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Radius FracturesPhase 4ADRIBNCT02630290

Addition of Dexmedetomidine to Ropivacaine-induced Supraclavicular Block (ADRIB Trial)

A Phase 4 study testing Ropivacaine and Ropivacaine + Dexmedetomidine in people with Radius Fractures and Ulna Fractures, run by Guangzhou First People's Hospital at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Dexmedetomidine, an alpha 2-adrenoreceptor agonist, has been found to exerts an excellent influences on the filed of perineural block. It could shorten the onset time and prolong the duration of the nerve block and improved postoperative pain. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Radius Fractures, Ulna Fractures, Hand Injuries
What is being tested?
Ropivacaine and Ropivacaine + Dexmedetomidine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteChina
Study dates
Dec 2015to Jun 2016
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Surgery: elective forearm and hand surgery under ultrasound-guided supraclavicular brachial plexus block
  • American Society of Anesthesiologist(ASA) physical status of Ⅰ to III
  • Age between 18 to 60 years old

Who cannot join

  • Having an ongoing another clinical trials
  • Taking antihypertensive drugs such as methyldopa, clonidine and other α2 receptor agonist
  • Peripheral neuropathy
  • Cerebrovascular disease
  • Psychiatric disease
  • Coagulopathies
Show all 11Show fewer
  • Pregnant women
  • Liver and kidney dysfunction
  • Heart failure
  • Known allergy or hypersensitive reaction to dexmedetomidine or anesthetic
  • Patient refusal

Trial locations and contacts

1 site in 1 country.

China1 site
  • Guangzhou First Municipal People's Hospital

    Guangzhou, Guangdong, 020

Other trials in China

About this study

Official title: Addition of Dexmedetomidine to Ropivacaine-induced Supraclavicular Plexus Block, a Randomized Controlled Study

Dexmedetomidine, an alpha 2-adrenoreceptor agonist, has been found to exerts an excellent influences on the filed of perineural block. It could shorten the onset time and prolong the duration of the nerve block and improved postoperative pain. However, Dexmedetomidine-induced bradycardia or hypotension has recently attracted considerable attention because of potentially grave consequences, including sinus arrest and refractory cardiogenic shock. A low dose may help minimize cardiovascular risks associated with dexmedetomidine. However, few studies have addressed the clinical effects of low-dose dexmedetomidine as an perineural adjuvant. The present study was designed to test the hypothesis that low-dose dexmedetomidine added to ropivacaine would safely enhance the duration of analgesia without adverse effects when compared with ropivacaine alone. Investigators will conduct a single-center, prospective, randomized, triple-blind, controlled trial in patients undergoing elective forearm and hand surgery under ultrasound-guided supraclavicular brachial plexus block using either ropivacaine or ropivacaine plus low-dose dexmedetomidine. The primary outcome is self-reported duration of analgesia . Secondary outcomes include onset time and duration of motor and sensory block, total postoperative analgesics, and safety assessment (adverse effects and postoperative abnormal sensation).

Read the detailed description

Dexmedetomidine, an alpha 2-adrenoreceptor agonist, has been found to exerts an excellent influences on the filed of perineural block. It could shorten the onset time and prolong the duration of the nerve block and improved postoperative pain. However, Dexmedetomidine-induced bradycardia or hypotension has recently attracted considerable attention because of potentially grave consequences, including sinus arrest and refractory cardiogenic shock. Although meta-analysis showed that perineural dexmedetomidine as a local anaesthetic adjuvant for neuraxial and peripheral nerve blocks produced reversible bradycardia in only 7% of brachial plexus block patients and no effect on the incidence of hypotension, various clinical studies reported a significant decrease in heart rate. A low dose may help minimize cardiovascular risks associated with dexmedetomidine. However, few studies have addressed the clinical effects of low-dose dexmedetomidine as an perineural adjuvant. The present study was designed to test the hypothesis that low-dose dexmedetomidine, which till today has not been reported in the literature, added to ropivacaine for brachial plexus block would safely enhance the duration of analgesia without adverse effects when compared with ropivacaine alone. Investigators will conduct a single-center, prospective, randomized, triple-blind, controlled trial in patients undergoing elective forearm and hand surgery under ultrasound-guided supraclavicular brachial plexus block using either 20 mL of 0.5% ropivacaine or 0.5% ropivacaine plus 30 microg dexmedetomidine. The primary outcome is self-reported duration of analgesia . Secondary outcomes include onset time and duration of motor and sensory block, total postoperative analgesics, and safety assessment (adverse effects including cardiovascular inhibitions and postoperative abnormal sensation). Data will be collected and analyzed in a blinded fashion.

