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Regional AnesthesiaNEURALNCT07238933

Neurological Events and Unforeseen Risks After Locoregional-anesthesia

An observational study of Regional Anesthesia and Regional Anesthesia Block, run by Societa Italiana Anestesia Analgesia Rianimazione e Terapia Intensiva at 4 sites in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a multicenter, prospective, observational study aimed at determining the incidence of neurological and non-neurological complications following locoregional anesthesia procedures. The study will collect data on events such as nerve injury, hematoma, pneumothorax, and local anesthetic systemic toxicity. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Observational assessment after regional anesthesia
How many people
3,396 participants
Where
4 sitesItaly
Study dates
18 Feb 2026to 1 Jan 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients (≥18 years) undergoing single-shot locoregional anesthesia of the upper limb, lower limb, or fascial blocks.

Who may be able to join

  • Age ≥ 18 years.
  • Scheduled to undergo a single-shot nerve or fascial plane block.
  • Ability to provide written informed consent.

Who cannot join

  • Performance of more than one single-shot nerve or fascial plane block within the same anatomical region or sensory distribution during the same procedure.
  • Use of continuous nerve or fascial plane catheter-based anesthesia.
  • Presence of a language barrier that, in the investigator's judgment, would prevent adequate follow-up.

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Cristina Cacciagrano Clinical Reasearch Office SIAARTI contact

+39 06 4452816

ricerca@siaarti.it

Italy4 sites, 4 recruiting
  • ASST Papa Giovanni XXIII

    Bergamo, Bergamo, 24127

    Dr. Bugada, +39 06 4452816, ricerca@siaarti.it

    Not yet recruiting
  • Spedali Civili di Brescia

    Brescia, Brescia, 25123

    Dr. Torrano, +39 06 4452816, vito.torrano@asst-spedalicivili.it

    Not yet recruiting
  • Azienda Ospedale-Università Padova

    Padova, Padova, 35128

    Alessandro De Cassai Alessandro De Cassai, 049 821 1111, alessandro.decassai@unipd.it

    Recruiting
  • Irccs Humanitas Research Hospital

    Rozzano, Milan, 20089

    Dr. Tasso, +39 06 4452816, francesco.tasso@humanitas.it

    Not yet recruiting

Other trials in Italy

About this study

This is a multicenter, prospective, observational study aimed at determining the incidence of neurological and non-neurological complications following locoregional anesthesia procedures. The study will collect data on events such as nerve injury, hematoma, pneumothorax, and local anesthetic systemic toxicity.

Read the detailed description

Locoregional anesthesia is generally considered safe, but rare neurological and systemic complications have been reported. Current data on the true incidence of these complications are limited and often derived from small sample sizes or registries. The NEURAL study aims to fill this knowledge gap by prospectively collecting data on complications following single-shot nerve blocks in the upper limb, lower limb, and fascial plane. In addition to incidence, the study will investigate potential risk factors for these complications.

Being tested
Observational assessment after regional anesthesia
Keywords
Nerve Injury, Pneumothorax, Local Anesthetic Systemic, Toxicity, Upper limb block, Lower limb block, Fascial plane block
Medical subject headings
Pneumothorax

What participants receive

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

  • Observational assessment after regional anesthesiaOther

    Adult patients undergoing single-shot regional anesthesia, including:

    Upper limb blocks - interscalene, superior trunk, supraclavicular, infraclavicular (coracoid, retroclavicular, costoclavicular), suprascapular (anterior, posterior), axillary, and superficial/intermediate/deep cervical plexus blocks.

    Lower limb blocks - lumbar, sacral, fascia iliaca (supra/infrainguinal), adductor canal, PENG, femoral, femoral triangle, sciatic (anterior, transgluteal, infragluteal, popliteal), nerve to vastus medialis, genicular, IPACK, common peroneal, ankle, and pudendal blocks.

    Fascial plane blocks - rectus sheath, ilioinguinal/iliohypogastric, TAP (standard/subcostal/midaxillary), ESP, serratus anterior (deep/superficial), parasternal intercostal (superficial/deep), interpectoral, transversalis fascia, rhomboid intercostal, retrolaminar, quadratus lumborum (anterior/lateral/posterior), paravertebral, intertransverse process, and pectoserratus blocks.

