The Impact of Local Anesthetic Dilution on Possible Blinding for Nerve Blocks

Summary

This study aims to determine the appropriate dosage of a placebo anesthetic to enable future placebo-controlled studies that can more accurately examine the effects of nerve blocks. The main challenge in conducting such studies is the difficulty in blinding participants and researchers due to the noticeable effects of nerve blocks, such as numbness and motor impairments. The goal is to find a placebo solution that can: * Mimic the sensations of a real nerve block * Not provide actual pain relief * Allow for effective blinding in future studies By developing an appropriate placebo, researchers hope to: * Enable more rigorous investigations into the efficacy of nerve blocks for pain management * Conduct comprehensive placebo-controlled studies, which are currently lacking in the field * Overcome the obstacle of ensuring successful blinding in nerve block research This study is focused to establish a methodology for creating a convincing placebo that can be used in future research to more accurately assess the true effects of nerve blocks in pain medicine.

Timeline

Start

2024-12-11

Primary completion

2025-10-31

Completion

2025-10-31

Publications

• Background Curatolo M, Petersen-Felix S, Arendt-Nielsen L. Sensory assessment of regional analgesia in humans: a review of methods and applications. Anesthesiology. 2000 Dec;93(6):1517-30. doi: 10.1097/00000542-200012000-00025. No abstract available.
• Background Sveticic G, Gentilini A, Eichenberger U, Zanderigo E, Sartori V, Luginbuhl M, Curatolo M. Combinations of bupivacaine, fentanyl, and clonidine for lumbar epidural postoperative analgesia: a novel optimization procedure. Anesthesiology. 2004 Dec;101(6):1381-93. doi: 10.1097/00000542-200412000-00019.
• Background Curatolo M, Kaufmann R, Petersen-Felix S, Arendt-Nielsen L, Scaramozzino P, Zbinden AM. Block of pinprick and cold sensation poorly correlate with relief of postoperative pain during epidural analgesia. Clin J Pain. 1999 Mar;15(1):6-12. doi: 10.1097/00002508-199903000-00003.
• Background Vadhanan P, Tripaty DK, Adinarayanan S. Physiological and pharmacologic aspects of peripheral nerve blocks. J Anaesthesiol Clin Pharmacol. 2015 Jul-Sep;31(3):384-93. doi: 10.4103/0970-9185.161679.
• Background Curatolo M, Schnider TW, Petersen-Felix S, Weiss S, Signer C, Scaramozzino P, Zbinden AM. A direct search procedure to optimize combinations of epidural bupivacaine, fentanyl, and clonidine for postoperative analgesia. Anesthesiology. 2000 Feb;92(2):325-37. doi: 10.1097/00000542-200002000-00012.
• Background Inan LE, Inan N, Karadas O, Gul HL, Erdemoglu AK, Turkel Y, Akyol A. Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study. Acta Neurol Scand. 2015 Oct;132(4):270-7. doi: 10.1111/ane.12393. Epub 2015 Mar 13.
• Background Dahan TH, Fortin L, Pelletier M, Petit M, Vadeboncoeur R, Suissa S. Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol. 2000 Jun;27(6):1464-9.
• Background Adey-Wakeling Z, Crotty M, Shanahan EM. Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial. Stroke. 2013 Nov;44(11):3136-41. doi: 10.1161/STROKEAHA.113.002471. Epub 2013 Aug 22.
• Background Lord SM, Barnsley L, Bogduk N. The utility of comparative local anesthetic blocks versus placebo-controlled blocks for the diagnosis of cervical zygapophysial joint pain. Clin J Pain. 1995 Sep;11(3):208-13. doi: 10.1097/00002508-199509000-00008.
• Background Engel A, MacVicar J, Bogduk N. A philosophical foundation for diagnostic blocks, with criteria for their validation. Pain Med. 2014 Jun;15(6):998-1006. doi: 10.1111/pme.12436. Epub 2014 Apr 9.

Drugs

Indications

No indication recorded.