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Trial registered on ANZCTR
Registration number
ACTRN12620001073998p
Ethics application status
Submitted, not yet approved
Date submitted
11/07/2020
Date registered
19/10/2020
Date last updated
19/10/2020
Date data sharing statement initially provided
19/10/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Sensory innervation of the forearm detected by ultrasound-guided local anaesthetic block
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Scientific title
Distribution pattern and area of sensory overlap of the posterior antebrachial, medial antebrachial and lateral antebrachial cutaneous nerves of the forearm detected by ultrasound guided local anaesthetic nerve block in healthy volunteers.
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Secondary ID [1]
301750
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Nil
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Universal Trial Number (UTN)
U1111-1255-1752
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Sensory innervation of skin of forearm and hand
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Condition category
Condition code
Neurological
316216
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0
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Studies of the normal brain and nervous system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study is designed to precisely map the distribution pattern, area of sensory overlap and any proximal extension into the hand of the three antebrachial cutaneous nerves of the forearm. This has not been previously reported. The posterior ante-brachial cutaneous nerve (PABCN) medial ante-brachial cutaneous nerve (MABCN) and lateral ante-brachial cutaneous nerve (LABCN) will be located with ultrasound and separately blocked with local anaesthetic (lidocaine). The total cutaneous sensory block area (CSBA) for each individual nerve will be mapped.
Sensation will be tested using a Neuropen. This device is used in the screening of peripheral neuropathy.
Overlapping areas of innervation in the forearm and hand will be reported as a percentage of the total CSBA. Areas of the forearm that remain unblocked will be reported as a percentage of the total CSBA.
Sensory mapping will be done for all three nerves on separate occasions. The time to complete mapping will be less than 15 minutes.
The total duration of the study will be approximately one hour on 3 separate days. On the fourth day the study time will be less than 5 minutes. Mapping will be done by the PI.
The PI is a senior anaesthetist with 20 years experience in regional anaesthesia.
There will be no movement required of the participants for mapping.
The local anaesthetic drug lidocaine will be used to anaesthetise the nerves using a small needle introduced through the skin.
The purpose of the study is to mapping the sensory distribution of the cutaneous nerves of the forearm.
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Intervention code [1]
318047
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Other interventions
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The CSBA for each individual nerve will be mapped by testing for loss of sharp touch sensation with a peripheral neuropathy screening device (Neuropen)
The total CSBA (cm2) for each individual nerve will then be calculated from photographs of a paper transparency using the software SketchAndCalc. This software can be used to draw a perimeter around a shape to calculate an area.
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Assessment method [1]
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Timepoint [1]
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Individual nerves will be assessed on days 1, 2 and 3 post-enrolment.
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Primary outcome [2]
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Areas of sensory overlap will be determined by examining the tracings of the CSBA of individual nerves. Areas that overlap will be marked on the transparency and the software SketchAndCalc used to determine this area.
The SketchAndCalc software can be used to draw a perimeter around a shape to calculate an area.
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Assessment method [2]
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Timepoint [2]
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Individual nerves will be assessed on days 1,2 and 3 post-enrolment.
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Secondary outcome [1]
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If sensory block in the hand occurs the area will be mapped and reported according to which nerve was mapped i.e the PABCN, LABCN or MABCN
The area of sensory block in the hand will be reported as a percentage for each nerve using the software SketchAndCalc. This software can be used to draw a perimeter around a shape to calculate an area.
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Assessment method [1]
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Timepoint [1]
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Individual nerves will be assessed on Days 1, 2 and 3 post-enrolment,
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Secondary outcome [2]
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Areas that remain unblocked will be outlined on the transparency and reported as a percentage of the total CSBA for all nerves. The application SketchAndCalc will be used. This software can be used to draw a perimeter around a shape to calculate an area.
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Assessment method [2]
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Timepoint [2]
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Days 1, 2 and 3 post-enrolment,
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Eligibility
Key inclusion criteria
Healthy volunteers, male and female aged 18-65, BMI 18-35 kg/m2.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Known allergy to local anaesthetic drugs; injury, deformity or previous surgery to the right arm or cutaneous nerves of the forearm; pain or pre-exiting neurological deficit of the right arm; identifying features on the arm such as tattoos, moles, scars or birthmarks.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
not applicable
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We will be using a sample size of 12. This is consistent with prior studies which have explored cutaneous innervation and sensation in the hand and forearm. Gender, age and body mass index (BMI) of volunteers will be reported. These variables ensure that the volunteers are representative of the study population. The total cutaneous sensory block area (CSBA) for each individual nerve will be mapped.
Overlapping areas of innervation in the forearm and hand will be reported as a percentage of the total CSBA. Areas of the forearm that remain unblocked will be reported as a percentage of the total CSBA. Any failed block will be reported. The area of sensory cutaneous loss and overlap will be depicted in diagrams and photographs. Any adverse events will be documented and reported. Statistical data will be reported as median and range
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/12/2020
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Actual
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Date of last participant enrolment
Anticipated
21/12/2020
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Actual
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Date of last data collection
Anticipated
31/12/2020
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
30725
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2137 - Concord
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Concord Repatriation General Hospital
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Address [1]
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Hospital Road
Concord
NSW 2137
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Concord Repatriation General Hospital
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Address
Hospital Road
Concord
NSW 2137
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
306656
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Sydney Local Area Human Research Ethics Committee-Concord Repatriation General Hospital
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Ethics committee address [1]
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Hospital Road Concord NSW 2137
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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01/08/2020
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Approval date [1]
306395
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Ethics approval number [1]
306395
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Summary
Brief summary
The primary aim of this study is to map the sensory distribution pattern and area of sensory overlap of the posterior antebrachial, medial antebrachial and lateral antebrachial cutaneous nerves (PABCN, MABCN, LABCN) of the forearm following an ultrasound-guided local anaesthetic block. The secondary aim is to map any sensory block that occurs in the hand. Results from the study will enhance our current understanding of the variability of cutaneous sensory innervation. It may clarify why some local anaesthetic nerve blocks do not produce the expected area of cutaneous sensory anaesthesia. It will benefit pain physicians when investigating and managing the cause of symptoms of injury to the cutaneous nerves of the forearm. Forearm flaps are often used by plastic surgeons to repair soft tissue defects. Sensory deficits often occur over the skin at the donor site. The results of this study will help with sensory matching when designing forearm flaps for reconstructive surgery
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Philip John Corke
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Address
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Department of Anaesthesia and Pain Management
Concord Repatriation General Hospital
Hospital Road
Concord
NSW 2137
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Country
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Australia
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Phone
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+61 297676450
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Philip John Corke
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Address
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Department of Anaesthesia and Pain Management
Concord Repatriation General Hospital
Hospital Road
Concord
NSW 2137
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Country
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Australia
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Phone
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+61 297676450
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Philip John Corke
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Address
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Department of Anaesthesia and Pain Management
Concord Repatriation General Hospital
Hospital Road
Concord
NSW 2137
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Country
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Australia
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Phone
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+61 297676450
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Fax
103736
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
8472
Study protocol
[email protected]
380169-(Uploaded-07-08-2020-15-11-12)-Study-related document.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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