Clinical Trial: Transversalis Fascial Plane Nerve Block in Iliac Crest Bone Graft

Study Status: Recruiting
Recruit Status: Unknown status
Study Type: Interventional

Official Title: The Analgesic Efficacy of the Transversalis Fascia Plane Block in Iliac Crest Bone Graft Harvesting

Brief Summary: Hand or wrist surgery often requires the use of bony material in order to accomplish any associated reconstructive aspects required for the surgery. The iliac crest is often used as the source of bone for such surgery and harvesting from this site is performed simultaneously with the hand/wrist surgery. In terms of anesthesia, patients typically receive a supraclavicular nerve block for the hand/wrist surgery, and a general anesthestic for the bone graft, though spinal block may also be performed. This study will look at the use of a transversalis fascia plane (TFP) nerve block (ie, to numb the nerves going to the iliac crest) in combination with a general anesthetic to see if post-operative pain and opioid consumption is reduced using the TFP block.

Detailed Summary:
Sponsor: University Health Network, Toronto

Current Primary Outcome: Opioid consumption [ Time Frame: 24 hours ]

Opioid consumption in the first 24 hours following ICBG. This will be expressed in terms of milligrams doses of IV morphine. Where other opioids are used, the doses will be converted to the equivalent IV morphine dose using standard opioid dosage conversion tables.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Opioid consumption [ Time Frame: 7 days ]

    Opioid consumption (expressed as milligram doses of IV morphine) in the following phases

    • Intraoperative phase (from start of surgery to end of surgery)
    • Postoperative care unit stay (from admission to discharge)
    • First 48 hours following ICBG
  • Pain measures [ Time Frame: 48 hours ]
    • Pain scores at the ICBG site, measured using a visual analogue scale (VAS) (scale 0-10) and starting in recovery, then every 4 hrs for the next 48 hrs.
    • Pain at the primary surgical site (VAS 0-10)
    • Duration of block, defined as the time from completion of block performance to the time of onset of increased pain at the ICBG harvest site (as perceived by the patient)
  • Time of block performance [ Time Frame: 6 hours ]
    Time required to perform the TFP block (defined as the time between placement of the ultrasound probe on the patient, and withdrawal of the block needle)
  • Complications [ Time Frame: 12 months ]
    TFP block complications and adverse events (e.g. vascular puncture, intravascular local anesthetic injection and local hematoma)


Original Secondary Outcome: Same as current

Information By: University Health Network, Toronto

Dates:
Date Received: May 27, 2010
Date Started: August 2010
Date Completion: December 2012
Last Updated: April 25, 2012
Last Verified: May 2010