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PainNCT05555147

The Effect of Bilateral Infraorbital and Infratrochlear Nerve Block on Perioperative Period of Hypophysectomy

A study testing nerve block with 0.5% ropivacaine and without any nerve block in people with Pain and Nerve Block, run by Tongji Hospital at 1 site in China.

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 The sponsor has not verified this record for over two years, so it may be out of date.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 endoscopic binostril transnasal transsphenoidal resection of pituitary procedures often cause intense pain which is difficult to suppress at the depth of conventional general anesthesia, resulting in severe hemodynamic fluctuations in patients. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Pain, Nerve Block
What is being tested?
nerve block with 0.5% ropivacaine and without any nerve block
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 siteChina
Study dates
1 Sep 2022to 28 Sep 2023
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. Elective endoscopic binostril transnasal transsphenoidal resection
  • 2. Patients aged between 18 and 65.
  • 3. American Society of Anesthesiologists (ASA) physical status I, Ⅱ and III

Who cannot join

  • 1. Emergency operation.
  • 2. Patients allergic to ropivacaine.
  • 3. Infection nearby the puncture point.
  • 4. Patients with preoperative usage of sedative and analgesic drugs with history of alcohol abuse.
  • 5. Patient with renal insufficiency or hepatic failure.
  • 6. Patients who have undergone craniotomy in the recent 6 months.
  • 7. Pregnant or lactating women, being participating in other studies.
  • 8. Patients unable to cooperate.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Tongji Hospital

    Wuhan, Hubei, 430030

Other trials in China

About this study

Official title: The Effect of Bilateral Infraorbital and Infratrochlear Nerve Block on Perioperative Analgesia After Endoscopic Binostril Transnasal Transsphenoidal Resection of Pituitary: a Prospective, Randomized Study

The endoscopic binostril transnasal transsphenoidal resection of pituitary procedures often cause intense pain which is difficult to suppress at the depth of conventional general anesthesia, resulting in severe hemodynamic fluctuations in patients. Infraorbital and infratrochlear nerve block can block the pain signal caused by the endoscopic binostril transnasal transsphenoidal resection of pituitary theoretically, which has been proven to provide satisfactory analgesia after septorhinoplasty. However, whether bilateral infraorbital and infratrochlear nerve block can provide stable hemodynamics and reduce the hemodynamic fluctuation the patients undergoing endoscopic binostril transnasal transsphenoidal resection of pituitary remains unclear.

Read the detailed description

Surgical stimulation is one of the important factors leading to hemodynamic fluctuation and affecting postoperative recovery quality. The endoscopic binostril transnasal transsphenoidal resection of pituitary procedures often cause intense pain because of there were numerous nerve endings at the surgical site which is originated from branches of the trigeminal nerve (including infraorbital and infratrochlear nerve). It's difficult to suppress intraoperative stimulation at the depth of conventional general anesthesia, resulting in severe hemodynamic fluctuations in patients. It's reported that pterygomaxillary fossa block can inhibit hypertension caused by surgical procedures, however the block may cause complications because of its complicated operations. Infraorbital and infratrochlear nerve block can block the pain signal caused by the endoscopic binostril transnasal transsphenoidal resection of pituitary theoretically, which has been proven to provide satisfactory analgesia after septorhinoplasty. However, whether bilateral infraorbital and infratrochlear nerve block can reduce the pain in the patients undergoing endoscopic binostril transnasal transsphenoidal resection of pituitary remains unclear. Therefore, the investigators propose the hypothesis that preoperative bilateral infraorbital and infratrochlear nerve block could effectively reduce the pain in patients undergoing endoscopic binostril transnasal transsphenoidal resection of pituitary. The objective of this study is to observe the heart rate and blood pressure at a specific point in time during the operation and pain at 2, 8, 24, 48 hours postoperatively between adult patients receiving or not receiving bilateral infraorbital and infratrochlear nerve block.

