Comparing Ultrasound-Guided Transgluteal Nerve Block to Standard Care

N/ANot Yet RecruitingNCT07397117

University of California, San Francisco100 enrolled

Overview

The goal of this clinical trial is to compare transgluteal sciatic nerve block to standard of care to treat sciatic back pain in adult patients who present to the emergency department. The main question it aims to answer is: Is a transgluteal sciatic nerve block better than standard of care in improving pain in ER patients with sciatic back pain? If there is a comparison group: Researchers will compare patients who receive transgluteal sciatic nerve blocks to patients who receive standard of care to see if pain scores improve in ER patients with sciatic back pain. Participants will be randomized into the transgluteal sciatic nerve block group or the control group (standard of care). Participants will be asked to answer questions about their pain and will be asked to walk a timed short distance.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

100

Conditions

Sciatica Acute

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged 18 years and older * Presentation to ED with: * Acute or acute-on-chronic pain consistent with sciatica, defined as unilateral lumbosacral radicular pain radiating from the lower back or gluteal region to the posterior leg, may extend distal to the knee. * Pain score ≥ 5/10 on Numeric Rating Scale (NRS) Exclusion Criteria: * Known allergy to study medications (e.g., local anesthetics) * Coagulopathy or current anticoagulation therapy * Suspected or confirmed spinal infection, or tumor * Neurological deficits (bowel or bladder dysfunction, leg weakness) * Inability to provide informed consent

Outcomes

Primary Outcomes

Pain scores

Patients in each group will be asked their pain score 30 minutes after their received intervention and at time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours). Patients will then be contacted 24 and 48 hours after intervention to ask their pain score

Time frame: 30 minutes after intervention, time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours), 24 hours after ED visit, 48 hours after ED visit

Secondary Outcomes

Ambulatory status

Before ED disposition, patients will be asked to perform another timed up and go (TUG) test. A patient rises from a chair, walks at a normal pace to a line (3 meters total), turns, walks back, and sits down. Patients will then be contacted 24 and 48 hours after intervention to ask about how their ambulatory status is.

Time frame: Before ED disposition, 24 and 48 hours after ED visit

ED Bouncback

A chart review will be performed after 30 days to assess bounce-back rate

Time frame: 30 days after ED visit