A new infusion strategy named the 'programmed intermittent bolus' (PIB) technique delivers the hourly dose within minutes compared to the traditional infusion that delivers such dose over an hour. The PIB technique has demonstrated superior patient satisfaction and reduced local anesthetic consumption when utilized for pain control during labour and delivery. However, it is not known if the PIB technique gives any benefits during a continuous nerve block in other settings. The aim of this randomized controlled trial (RCT) is to elucidate if PIB is better than (traditional) continuous infusion for postoperative analgesia in patients receiving a continuous nerve block for total shoulder arthroplasty with respect to pain control.
Local anesthetics are often given in a continuous fashion to block specific nerves after an operation for pain control. A new infusion strategy named the 'programmed intermittent bolus' (PIB) technique delivers the hourly dose within minutes compared to the traditional infusion that delivers such dose over an hour. The PIB technique has demonstrated superior patient satisfaction and reduced local anesthetic consumption when utilized for pain control during labour and delivery. However, it is not known if the PIB technique gives any benefits during a continuous nerve block in other settings. The aim of this randomized controlled trial (RCT) is to elucidate if PIB is better than (traditional) continuous infusion for postoperative analgesia in patients receiving a continuous nerve block for total shoulder arthroplasty with respect to pain control.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
110
The Smith CADD(R)-Solis Ambulatory Infusion Pump will be used to provide programmed intermittent bolus for the interscalene block.
The Smith CADD(R)-Solis Ambulatory Infusion Pump will be used to provide continuous infusion for the interscalene block.
St. Joseph's Health Care London
London, Ontario, Canada
RECRUITINGPain score on 11 point (0 - 10) numeric rating scale
Postoperative pain score
Time frame: FIrst 24 hour since the operation
Local anesthetic consumption
The total dose of local anesthetic used until the block is discontinued
Time frame: 36 hours (or until block discontinuation)
Opioid consumption
The total amount of opioids consumed will be recorded until the patient is discharged
Time frame: 48 hours (or until discharge)
Side effect
nausea, voting, pruritus
Time frame: through to patient discharge, on average 48 hours
patient satisfaction
100 mm visual analogue scale
Time frame: through to patient discharge, on average 48 hours
Block complication
persistent motor or sensory block, dyspnea, hoarseness, Horner syndrome
Time frame: through to patient discharge, on average 48 hours
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