Peripheral Sensory Input in Central Post Stroke Pain (CPSP)

Washington University School of Medicine8 enrolled

Overview

Prospective, open-label study in 10 patients with Central Post Stroke Pain (CPSP). The study will evaluate the effects of peripheral nerve blockade on spontaneous pain and evoked thermal and mechanical responses in CPSP, and assesses the associated local anesthetic pharmacokinetics.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Central Post Stroke Pain

Interventions

Ultrasound-guided peripheral nerve block with 2% lidocaineDRUG

Patients will have a peripheral nerve blockade with a local anesthetic (lidocaine) Assessment of spontaneous and evoked pain responses Completion of NPSI questionnaire Mapping of the affected limb

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Each subject must meet all of the following criteria: * Age ≥18; * CPSP affecting an upper or a lower limb, in a distribution that may be completely covered by a peripheral nerve block; * Patient fulfills all mandatory criteria for CPSP, fulfills at least one supportive criteria, and has definite CPSP by probability grading. * Pain duration at least 3 months; * Spontaneous pain intensity (average pain in past week) of ≥ 4 on 0-10 Numerical Rating Scale (NRS). Exclusion Criteria Subjects will not be enrolled if any of the following criteria exist: * Not giving consent to participate in the study; * Significant psychiatric or cognitive impairment; * Moderate to severe renal or liver failure; * Concomitant treatment with warfarin or other anticoagulants; * Pregnancy or lactation.

Locations (1)

Washington University School of Medicine

St Louis, Missouri, United States

Outcomes

Primary Outcomes

Reduction in Spontaneous Pain Intensity After a Peripheral Nerve Block.

Reduction in spontaneous pain intensity in the painful extremity from baseline to 30 minutes after a peripheral nerve block.Spontaneous pain intensity was measured on 0-10 numerical rating scale (NRS), where 0 represents "no pain", and 10 represents "worst pain imaginable"

Time frame: baseline and 30 minutes

Secondary Outcomes

Change in the Intensity of Cold Sensation

The intensity of cold sensation (application of roller cooled down to 20 degrees Celsius) was measured on 0-10 scale, where 5 represents "normal" sensation (comparable to contralateral non-painful extremity). Higher scores indicate increased sensitivity (10= painful cold); lower scores represent reduced sensitivity (0=no cold sensation)

Time frame: baseline and 30 min

Change in the Intensity of Warm Sensation

The intensity of warm sensation (application of roller heated up to 40 degrees Celsius) was measured on 0-10 scale, where 5 represents "normal" sensation (comparable to contralateral non-painful extremity). Higher scores indicate increased sensitivity (10= painful hot); lower scores represent reduced sensitivity (0=no warmth sensation)

Time frame: baseline and 30 min

Change in the Intensity of Pinprick Sensation

The intensity of pinprick sensation (application of Semmes-Weinstein monofilament #6.1, \~100g target force) was measured on 0-10 scale, where 5 represents "normal" sensation (comparable to contralateral non-painful extremity). Higher scores indicate increased sensitivity (10= painful sharp); lower scores represent reduced sensitivity (0=no pricking sensation)

Time frame: baseline and 30 min

Change in the Intensity of Brush Sensation

The intensity of brush sensation (application of SENSELab Brush-05) was measured on 0-10 scale, where 5 represents "normal" sensation (comparable to contralateral non-painful extremity). Higher scores indicate increased sensitivity (10= painful brushing sensation); lower scores represent reduced sensitivity (0=no brushing sensation)

Data from ClinicalTrials.gov

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