Being tested
Ropivacaine, Ropivacaine + Dexmedetomidine
Keywords
Brachial plexus block, Dexmedetomidine, Ropivacaine, ultrasound-guided nerve block, supraclavicular brachial plexus block
Medical subject headings
Radius Fractures, Ulna Fractures, Hand Injuries, Wrist Injuries, Forearm Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RopivacaineDrug

    Also called placebo

    Ultrasound-guided supraclavicular brachial plexus block with 0.5% ropivacaine

  • Ropivacaine + DexmedetomidineDrug

    Also called experimental

    Ultrasound-guided supraclavicular brachial plexus block with 0.5% ropivacaine plus low-dose (30 microg) dexmedetomidine

Study groups in NCT02630290
Study groupRoleWhat they receive
RopivacainePlacebo comparatorAfter a careful aspiration, 1 to 2 mL of normal saline is injected for a distribution in and around the brachial plexus. Additional needle tip repositioning and injections may be needed when the distribution is not attained. Then the study drug (0.5% ropivacaine in a total volume of 20 mL) will be injected with additional fine adjustment of the block needle under continuous ultrasound monitoring.
Receives: Drug: Ropivacaine
Ropivacaine + DexmedetomidineExperimentalAfter skin infiltration with 1-2 mL of lidocaine 2%, a 21-gauge 90-mm spinal needle will be inserted into the brachial plexus sheath using in-plane technique. After a careful aspiration, 1 to 2 mL of normal saline is injected for a distribution in and around the brachial plexus. Additional needle repositioning and injections may be needed when the distribution is not attained. Then the study drug (0.5% ropivacaine plus 30 microg dexmedetomidine in a total volume of 20 mL) will be injected with additional fine adjustment of the block needle under realtime ultrasound monitoring.
Receives: Drug: Ropivacaine + Dexmedetomidine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Duration of analgesia

    Postoperative pain using visual analog scale (VAS, 0-100, 0 = no pain, 100 = maximum imaginable pain) will be assessed. Duration of analgesia is defined by time between administration of block and the postoperative pain >3.

    Measured: up to 24 hours postoperatively

Secondary outcomes (16)
  1. Blood pressure (BP)

    Noninvasive arterial BP is measured at the non-operated arm. episode of hypotension (30% decrease in mean BP in relation to baseline values) and hypertension (30% increase in mean BP in relation to baseline values) will be recorded.

    Measured: up to 24 hours postoperatively

  2. Heart rate (HR):

    HR, bradycardia (HR < 50 beats/min), and tachycardia (HR > 100 beats/min) will be recorded at the same time as BP recording.

    Measured: up to 24 hours postoperatively

  3. Peripheral oxygen saturation (SpO2)

    SpO2 and hypoxemia (SpO2 <90%) will be recorded at the same time as BP recording.

    Measured: up to 24 hours postoperatively

  4. Sensory block of median nerve

    is defined by pinprick sensation using a 3-point scale (0-2, 0 = normal sensation, 1 = decreased pain sensation to pinprick, 2 = loss of pain sensation to pinprick) in the median nerve locations.

    Measured: up to 30 minutes after administration of block

  5. Sensory block of ulnar nerve

    Sensory block of ulnar nerve is defined by pinprick sensation using a 3-point scale (0-2, 0 = normal sensation, 1 = decreased pain sensation to pinprick, 2 = loss of pain sensation to pinprick) in the ulnar nerve locations.

    Measured: up to 30 minutes after administration of block

  6. Sensory block of radial nerve

    Sensory block of radial nerve is defined by pinprick sensation using a 3-point scale (0-2, 0 = normal sensation, 1 = decreased pain sensation to pinprick, 2 = loss of pain sensation to pinprick) in the radial nerve locations.

