Retrospective Analysis of Pain After Nerve Block in Surgical Patients

Knee Osteoarthritis Clinical Trial

Official title:

Retrospective Analysis of Pain in Patients Who Receive a Nerve Block for Surgery

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06042322
• Other study ID #: 2023P000514
• Status: Active, not recruiting
• Start date: January 1, 2017
• Est. completion date: July 31, 2024

Study information

• Verified date: January 2024
• Source: Brigham and Women's Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This is a retrospective study looking at patients who received a nerve block for surgery and assessing pain after the nerve block resolves, with or without an educational intervention, over two periods of time.

Description:

Regional anesthesia (RA) is a vital tool that can serve as the primary anesthetic or as part of a multimodal perioperative pain regimen. RA is strongly associated with decreased acute and persistent pain and opioid consumption postoperatively. However, some patients experience an acute worsening of pain into the severe range around the time of RA resolution, also known as "rebound pain" (RP). The incidence of RP has been reported as high as 40-50% after a single shot nerve block for patients undergoing ambulatory surgery. This retrospective study aims to look at patients who received a nerve block for surgery and assessing pain after the nerve block resolves in the presence and absence of certain interventions, such as a multidisciplinary educational intervention. The investigators will assess patients who received a primary total knee arthroplasty who received a single shot adductor canal nerve block, received pericapsular injection by the surgeon, and had a length of stay > 16 hours.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 166
• Est. completion date: July 31, 2024
• Est. primary completion date: July 31, 2024
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• primary total knee arthroplasty
• received an adductor canal nerve block
• received pericapsular injection by surgeon intraoperatively
• admitted for overnight stay and > 16 hours post-nerve block

Exclusion Criteria:

• age < 18
• prior total knee arthroplasty on ipsilateral knee

Related Conditions & MeSH terms

• Acute Pain
• Knee Osteoarthritis
• Regional Anesthesia Morbidity

Intervention

Other:
• Educational intervention
Multidisciplinary educational intervention was performed by orthopedic, anesthesia, and nursing team. This included a discussion of the patient's pain plan and a patient visit.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Brigham and Women's Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Difference in maximum pain score, 0-10; (0 = no pain, 10 = worst pain)	Difference in maximum pain score, numerical pain rating scale 0-10, 6-24 hours after nerve block between the two cohorts	6-24 hours
Secondary	Average pain score 0-10; (0 = no pain, 10 = worst pain)	Difference in area under the curve of pain scores, numerical pain rating scale 0-10, 6-24 hours after nerve block between the two cohorts (educational intervention and non-educational intervention time periods)	6-24 hours
Secondary	Difference in incidence of rebound pain	Difference in incidence pain score = 7 between 6-24 hours post nerve block between the two cohorts	6-24 hours
Secondary	Comparison of evening opioids given	Comparison of if evening opioids were or were not given (yes/no) between the two cohorts	6-24 hours
Secondary	Difference in total opioids given	Difference in total opioids given (mEq of morphine) between the two cohorts	6-24 hours
Secondary	Difference in length of stay	Difference in length of stay (days) between the two cohorts	0-2 years