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Trigger-point Blockade in Persistent Pain After Open Groin Hernia Repair

Phase 3
Completed
Conditions
Chronic Pain
Inguinal Hernia
Interventions
Drug: Placebo
Registration Number
NCT02065219
Lead Sponsor
University of Copenhagen
Brief Summary

Groin hernia repair is a common procedure performed in approximately 2,000 patients per one million inhabitants. Severe chronic pain following groin hernia repair is seen in 2-5% of the patients indicating that a large number of patients each year suffer from debilitating reduction in health-related quality of life.

This study examines the effect of ultra-sound guided blocks with local anesthesia in the groin in regard to pain relief and sleep quality.

The hypothesis of the study is that a block will confer significant pain relief to patients with severe chronic pain following open groin hernia repair.

Detailed Description

This placebo-controlled, randomized, double-blind, cross-over study in subjects with severe pain after open groin hernia, examines the effect of an ultra-sound guided local anesthetic block of a trigger-point, situated near the spermatic cord at the superficial inguinal ring. In order to compare effects and distribution of the blocks in patients vs. healthy subjects, the block is tested and examined in volunteers using a similar methodology.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Patients with persistent pain (< 6 mo) after open groin hernia repair
  • Patients with maximal pain area 3 cm or less from the superficial inguinal ring
  • Patients living in the Capital Region of Denmark (Region Hovedstaden) or the Region of Zealand (Region Sjælland)
Exclusion Criteria
  • Known allergy to bupivacaine or other local anesthetics of amide-type
  • Declared incapable of making his/hers own affairs
  • Does not comprehend Danish in the written or spoken language
  • Cognitive impairment to a degree influencing the testing reliability
  • Known recurrence of the inguinal hernia
  • Other surgical procedures performed in the groin or on the external genitals
  • Neuropathy affecting the groin region caused by other conditions, e.g. post-stroke, multiple sclerosis, herniated intervertebral disc
  • Abuse of alcohol or drugs
  • Unable to cooperate with the sensory examinations

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboinjection, 10 ml 0.9% sodium chloride, once, 5 min
BupivacaineBupivacaineinjection, 25 mg, once, 5 min
Primary Outcome Measures
NameTimeMethod
Normalized summed pain intensity difference (SPID)20 min

The number of patients with normalized summed pain intensity differences (SPID) of more or equal to 50% after bupivacaine AND SPID less or equal to 25% after placebo.

Secondary Outcome Measures
NameTimeMethod
Suprathreshold heat stimulation20 min

Quantitative changes in pain ratings to suprathreshold heat stimulation after bupivacaine compared to placebo

Pressure pain thresholds20 min

Quantitative changes in pain rating to pressure algometry stimulation after bupivacaine compared to placebo

Pain questionnaire7 days

Quantitative changes in summed pain intensity differences (SPIDs) during rest, movement and during auto-palpation, assessed morning and evening after bupivacaine compared to placebo

Sleep quality7 days

Quantitative changes in sleep quality assessed each morning, after bupivacaine compared to placebo

Thermal thresholds20 min

Quantitative changes in thermal thresholds (warmth detection threshold, cool detection thresholds, heat pain threshold) after bupivacaine compared to placebo

Sensory mapping20 min

Quantitative changes in area of cool hypoesthesia assessed by a thermal roller after bupivacaine compared to placebo

Trial Locations

Locations (1)

Multidisciplinary Pain Center, Neuroscience Center, Copenhagen University Hospital, DENMARK

🇩🇰

Copenhagen, Denmark

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