Study groups in NCT07238933
Study groupRoleWhat they receive
Single group of enrolled patientsAdult patients (≥18 years) undergoing single-shot upper limb, lower limb, or fascial plane regional anesthesia. All participants meeting inclusion criteria and providing informed consent will be enrolled consecutively.
Receives: Other: Observational assessment after regional anesthesia

What is being measured

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

  1. Incidence of Composite Complications Following Single-Shot Locoregional Anesthesia

    Incidence of any major complication - including nerve injury, hematoma requiring medical intervention, pneumothorax, or local anesthetic systemic toxicity (LAST) - following single-shot locoregional anesthesia. The rate is calculated as the number of procedures with at least one complication divided by the total number of procedures performed.

    Measured: From the time of the locoregional anesthesia procedure up to 30 days post-procedure (periprocedural and early postoperative period, with follow-up at 24 hours, 48 hours, 15 days, and 30 days).

Secondary outcomes (12)
  1. Incidence of Complications in Upper Limb Nerve Blocks

    Incidence of each complication type (nerve injury, hematoma, pneumothorax, LAST) following upper limb single-shot nerve blocks. Calculated as the number of events divided by the total number of upper limb procedures

    Measured: From the procedure to 30 days post-procedure.

  2. Incidence of Complications in Fascial Plane Blocks

    Incidence of each complication type (nerve injury, hematoma, pneumothorax, LAST) following fascial plane single-shot blocks.

    Measured: From the procedure to 30 days post-procedure.

  3. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Age

    Measured in years

    Measured: Baseline

  4. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Gender

    Using a dichotomic male/female framework

    Measured: Baseline

  5. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Body Mass Index

    Calculated dividing a person's weight in kilograms by the square of their height in meters (BMI = weight ÷ height²) (kg/cm²)

    Measured: Baseline

  6. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Presence of comorbidities

    Hypertension, diabetes, and central or peripheral neuropathies each expressed dichotomically as "Yes" (present) or "No" (absent).

    Measured: Baseline

  7. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Use of anticoagulant or antiplatelet therapy

    Use of anticogulants and/or antiplatetets drugs expressed as a Yes or No

    Measured: Baseline

  8. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Use of sedative during the block procedure

    Use of any sedative agents during the block procedure reported as a Yes or No

    Measured: Periprocedural

  9. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Pain at injection

    Reported pain during the injection of local anesthetics expressed as a Yes or No

    Measured: Baseline

  10. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Ultrasound guidance

    Use of ultrasound guidance to perform the block, measured with a "Yes" or "No" variable

    Measured: Periprocedural

  11. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Local anesthetic used to perform the block

    Name, volume(ml) and dose(mg) of the local anesthetic used to perform the block

    Measured: Periprocedural

  12. (Predictor of Complications in Upper Limb, Lower Limb or Fascial Plane Blocks) Adjuvants used to perform the block

    Name, volume(ml) and dose(mcg) of the adjuvants used to perform the block

    Measured: Periprocedural

Timeline

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

  1. First posted20 Nov 2025
  2. Study start18 Feb 2026
  3. Primary completion1 Jan 2027 (estimated)
  4. Study completion1 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
3,396 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07238933
Sponsor's protocol ID
NEURAL
Acronym
NEURAL
Status last verified
Nov 2025
First submitted
2 Oct 2025
Last updated
11 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • McLeod GA, Sadler A, Hales TG. Traumatic needle damage to nerves during regional anesthesia: presentation of a novel mechanotransduction hypothesis. Reg Anesth Pain Med. 2022 Jul 25:rapm-2022-103583. doi: 10.1136/rapm-2022-103583. Online ahead of print.

    PubMed 35878962
  • Gitman M, Fettiplace MR, Weinberg GL, Neal JM, Barrington MJ. Local Anesthetic Systemic Toxicity: A Narrative Literature Review and Clinical Update on Prevention, Diagnosis, and Management. Plast Reconstr Surg. 2019 Sep;144(3):783-795. doi: 10.1097/PRS.0000000000005989.

    PubMed 31461049
  • Neal JM, Barrington MJ, Brull R, Hadzic A, Hebl JR, Horlocker TT, Huntoon MA, Kopp SL, Rathmell JP, Watson JC. The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine: Executive Summary 2015. Reg Anesth Pain Med. 2015 Sep-Oct;40(5):401-30. doi: 10.1097/AAP.0000000000000286.

