OPTIMIZING LOCAL ANESTHETIC CONCENTRATION FOR CONTINUOUS PERIPHERAL NERVE BLOCKS

优化连续周围神经阻滞的局部麻醉浓度

• 批准号: 7605496
• 负责人: Linda T Le
• 金额: $ 0.26万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-23 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7605496
• 关键词: Absence of pain sensation; Adverse effects; Analgesics; Anesthetics; Bolus Infusion; Clinical Trials; Computer Retrieval of Information on Scientific Projects Database; Consumption; Dose; End Point; Event; Funding; Grant; Infusion procedures; Institution; Limb structure; Local Anesthetics; Masks; Nerve Block; Numbers; Numbness; Operative Surgical Procedures; Orthopedic Procedures; Pain; Patients; Peripheral Nerves; Pharmaceutical Preparations; Postoperative Period; Randomized; Rate; Research; Research Personnel; Resources; Score; Sleep disturbances; Source; Testing; United States National Institutes of Health; Upper arm; base; experience; perineural; ropivacaine; satisfaction

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The moderate-to-severe pain many patients experience following orthopedic procedures is now often being treated with a perineural local anesthetic infusion-or continuous peripheral nerve block-providing potent analgesia with very rare side effects. However, it remains unknown whether local anesthetic concentration, or simply total drug dose, is the primary determinant of analgesia and limb numbness. The result is that clinicians use both lower concentration local anesthetics at a higher rate of infusion, and higher concentration local anesthetics at a lower rate of infusion-based on their own experiences and biases rather than the results of formal studies. Consequently, patients may receive inadequate analgesia or experience a numb extremity. We therefore propose to test the null hypothesis that differing the concentration (0.2% vs. 0.4%) but providing an equal total dose of ropivacaine has no impact on the number of incident numbness events. The proposed study is a multicenter, randomized, observer-masked, controlled, parallel-arm clinical investigation involving patients receiving a perineural local anesthetic infusion for postoperative analgesia following moderate-to-severely painful surgery. Patients will be randomized to receive a local anesthetic-ropivacaine-at either 0.2% or 0.4%. However, basal infusion rate and bolus volume will be doubled in the 0.2% treatment group resulting in the same total delivered ropivacaine dose. The primary endpoint will involve extremity numbness; and secondary endpoints will include pain scores, bolus-dose use, volume of anesthetic consumption, duration of anesthetic delivery, sleep disturbances, and satisfaction with analgesia.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 骨科手术后许多患者经历的中度至重度疼痛现在通常用神经周围局部麻醉剂输注或连续外周神经阻滞来治疗，提供有效的镇痛，副作用非常罕见。 然而，局麻药浓度，或简单的总药物剂量，是否是镇痛和肢体麻木的主要决定因素，仍然是未知的。 结果是临床医生根据自己的经验和偏见而不是正式研究的结果，以较高的输注速率使用较低浓度的局部麻醉剂，以较低的输注速率使用较高浓度的局部麻醉剂。 因此，患者可能接受的镇痛不足或出现四肢麻木。 因此，我们建议检验零假设，即不同浓度（0.2% vs. 0.4%）但提供相同的罗哌卡因总剂量对麻木事件的数量没有影响。 拟定研究是一项多中心、随机、双盲、对照、平行组临床研究，涉及接受神经周围局麻药输注用于中重度疼痛手术后镇痛的患者。 患者将随机接受0.2%或0.4%的局部麻醉剂-罗哌卡因。 然而，0.2%治疗组的基础输注速率和推注体积将加倍，导致相同的罗哌卡因总输送剂量。 主要终点将涉及肢体麻木;次要终点将包括疼痛评分、推注剂量使用、麻醉剂消耗量、麻醉剂输送持续时间、睡眠障碍和镇痛满意度。