Duration of Peripheral Nerve Blocks in Opioid Tolerant Individuals - A Volunteer Blinded Matched Case-control Study

Launched by CHARLOTTE RUNGE · Jun 28, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how effective a type of pain relief called a peripheral nerve block is for people who regularly use opioids compared to those who do not. Peripheral nerve blocks are injections that help numb specific areas of the body to reduce pain after surgery. Researchers want to find out if these nerve blocks last as long and work as well in people who are used to taking opioids for chronic pain, compared to those who have never taken opioids.

To participate, individuals need to be over 18 years old and meet certain health criteria. For example, those in the opioid group need to have been using high doses of opioids for at least a week, while those in the control group should not have used opioids in the past month. Participants will receive the nerve block and the researchers will measure how quickly it works and how long the numbness lasts. This study will help determine if special care is needed for people who are opioid tolerant after surgery.

Gender

ALL

Eligibility criteria

• • Inclusion criteria for opioid group
• • Age \> 18 years old
• • ASA 1-3
• • Chronic pain, defined as persisting pain for more than three months
• • Daily use of more than 60 mg of morphine equivalent in more than 7 days
• • Legally competent and able to give informed consent
• • Inclusion criteria for the opioid naive control group
• • Age \> 18 years old
• • ASA 1-3
• • No use of opioids within 30 days prior to participation
• • Legally competent and able to give informed consent
• Exclusion Criteria:
• • Age \> 84 years old
• • Volunteers who cannot cooperate with the study
• • Volunteers who cannot understand or speak Danish
• • Allergy to the lidocaine or the preservatives used in the study
• • Alcohol or drug abuse other than opioids
• • Peripheral neuropathy at the upper limb non-dominant arm
• • Pathology or previous major surgery to the upper limb
• • Active signs of infection in the cutaneous area of injection
• • Pregnancy at the time of the trial
• • Partial or complete 2nd or 3rd degree atrioventricular heart block without a pacemaker
• • Severe liver disease
• • Severe kidney disease and reduced kidney function (eGFR below 30 mL/min)
• • Daily treatment with drugs that are structurally related to local analgesics or class IB antiarrhythmics, as the toxic effects are additive
• • Daily treatment with class III antiarrhythmics e.g., amiodarone.