Peripheral Analgesia in Painful Diabetic Neuropathy

Neuropathic Pain Clinical Trial

— DIALOXY  

Official title:

Peripheral Analgesia in Painful Diabetic Neuropathy

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT03354806
• Other study ID #: 2016/CHU/05
• Status: Withdrawn
• Phase: N/A
• Start date: June 2018
• Est. completion date: December 2019

Study information

• Verified date: March 2019
• Source: Centre Hospitalier Universitaire de la Réunion
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Chronic obliterative arteriopathy of the inferior limbs is a frequent condition observed in diabetics. The later stages induce pain at rest and trophic disorders (ulcer, gangrene) that lead to chronic limb ischemia. Without possible surgical revascularization ,pain management and tissue healing are used to avoid amputation.

Prevalence of diabetes is twice higher in Reunion Island than in metropolitan France. As a consequence, the rate co-morbobidities, such as chronic obliterative arteriopathy of the inferior limbs, is also increases.

This study compares the efficiency of two analgesic treatments in diabetics with forefoot injuries.

Description:

Patients are allocated in two groups regarding :

• their eligibility to analgesic treatment using continuous peripheral nerve blocks

• the unability of usual pain management to reduce their pain (pain visual analogic scale equal to or more than 4).

When patient 's response to pharmacological analgesic treatment is sufficient (pain visual analogic scale equal to or less than 3), patient is allocated to the control group.

Patients of experimental group received a continous analgesic treatment for 6 weeks using ropivacaine (2mg/ml, flow rate 7 ml/h).

Patients of control group received an analgesic treatment according the recommended pain ladder of World Health Organization (WHO). Opioids for mild-to-moderate pain are used in combination with a non-opioid analgesic, such as paracetamol, at the second step of the ladder. If regular maximum doses of opioids for mild-to-moderate pain do not achieve adequate analgesia, then they should be replaced with an opioid for moderate-to-severe pain, such as morphine.

Efficiency of both treatment is assessed the improvement of oxygen level in the tissue below the skin of the injured forefoot through the study.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 2019
• Est. primary completion date: September 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Hospitalized patient

• Diabetics with chronic obliterative arteriopathy of the inferior limbs

• Permanent limb ischaemia with a TcPO2 of the front-foot of at least 10 mmHg under atmospheric conditions

• Lack of surgical revascularization

• No contraindication to hyperbaric therapy

• Signed informed consent

Exclusion Criteria:

• Contraindication to ropivacaine

• Conditions that could alter hyperbaric measurements (anemia < 8 g/dl, cardiac or respiratory insufficiency)

• patients with planned limb amputation

Related Conditions & MeSH terms

• Diabetic Foot
• Diabetic Foot Infection
• Diabetic Neuropathies
• Diabetic Neuropathy Peripheral
• Neuralgia
• Neuropathic Pain
• Peripheral Nervous System Diseases

Intervention

Procedure:
• Continuous peripheral nerve blocks
6 weeks-ropivacaine treatment delivered by continuous peripheral nerve blocks Transcutaneous oxygen measurement is assessed on day 2, week 3 and week 6 under atmospheric and hyperbaric conditions
• Analgesic treatment
6 weeks-analgesic treatment according to WHO's pain relief ladder Transcutaneous oxygen measurement is assessed on day 2, week 3 and week 6 under atmospheric and hyperbaric conditions

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier Universitaire de la Réunion

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Foot tissue oxygenation on day 2	Measurement of transcutaneous oxygen tension (TcPO2) at room conditions	on day 2
Secondary	Foot tissue oxygenation in hyperaemia-induced condition on day 2	Measurement of transcutaneous oxygen tension (TcPO2) under hyperbaric conditions	on day 2
Secondary	Foot tissue oxygenation on week 6	Measurement of transcutaneous oxygen tension (TcPO2) at room conditions	on week 6
Secondary	Foot tissue oxygenation in hyperaemia-induced condition on day 2	Measurement of transcutaneous oxygen tension (TcPO2) under hyperbaric conditions	on week 6