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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03970655
Other study ID # IRB201900782
Secondary ID OCR21462
Status Recruiting
Phase Phase 1/Phase 2
First received
Last updated
Start date September 25, 2019
Est. completion date December 15, 2026

Study information

Verified date May 2024
Source University of Florida
Contact Cameron R Smith, MD
Phone 352-273-8651
Email csmith@anest.ufl.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The aim of this study is to evaluate the effect of the addition of epinephrine to bilateral real time ultrasound guided pterygopalatine ganglion blocks on intra-operative bleeding and blood loss during functional endoscopic sinus surgery (FESS).


Description:

FESS is the treatment of choice in patients with medically refractory chronic rhinosinusitis and chronic polypous rhinosinusitis. This surgery relies on minimal surgical site bleeding to be performed efficiently and safely. Hemorrhage during FESS decreases visibility of the surgical field and this increases the risk of vascular, orbital and intracranial complications as well as procedural failure. Thus the importance of minimizing surgical bleeding in this procedure. The maxillary artery is the primary blood supply for the sinuses and midface. Conceptually the application of epinephrine into the pterygopalatine fossa onto the maxillary artery with the block should result in constriction of this artery and subsequently, less bleeding from the surgical site. This randomized, double-blinded, controlled pilot study will investigate the utility of addition of epinephrine to bilateral pterygopalatine ganglion blocks performed under ultrasound guidance in minimizing surgical site bleeding and overall blood loss and the potential for shortening the surgical time.


Recruitment information / eligibility

Status Recruiting
Enrollment 80
Est. completion date December 15, 2026
Est. primary completion date December 15, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years to 90 Years
Eligibility Inclusion Criteria: 1. Patient presenting for bilateral FESS 2. Adult patients (>18 and < 90 years old) 3. Patient consents to participate 4. No underlying chronic pain condition 5. No underlying bleeding diathesis Exclusion Criteria: 1. Patient refuses to consent 2. Patient requires revision or unilateral surgery 3. Patient requires surgery in addition to FESS 4. Age younger than 18 or older than 90 years 5. Any underlying chronic pain condition 6. History of bleeding diathesis 7. Presence of any other factor which, at the discretion of any member of the study team, makes the patient a poor candidate for block placement. 8. Presence of any other factor which, at the discretion of any member of the study team, makes the patient a poor candidate for research participation. 9. Vulnerable patient population

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bupivacaine or Ropivacaine with epinephrine plus dexamethasone - Group 1
Group 1 will receive 4 ml of 0.5% Bupivacaine or Ropivacaine with epinephrine in the LEFT pterygopalatine fossa
Bupivacaine or Ropivacaine with epinephrine plus dexamethasone - Group 2
Group 2 will receive 4 ml of 0.5% Bupivacaine or Ropivacaine with epinephrine in the RIGHT pterygopalatine fossa

Locations

Country Name City State
United States UF Health of University of Florida Gainesville Florida

Sponsors (1)

Lead Sponsor Collaborator
University of Florida

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Endoscopic Grading of Nasal Bleeding Endoscopic Grading of Nasal Bleeding will be calculated using the 0-5 point Boezaart surgical field grading scale; 0 being no bleeding and 5 being severe bleeding. Every 10 minutes up to 36 hours
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