Conditions
Pain, Nerve Block
Being tested
nerve block with 0.5% ropivacaine, without any nerve block
Medical subject headings
Pain

What participants receive

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

  • nerve block with 0.5% ropivacaineDrug

    After general anesthesia, the patients will receive bilateral infraorbital and infratrochlear nerve block 30 minutes prior to surgery. Infraorbital nerve block is performed while using an extraoral approach. A 25-gauge needle was inserted laterally to the ipsilateral nostril after palpating the infraorbital ridge to locate the infraorbital foramen. The index finger of the non-dominant hand was positioned above the infraorbital foramen, and the needle was advanced until it was felt beneath the finger. 2 ml of the 0.5% ropivacaine slowly injected after negative aspiration of blood was confirmed. Inserting the needle 1 cm above the inner canthus, targeting the junction of the orbit and the nasal bone, performed infratrochlear nerve block. After negative aspiration of blood, 1 ml of the 0.5% ropivacaine was injected. Contralateral nerve block was performed in the same manner.

  • without any nerve blockOther

    Also called nerve block with 0.5% ropivacaine

    Patients receiving general anesthesia without Infraorbital and Infratrochlear nerve block.

Study groups in NCT05555147
Study groupRoleWhat they receive
Nerve Block GroupExperimentalThirty minutes prior to surgery the patients received bilateral infraorbital and infratrochlear nerve block. Infraorbital nerve block was performed while using an extraoral approach. A 25 gauge needle was inserted laterally to the ipsilateral nostril after palpating the infraorbital ridge to locate the infraorbital foramen. The index finger of the non-dominant hand was positioned above the infraorbital foramen, and the needle was advanced until it was felt beneath the finger. 2 mL of the 0.5% ropivacaine slowly injected after negative aspiration of blood was confirmed. Inserting the needle 1 cm above the inner canthus, targeting the junction of the orbit and the nasal bone, performed Infratrochlear nerve block. After negative aspiration of blood, 1 mL of the 0.5% ropivacaine was injected. Contralateral nerve block was performed in the same manner.
Receives: Drug: nerve block with 0.5% ropivacaine
Control GroupSham comparatorPatients receiving general anesthesia without Infraorbital and Infratrochlear nerve block.
Receives: Other: without any nerve block

