration of sensory block, onset and duration of motor block and duration of analgesia between these two drugs.

Read the detailed description

This is a prospective comparative randomized study to compare Bupivacaine and Ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block. A sample size of 100 was considered who are meeting the inclusion and exclusion criteria were selected, and divided into two groups of 50 each using computer-generated randomization and allocation concealment was done using sealed sequentially numbered containers opaque envelope technique (SNOSE). One group will receive Bupivacaine and the other Ropivacaine. Patients were blind to the study. In the Bupivacaine group, 30 ml of 0.5% bupivacaine was injected equally divided and injected in four nerves (musculocutaneous, median, radial and ulnar nerves). In the Ropivacaine group, 30 ml of a solution containing 0.5% ropivacaine was equally divided and injected in the four nerves. Sensory block was tested with a 22-gauge hypodermic needle by using the pinprick test and compared with the contralateral hand. Sensory block was graded as Grade 0: Sharp pin felt, Grade 1: Analgesia, dull sensation felt and Grade 2: Anaesthesia, no sensation felt. Motor function was assessed as per the modified Bromage scale. 0: Able to raise the extended arm to 90 degrees for a full 2 sec, 1: Able to flex the elbow and move the fingers but unable to raise the extended arm, 2: Unable to flex the elbow but able to move the fingers and 3: Unable to move the arm, elbow or fingers. The onset of sensory blockade was assessed by the time from the completion of injection of the study drug till the loss of pinprick sensation. It was assessed every minute. The onset of motor blockade was assessed when there was Grade 1 motor blockade. It was assessed every minute. Duration of sensory blockade was assessed by the time between onset of sensory blockade and return of dull sensation to pinprick. .It was assessed every 15 minutes. Duration of motor blockade was assessed by the time between onset of motor blockade and time at which patients could first move their fingers. It was assessed every 15minutes. Duration of analgesia is the time interval between the onset of sensory block and the patient's first analgesic request. The rescue analgesia in the form of inj. Diclofenac sodium (1.5 mg/kg) intramuscularly was given. Block was considered to have failed when sensory anaesthesia was not achieved within 30 min. General anaesthesia was given subsequently to these patients and was excluded from the study. Again, a patient showing an allergic reaction to the intervention were also withdrawn from the study.

Statistical Analysis - Normally distributed quantitative data were presented as mean ± SD, whereas data not normally distributed were presented as median (IQR). While comparing quantitative data between the two groups, for normally distributed quantitative data, Independent student t-test was used, on the other hand, Mann-Whitney test was used. For comparing qualitative variable chi-square or Fischer exact test was applied as appropriate. In case of repeated measure data, mixed effect ANOVA was used. For all test P value of < 0.05 was considered as significant and P-value < 0.001 was considered as highly significant. SPSS version 21 (IBM, Newyork) was used for data analysis.

Conditions
Effect of Drug
Being tested
Axillary Brachial plexus block

What participants receive

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

  • Axillary Brachial plexus blockProcedure or surgery

    Also called Brachial plexus block for forearm surgeries

    Brachial plexus block via axillary route was administered using 30 ml of 0.5% Bupivacaine in group B and 30 ml of 0.5% Ropivacaine in Group R

Study groups in NCT04729842
Study groupRoleWhat they receive
Group - B , Patients who recieved BupivacaineActive comparator30 ml of 0.5% bupivacaine was injected equally divided and injected in four nerves (musculocutaneous, median, radial and ulnar nerves)
Receives: Procedure: Axillary Brachial plexus block
Group - R , Patients who received RopivacaineActive comparator30 ml of a solution containing 0.5% ropivacaine was equally divided and injected in the four nerves (musculocutaneous, median, radial and ulnar nerves)
Receives: Procedure: Axillary Brachial plexus block

What is being measured

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

  1. Onset of sensory block

    Sensory block was tested with a 22-gauge hypodermic needle by using the pinprick test and compared with the contra-lateral hand. Sensory block was graded as Grade 0: Sharp pin felt, Grade 1: Analgesia, dull sensation felt and Grade 2: Anaesthesia, no sensation felt.

    Measured: Time in minutes from the completion of injection of the study drug till the loss of pinprick sensation. The estimated time frame from injection of study drug to onset of sensory block is 15 minutes.

  2. Duration of sensory block

    Duration was assessed from loss of pinprick sensation to return of sensation.

    Measured: Time in minutes between onset of sensory blockade and return of dull sensation to pin prick. The estimated time frame for duration of sensory block is 540 minutes.

Secondary outcomes (3)
  1. Onset of motor block

    Motor function was assessed as per modified Bromage Scale . 0: Able to raise the extended arm to 90o for a full 2 sec, 1: Able to flex the elbow and move the fingers but unable to raise the extended arm, 2: Unable to flex the elbow but able to move the fingers and 3: Unable to move the arm, elbow or fingers .

    Measured: Time from the completion of injection of the study drug till the patient is unable to move his fingers. The estimated time frame for onset of motor block is 20 minutes.

  2. Duration of motor block

    Duration was assessed from loss of motor function till the return of the function.

    Measured: Time in minutes between onset of motor blockade and time at which patient could first move their fingers. The estimated time frame for duration of motor block is 480 minutes.