    PubMed 26288034
  • El-Boghdadly K, Wolmarans M, Stengel AD, Albrecht E, Chin KJ, Elsharkawy H, Kopp S, Mariano ER, Xu JL, Adhikary S, Altiparmak B, Barrington MJ, Bloc S, Blanco R, Boretsky K, Borglum J, Breebaart M, Burckett-St Laurent D, Capdevila X, Carvalho B, Chuan A, Coppens S, Costache I, Dam M, Egeler C, Fajardo M, Gadsden J, Gautier PE, Grant SA, Hadzic A, Hebbard P, Hernandez N, Hogg R, Holtz M, Johnson RL, Karmakar MK, Kessler P, Kwofie K, Lobo C, Ludwin D, MacFarlane A, McDonnell J, McLeod G, Merjavy P, Moran E, O'Donnell BD, Parras T, Pawa A, Perlas A, Rojas Gomez MF, Sala-Blanch X, Saporito A, Sinha SK, Soffin EM, Thottungal A, Tsui BCH, Tulgar S, Turbitt L, Uppal V, van Geffen GJ, Volk T, Elkassabany NM. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of abdominal wall, paraspinal, and chest wall blocks. Reg Anesth Pain Med. 2021 Jul;46(7):571-580. doi: 10.1136/rapm-2020-102451.

    PubMed 34145070
  • El-Boghdadly K, Albrecht E, Wolmarans M, Mariano ER, Kopp S, Perlas A, Thottungal A, Gadsden J, Tulgar S, Adhikary S, Aguirre J, Agur AMR, Altiparmak B, Barrington MJ, Bedforth N, Blanco R, Bloc S, Boretsky K, Bowness J, Breebaart M, Burckett-St Laurent D, Carvalho B, Chelly JE, Chin KJ, Chuan A, Coppens S, Costache I, Dam M, Desmet M, Dhir S, Egeler C, Elsharkawy H, Bendtsen TF, Fox B, Franco CD, Gautier PE, Grant SA, Grape S, Guheen C, Harbell MW, Hebbard P, Hernandez N, Hogg RMG, Holtz M, Ihnatsenka B, Ilfeld BM, Ip VHY, Johnson RL, Kalagara H, Kessler P, Kwofie MK, Le-Wendling L, Lirk P, Lobo C, Ludwin D, Macfarlane AJR, Makris A, McCartney C, McDonnell J, McLeod GA, Memtsoudis SG, Merjavy P, Moran EML, Nader A, Neal JM, Niazi AU, Njathi-Ori C, O'Donnell BD, Oldman M, Orebaugh SL, Parras T, Pawa A, Peng P, Porter S, Pulos BP, Sala-Blanch X, Saporito A, Sauter AR, Schwenk ES, Sebastian MP, Sidhu N, Sinha SK, Soffin EM, Stimpson J, Tang R, Tsui BCH, Turbitt L, Uppal V, van Geffen GJ, Vermeylen K, Vlassakov K, Volk T, Xu JL, Elkassabany NM. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks. Reg Anesth Pain Med. 2024 Nov 4;49(11):782-792. doi: 10.1136/rapm-2023-104884.

    PubMed 38050174
  • Long B, Chavez S, Gottlieb M, Montrief T, Brady WJ. Local anesthetic systemic toxicity: A narrative review for emergency clinicians. Am J Emerg Med. 2022 Sep;59:42-48. doi: 10.1016/j.ajem.2022.06.017. Epub 2022 Jun 13.

    PubMed 35777259

Questions about this trial

What is this clinical trial studying?

An observational study of Regional Anesthesia and Regional Anesthesia Block, run by Societa Italiana Anestesia Analgesia Rianimazione e Terapia Intensiva at 4 sites in Italy.

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 3 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: looking for participants now, as of the sponsor's last update on 11 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Cristina Cacciagrano Clinical Reasearch Office SIAARTI (+39 06 4452816, ricerca@siaarti.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Composite Complications Following Single-Shot Locoregional Anesthesia (time frame: From the time of the locoregional anesthesia procedure up to 30 days post-procedure (periprocedural and early postoperative period, with follow-up at 24 hours, 48 hours, 15 days, and 30 days).). 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 NCT07238933, 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 11 Sep 2026.

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