    Measured: up to 30 minutes after administration of block

  7. Sensory block of musculocutaneous nerve

    Sensory block of musculocutaneous nerve is defined by pinprick sensation using a 3-point scale (0-2, 0 = normal sensation, 1 = decreased pain sensation to pinprick, 2 = loss of pain sensation to pinprick) in the musculocutaneous nerve locations.

    Measured: up to 30 minutes after administration of block

  8. Motor block of median nerve

    Motor block of median nerve is defined by thumb and fifth finger pinch.

    Measured: up to 30 minutes after administration of block

  9. Motor block of ulnar nerve

    Motor block of ulnar nerve is defined thumb and second finger pinch.

    Measured: up to 30 minutes after administration of block

  10. Motor block of radial nerve

    Motor block of radial nerve is defined by finger abduction.

    Measured: up to 30 minutes after administration of block

  11. Motor block of musculocutaneous nerve

    Motor block of musculocutaneous nerve is defined by flexion of the elbow.

    Measured: up to 30 minutes after administration of block

  12. Duration of motor block

    Duration of motor block is defined as the time interval between the administration of the block and the recovery of complete motor function of the hand and forearm assessed.

    Measured: up to 24 hours postoperatively

  13. Success rate of nerve block

    A successful block is defined as surgery without patient discomfort and the need for supplementation of local infiltration or general anesthesia

    Measured: 30 minutes after administration of block

  14. Postoperative analgesic requirement

    IV tramadol 50mg will be administered when postoperative pain >3, and be titrated up by 50 mg increments as needed for pain every 4 to 6 hours, with the maximum total dose of 250mg.

    Measured: up to 24 hours postoperatively

  15. Postoperative nausea and vomiting (PONV)

    The incidence of PONV will be recorded using a 4-point objective score (1 = no PONV;2 = mild nausea, no vomiting; 3 = excessive nausea or vomiting;4 = vomiting ≥2 times).

    Measured: up to 24 hours postoperatively

  16. Abnormal sensation of brachial plexus

    Patient's self-reported abnormal sensation of the hand and forearm.

    Measured: Day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Dec 2015 (estimated)
  2. Study startDec 2015
  3. Primary completionJun 2016
  4. Study completionJun 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02630290
Sponsor's protocol ID
GZZD-2015008
Acronym
ADRIB
Status last verified
Aug 2016
First submitted
3 Dec 2015
Last updated
12 Aug 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided

Publications

  • Wu HH, Wang HT, Jin JJ, Cui GB, Zhou KC, Chen Y, Chen GZ, Dong YL, Wang W. Does dexmedetomidine as a neuraxial adjuvant facilitate better anesthesia and analgesia? A systematic review and meta-analysis. PLoS One. 2014 Mar 26;9(3):e93114. doi: 10.1371/journal.pone.0093114. eCollection 2014.

    PubMed 24671181
  • Marhofer D, Kettner SC, Marhofer P, Pils S, Weber M, Zeitlinger M. Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study. Br J Anaesth. 2013 Mar;110(3):438-42. doi: 10.1093/bja/aes400. Epub 2012 Nov 15.

    PubMed 23161360
  • Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth. 2013 Jun;110(6):915-25. doi: 10.1093/bja/aet066. Epub 2013 Apr 15.

    PubMed 23587874
  • Esmaoglu A, Yegenoglu F, Akin A, Turk CY. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block. Anesth Analg. 2010 Dec;111(6):1548-51. doi: 10.1213/ANE.0b013e3181fa3095. Epub 2010 Oct 1.

    PubMed 20889939
  • Liu W, Guo J, Zheng J, Zheng B, Ruan X; Addition of Dexmedetomidine to Ropivacaine-Induced supraclavicular Block (ADRIB) investigator. Low-dose dexmedetomidine as a perineural adjuvant for postoperative analgesia: a randomized controlled trial. BMC Anesthesiol. 2022 Aug 5;22(1):249. doi: 10.1186/s12871-022-01791-6.

    PubMed 35931989

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ropivacaine and Ropivacaine + Dexmedetomidine in people with Radius Fractures and Ulna Fractures, run by Guangzhou First People's Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Aug 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Duration of analgesia (time frame: up to 24 hours postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02630290, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2016; AzTrials last refreshed its copy on 8 Nov 2026.

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