Regional Anaesthesia in Intensive Care Unit
- Conditions
- Intensive Care Unit
- Registration Number
- NCT05131633
- Lead Sponsor
- University Hospital, Clermont-Ferrand
- Brief Summary
Pain is a major problem in Intensive Care Unit (ICU). Adequate pain management not only means decreasing the pain intensity, but also improving the functionality and allowing the early mobilization that is a prerequisite for improving recovery and decreasing the risk of complications in ICU. The complex problems involved in pain, analgesic interventions, and outcome have been emphasized in several surveys over the past decades, but apparently with only small improvements, despite the existence of several guidelines for perioperative pain management.
Regional analgesia techniques (peripheral and neuraxial nerve blocks) have the potential to decrease the physiological stress response to trauma or surgery, reducing the possibility of surgical complications and improving the outcomes. Recent studies suggested that surgical and trauma ICU patients receive opioid-hypnotics continuous infusions to prevent pain and agitation that could increase the risk of posttraumatic stress disorder and chronic neuropathic pain symptoms, and chronic opioid use. Also they may reduce the total amount of opioid analgesics necessary to achieve adequate pain control and the development of potentially dangerous side effects. The use of the regional anesthesia technique in the ICU, however, can, in part, be limited by the presence of hemodynamic instability, bleeding diathesis, and by the fear of the performing procedures potentially associated with significant side effects in heavily sedated patients.
Although regional anesthesia emerges as a new and very interesting player for pain management in ICU, today very few data exists about the use of RA (including PNB and neuraxial nerves blocks) by the practicians in ICU/stepdown units. The main objective of this study is to assess the use of RA for pain management both initiates in the operative room for surgical patients then transferred in ICU/stepdown units and performs directly by the practicians in ICU/stepdown units, in several french units.
- Detailed Description
Taken together, previous data indicate that regional anesthesia emerges as a new and very interesting player for pain management in ICU.
Because very few data exist about the use of RA (including PNB and neuraxial nerves blocks) by the practicians in ICU we, therefore, design this multicentric professional practice evaluation to :
* (1) , assess the use of RA in ICU/stepdown units but initiates by anesthesiologist in the operative room
* (2) , assess the use of RA in ICU/stepdown units directly perform by practicians in ICU
* (3) , describe the type, modalities and indications of RA performed
This study will have no effect on the management of the ICU/stepdown units patients.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
○ All medical, surgical, and trauma patients hospitalized in the participating centers and receiving RA during the one-week study period.
- Opposition to the processing of personal data
- Age <18 years old
- Absolute contraindications to the perform RA
- Previous hypersensitivity or anaphylactic reaction to local anesthetics
- Patient under a tutelage measure or placed under judicial protection
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Our primary objective is to assess the global use of RA in ICU/stepdown units During 1 week of the study . Number (prevalence) of RA performed in ICU over 1 week.
- Secondary Outcome Measures
Name Time Method Type of RA During 1 week of the study Nerves block or spinal anesthesia or epidural anesthesia
assess the use, in ICU/stepdown units patients, of RA previously initiated in the operative room by an anesthesiologist During 1 week of the study .Number of RA performed in operative room and then transferred in ICU over a week.
. Prevalence of RA performed in the operative room and then transferred in ICU over a weekIndications for RA During 1 week of the study Analgesia or anesthesia or mobilization or nursing or weaning from mechanical ventilation
Duration of catheter During 1 week of the study Duration in days
Evaluation of vital status: on ICU/stepdown units discharge Day 28 after the RA Name of local anesthetics used During 1 week of the study Name of local anesthetics used
Evaluation of analgesia During 1 week of the study Visual Analog Score for pain)
Evaluation of success or not in RA During 1 week of the study Sensitive and/or motor block
Complication of RA During 1 week of the study Type of complication
Reason for removal cathete During 1 week of the study Type of reason
Who perform RA During 1 week of the study Resident or senior and intensivist or anesthesiologist
Technical management to perform RA During 1 week of the study Use of continuous catheter (yes / no)
ICU/stepdown units length of stay Day 28 after the RA Length in days
Location of RA During 1 week of the study ICU or step-down unit or operating room
Concentration of local anesthetics used During 1 week of the study Concentration in mg/ml
Contraindication for RA During 1 week of the study Type of contraindication
Hospital length of stay Day 28 after the RA Length in days
Evaluation of vital status at day 28 Day 28 after the RA Death or alive
Ventilator-free days to day 28 Day 28 after the RA Unit : days
Trial Locations
- Locations (9)
Centre Jean-Perrin
🇫🇷Clermont-Ferrand, France
HCL Hôpital Sud
🇫🇷Lyon, France
HCL Centre des Grands Brulés
🇫🇷Lyon, France
APHP Bichat
🇫🇷Paris, France
CH
🇫🇷Saint-Grégoire, France
CHU
🇫🇷Toulouse, France
APHM la Timone
🇫🇷Marseille, France
APHM Nord
🇫🇷Marseille, France
AHPH Saint-Antoine
🇫🇷Paris, France