What is being measured

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

  1. mean arterial pressure (MAP) before nerve block

    mean arterial pressure (MAP) before nerve block

    Measured: before nerve block

  2. heat rate (HR) before nerve block

    heat rate (HR) before nerve block

    Measured: before nerve block

  3. MAP within 10 minutes after nerve block

    MAP within 10 minutes after nerve block

    Measured: within 10 minutes after nerve block

  4. HR within 10 minutes after nerve block

    HR within 10 minutes after nerve block

    Measured: within 10 minutes after nerve block

  5. MAP before nasal mucosal dissection

    MAP before nasal mucosal dissection

    Measured: before nasal mucosal dissection

  6. HR before nasal mucosal dissection

    HR before nasal mucosal dissection

    Measured: before nasal mucosal dissection

  7. MAP immediately after nasal mucosal dissection

    MAP immediately after nasal mucosal dissection

    Measured: immediately after nasal mucosal dissection

  8. HR immediately after nasal mucosal dissection

    HR immediately after nasal mucosal dissection

    Measured: immediately after nasal mucosal dissection

  9. MAP before septum resection

    MAP before septum resection

    Measured: before septum resection

  10. HR before septum resection

    HR before septum resection

    Measured: before septum resection

  11. MAP immediately after septum resection

    MAP immediately after septum resection

    Measured: immediately after septum resection

  12. HR immediately after septum resection

    HR immediately after septum resection

    Measured: immediately after septum resection

  13. MAP before sella bone resection

    MAP before sella bone resection

    Measured: before sella bone resection

  14. HR before sella bone resection

    HR before sella bone resection

    Measured: before sella bone resection

  15. MAP after sella bone resection

    MAP after sella bone resection

    Measured: before sella bone resection

  16. HR immediately after sella bone resection

    HR immediately after sella bone resection

    Measured: immediately after sella bone resection

  17. MAP before dural incision of sella

    MAP before dural incision of sella

    Measured: before dural incision of sella

  18. HR before dural incision of sella

    HR before dural incision of sella

    Measured: before dural incision of sella

  19. MAP immediately after dural incision of sella

    MAP immediately after dural incision of sella

    Measured: immediately after dural incision of sella

  20. HR immediately after dural incision of sella

    HR immediately after dural incision of sella

    Measured: immediately after dural incision of sella

  21. MAP before exploration of pituitary fossa

    MAP before exploration of pituitary fossa

    Measured: before exploration of pituitary fossa

  22. HR before exploration of pituitary fossa

    HR before exploration of pituitary fossa

    Measured: before exploration of pituitary fossa

  23. MAP immediately after exploration of pituitary fossa

    MAP immediately after exploration of pituitary fossa

    Measured: immediately after exploration of pituitary fossa

  24. HR immediately after exploration of pituitary fossa

    HR immediately after exploration of pituitary fossa

    Measured: immediately after exploration of pituitary fossa

Secondary outcomes (9)
  1. numerical rating scale (NRS) score when patient enters post-anaesthesia care unit (PACU) (immediately after surgery)

    numerical rating scale (NRS) score when patient enters PACU (immediately after surgery). The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: when patient enters PACU (immediately after surgery)

  2. numerical rating scale (NRS) score before patient leaves PACU

    numerical rating scale (NRS) score before patient leaves PACU. The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: before patient leaves PACU

  3. NRS 2 hours after surgery

    NRS 2 hours after surgery. The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: 2 hours after surgery

  4. NRS 8 hours after surgery

    NRS 8 hours after surgery. The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: 8 hours after surgery

  5. NRS 24 hours after surgery

    NRS 24 hours after surgery. The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: 24 hours after surgery

  6. NRS 48 hours after surgery

    NRS 48 hours after surgery. The participants subjectively determine the patient's pain scores using a 0 to 10 NRS (0 = no pain; 10 = unbearable pain), to evaluate the efficacy of the modified method.

    Measured: 48 hours after surgery

  7. quality of recovery Scale: Quality of Recovery-15 (QoR-15) 1 day after surgery

    quality of recovery Scale (QoR-15): QoR-15 1 day after surgery. QoR-15 contains the five aspects (physiological comfort, physiological independence, psychological support, emotion and pain), which can evaluate postoperative recovery quality.

    Measured: 1 day after surgery

  8. quality of recovery Scale: QoR-15 3 days after surgery

    quality of recovery Scale: QoR-15 3 days after surgery. QoR-15 contains the five aspects (physiological comfort, physiological independence, psychological support, emotion and pain), which can evaluate postoperative recovery quality.

    Measured: 3 days after surgery

  9. quality of recovery Scale: QoR-15 7 days after surgery

    quality of recovery Scale: QoR-15 7 days after surgery. QoR-15 contains the five aspects (physiological comfort, physiological independence, psychological support, emotion and pain), which can evaluate postoperative recovery quality.

    Measured: 7 days after surgery

Timeline

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

  1. First posted26 Sep 2022
  2. Study start1 Sep 2022
  3. Primary completion28 Sep 2023 (estimated)
  4. Study completion28 Sep 2023 (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 N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Thirty minutes prior to surgery the patients received bilateral infraorbital and infratrochlear nerve block. The patient's head was positioned on a central line in the supine position. A 25 gauge needle was inserted laterally to the ipsilateral nostril after palpating the infraorbital ridge to locate the infraorbital foramen. The index finger of the non-dominant hand was positioned above the infraorbital foramen, and the needle was advanced until it was felt beneath the finger . 2 mL of the study solution was slowly injected after negative aspiration of blood was confirmed. Inserting the needle 1 cm above the inner canthus, targeting the junction of the orbit and the nasal bone, performed Infratrochlear nerve block. After negative aspiration of blood, 1 mL of the study solution was injected. Contralateral nerve block was performed in the same manner.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05555147
Sponsor's protocol ID
TJ2012S152
Status last verified
Sep 2022
First submitted
1 Mar 2022
Last updated
26 Sep 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing nerve block with 0.5% ropivacaine and without any nerve block in people with Pain and Nerve Block, run by Tongji Hospital at 1 site in China.

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 3 inclusion and 8 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 26 Sep 2022. 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 China. 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.

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?

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?

mean arterial pressure (MAP) before nerve block (time frame: before nerve block). The study lists 24 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Sep 2022.

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