Chronic Pain Clinical Trial
Official title:
Intrathecal Pump Refill: Reservoir Fill Port Identification by Palpation Versus Ultrasound,a Mono-centre Prospective Comparison Study in Patients Undergoing Regular Intrathecal Pump Refill
Reservoir fill port identification by palpation versus ultrasound,a mono-centre prospective comparison study in patients undergoing regular intrathecal pump refill
Intrathecal drug therapy with implantable intrathecal pumps is being utilized increasingly
for the treatment of chronic refractory pain and spasticity. However, performing the regular
refill procedures of the pumps with the commonly performed "blind" technique caries the
potential risk of medication injection into the subcutaneous tissue, which can lead to an
overdose.
Objective: The primary purpose of this study is to assess the accuracy of the
ultrasound-guided technique for the refill procedure compared to the blind technique in
subjects undergoing regular refills of their intrathecal pumps for the treatment of chronic
non-malignant pain or spasticity.
Study design: Mono-center prospective efficacy and reliability study comparing two approaches
to enter the fill port. Study population: The investigators will include patients with an
intrathecal pump for the treatment of chronic non-malignant pain or spasticity, undergoing
regular refills of their intrathecal pumps at our Centro Terapia del Dolore at the Ospedale
Italiano a Viganello(EOC, Switzerland). Intervention: Two different experienced clinicians
will perform one time the blind technique and two times the ultrasound-guided technique on
all patients.sample size calculations can be performed. The sample size i.e. n=25 patients in
NSI-TD-001 Protocol v. 1.0 Final: August 4th, 2014 Confidential Page 31 of 40 total assessed
6 six times is therefore based on practical grounds related feasibility to duration of
inclusion (i.e. one year). This would imply 50 paired assessments for both fill port accuracy
assessment and intra-rater reliability. The investigators believe based on clinical
experience that this number would suffice to detect a difference between methods. Likewise,
although no formal power calculation are available for ICC based reliability assessment, as a
rule of thumb 50 paired assessments are usually considered adequate to evaluate intra-rater
liability.
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