  3. Duration of analgesia

    Duration was assessed from the onset of loss of sensory function till the patient feels pain. The rescue analgesia in the form of inj. Diclofenac sodium (1.5 mg/kg) intramuscularly was given.

    Measured: Time in minutes between onset of sensory block and patient's first analgesic request. Time frame for duration of analgesia is 600 minutes

Timeline

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

  1. First posted29 Jan 2021
  2. Study start1 Jul 2016
  3. Primary completion1 Jun 2017
  4. Study completion1 Jun 2017

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
a prospective randomized single-blind study. Patients were blind to the study of drugs. Blinding was achieved by the examiner of the study. Participants were randomly allocated into two groups (Group - B i.e. Bupivacaine Group and Group - R i.e. Ropivacaine group) using computer-generated randomization and allocation concealment was done using sealed sequentially numbered containers opaque envelope technique (SNOSE)
Masking
Single blind
Who is masked
Participant
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04729842
Sponsor's protocol ID
AssamMC
Status last verified
Feb 2021
First submitted
21 Jan 2021
Last updated
10 Feb 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Brennan F, Lohman D, Gwyther L. Access to Pain Management as a Human Right. Am J Public Health. 2019 Jan;109(1):61-65. doi: 10.2105/AJPH.2018.304743.

    PubMed 32941757
  • Neal JM, Gerancher JC, Hebl JR, Ilfeld BM, McCartney CJ, Franco CD, Hogan QH. Upper extremity regional anesthesia: essentials of our current understanding, 2008. Reg Anesth Pain Med. 2009 Mar-Apr;34(2):134-70. doi: 10.1097/AAP.0b013e31819624eb.

    PubMed 19282714
  • Armstrong KP, Cherry RA. Brachial plexus anesthesia compared to general anesthesia when a block room is available. Can J Anaesth. 2004 Jan;51(1):41-4. doi: 10.1007/BF03018545.

    PubMed 14709459
  • Clarkson CW, Hondeghem LM. Mechanism for bupivacaine depression of cardiac conduction: fast block of sodium channels during the action potential with slow recovery from block during diastole. Anesthesiology. 1985 Apr;62(4):396-405.

    PubMed 2580463
  • Hickey R, Hoffman J, Ramamurthy S. A comparison of ropivacaine 0.5% and bupivacaine 0.5% for brachial plexus block. Anesthesiology. 1991 Apr;74(4):639-42. doi: 10.1097/00000542-199104000-00002.

    PubMed 2008942
  • De Andres J, Sala-Blanch X. Peripheral nerve stimulation in the practice of brachial plexus anesthesia: a review. Reg Anesth Pain Med. 2001 Sep-Oct;26(5):478-83. doi: 10.1053/rapm.2001.26485. No abstract available.

    PubMed 11561271
  • Schulz KF, Grimes DA. Allocation concealment in randomised trials: defending against deciphering. Lancet. 2002 Feb 16;359(9306):614-8. doi: 10.1016/S0140-6736(02)07750-4.

    PubMed 11867132
  • Cline E, Franz D, Polley RD, Maye J, Burkard J, Pellegrini J. Analgesia and effectiveness of levobupivacaine compared with ropivacaine in patients undergoing an axillary brachial plexus block. AANA J. 2004 Oct;72(5):339-45.

    PubMed 15529729
  • Thornton KL, Sacks MD, Hall R, Bingham R. Comparison of 0.2% ropivacaine and 0.25% bupivacaine for axillary brachial plexus blocks in paediatric hand surgery. Paediatr Anaesth. 2003 Jun;13(5):409-12. doi: 10.1046/j.1460-9592.2003.01065.x.

    PubMed 12791114
  • Kooloth RA, Patel SN, Mehta MK. A comparison of 0.5% Ropivacaine and 0.5% Bupivacaine in supraclavicular brachial plexus block -. National Journal of Medical Research. 2015;5(1):67-70.

  • Kaur A, Singh RB, Tripathi RK, Choubey S. Comparision between bupivacaine and ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block: a prospective randomized study. J Clin Diagn Res. 2015 Jan;9(1):UC01-6. doi: 10.7860/JCDR/2015/10556.5446. Epub 2015 Jan 1.

    PubMed 25738062
  • Rathod H, Parikh H, Upadhayaya RM. Comparative study of 0.375% bupivacaine and 0.375% ropivacaine in brachial plexus block via supraclavicular approach. Int Jour of Biomed Res. 2015 Feb 28;6(2):77-82.

  • Modak S, Basantwani S. Comparative study of 0.5% ropivacaine and 0.5% bupivacaine for brachial plexus block by supraclavicular approach for upper limb surgeries. International Journal of Basic & Clinical Pharmacology. 2017 Jan 5;5(4):1205-9.

Questions about this trial

What is this clinical trial studying?

A study testing Axillary Brachial plexus block in people with Effect of Drug, run by Assam Medical College.

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 1 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: finished, as of the sponsor's last update on 10 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Onset of sensory block (time frame: Time in minutes from the completion of injection of the study drug till the loss of pinprick sensation. The estimated time frame from injection of study drug to onset of sensory block is 15 minutes.). The study lists 2 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 NCT04729842, which also lists 13 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 10 Feb 2021.

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