ClinicalTrials.gg
CompletedNCT03481725Updated Mar 18, 2021Results posted

Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: A Department of Defense Funded Multicenter Pilot Study

An interventional study of ACTIVE peripheral nerve stimulation with a percutaneously inserted lead and wearable stimulator (SPR Therapeutics, Cleveland, Ohio) and SHAM peripheral nerve stimulation with a percutaneously inserted lead and wearable SHAM stimulator (SPR Therapeutics, Cleveland, Ohio) in Rotator Cuff Repair, Anterior Cruciate Ligament Reconstruction and Ankle Arthrodesis or Arthroplasty, sponsored by University of California, San Diego. Completed at 6 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-03-18.

Sponsored by University of California, San Diego · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
65
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 32 studies in Hallux Valgus with a site in United States — 5 open to participants now, 7 under way, 1 of them phase 3. Hallux Valgus · United States.

Enrollment
15th of 24
65 · median 86
Started
2018
with 2 others
No phase
13 of 32
1 open now
Registered
12th of 32
by date
Lead sponsor
4 of 32
University of California, San Diego

Among the 32 studies in Hallux Valgus with a site in United States, this one is the 15th largest by enrollment of the 24 interventional ones that give a count, is one of 3 that started in 2018, is one of 13 with no phase, and was the 12th registered.

Hallux Valgus

157 studies on the registry are indexed under Hallux Valgus; 36 are open to participants now.

Browse Hallux Valgus studies →

Open to participants now

5 of the 32 studies in Hallux Valgus with a site in United States are open now. Recruiting first, the newest first:

All 5 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 21 Hallux Valgus studies recruiting now, 10 (48%) set no upper age limit and 7 (33%) stop at 75 or younger; 3 take children under 18; 4 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 32 studies in Hallux Valgus with a site in United States, or all of them as a file.
02

Study summary

Postoperative pain is usually treated with opioids that have undesirable and sometimes dangerous side effects (e.g., vomiting and respiratory depression)-and yet over 80% of patients still experience inadequate pain relief. A novel, non-pharmacologic analgesic technique-percutaneous peripheral nerve stimulation (PNS)- holds extraordinary potential to greatly reduce or obviate opioid requirements and concurrently improve analgesia following painful surgery. This technique involves inserting an insulated electric lead adjacent to a target nerve through a needle prior to surgery using ultrasound guidance. Following surgery, a tiny electric current is delivered to the nerve resulting in potent pain control without any cognitive or adverse systemic side effects whatsoever. The electrical pulse generator (stimulator) is so small it is simply affixed to the patient's skin. The leads are already cleared by the US Food and Drug Administration to treat acute (postoperative) pain for up to 60 days; and, since percutaneous PNS may be provided on an outpatient basis, the technique holds the promise of providing potent analgesia outlasting the pain of surgery-in other words, the possibility of a painless, opioid-free recovery following surgery.

The current project is a multicenter, randomized, double-masked, placebo-controlled, parallel-arm clinical pilot study to (1) determine the feasibility and optimize the protocol of a planned definitive clinical trial; and (2) estimate the treatment effect of percutaneous PNS on pain and opioid consumption following moderate-to-severely painful ambulatory surgery compared with usual and customary opioid-based analgesia. This will allow determination of the required sample size for a subsequent definitive multicenter clinical trial. Combined, the pilot study and definitive trial have a strong potential to dramatically reduce or obviate postoperative opioid requirements and their resultant negative effects on both individuals and society; while concurrently improving analgesia, increasing the ability to function in daily life, decreasing the risk of transition from acute to chronic pain, and improving quality of life.

Read the detailed description

This is a pilot or feasibility study (designated as UG3 by the Department of Defense) which will be a randomized, double-masked, placebo-controlled, parallel-arm, human subjects pilot study with two Specific Aims:

Specific Aim 1 (UG3): To determine the feasibility and optimize the protocol of the Implementation Phase (UH3) multicenter clinical trial that will compare percutaneous PNS with usual and customary opioid-based analgesia following moderate-to-severely painful ambulatory surgery.

Specific Aim 2 (UG3): To estimate the treatment effect of percutaneous PNS on pain and opioid consumption following moderate-to-severely painful ambulatory surgery compared with usual and customary opioid-based analgesia. This will allow determination of the required sample size of the definitive multicenter clinical trial of the Implementation Phase (UH3).

Anthropomorphic and demographic characteristics as well as baseline end points will be recorded/measured, including a pain score at the surgical site using the Numeric Rating Scale (NRS, 0-10), sensory deficits (measured with von Frey filaments within the cutaneous distribution of the target nerve), and muscle strength (measured with a pressure transducer).

Shoulder • Rotator cuff repair Brachial plexus trunks (lead \& interscalene nerve block)

Knee • Anterior cruciate ligament repair with a patellar autograph Femoral lead \& Adductor canal nerve block

Foot or ankle • Hallux valgus correction or Ankle arthrodesis/ arthroplasty Subgluteal sciatic lead and Popliteal sciatic nerve block

Insulated leads will be inserted prior to peripheral nerve block administration. The lead insertion sites will be cleansed with chlorhexidine gluconate and isopropyl alcohol, and a sterile, fenestrated drape applied. A portable ultrasound paired with either a linear or curved array transducer within a sterile sleeve will be used for lead insertion. The target nerve will be imaged in a transverse cross-sectional (short axis) view and a local anesthetic skin wheal raised lateral to the ultrasound transducer.

A needle and a pre-loaded, monopolar, helically-coiled, insulated lead (SPR Therapeutics, Cleveland, OH) will be inserted. Using an in-plane ultrasound approach, the needle tip will be advanced to the target nerve. The lead will be subsequently attached to an external stimulator (SPR Therapeutics). Accurate lead placement will be confirmed with subject reports of comfortable sensations over the surgical site without eliciting muscle contractions.

Stimulation parameters will be adjusted to improve stimulation coverage and comfort. Once optimum parameters have been determined, the needle will be withdrawn over the lead. The lead will be affixed to the skin with a sterile occlusive dressing. The stimulator will be set to deliver a range of currents. During their treatment, subjects can control these levels. Muscle strength will again be tested with the stimulator set for the optimal setting. The stimulator will be removed until after surgery.

Preoperatively, day of surgery. Subjects will continue to receive usual and customary local anesthetic-based analgesia. Because percutaneous PNS does not induce a sensory block and therefore does not provide anesthesia for the surgical procedure itself, we will continue to provide subjects with a preoperative single-injection local anesthetic-based peripheral nerve block (20 mL of ropivacaine 0.5% with epinephrine 1:400,000). In addition, surgeons will be permitted to infiltrate the surgical area with local anesthetic.

Treatment group assignment (randomization). Subjects will be allocated to a treatment only after confirmation of successfully-inserted electrical leads and surgical procedure initiation; and will be randomized to one of two possible treatment groups:

  1. Current delivered via the electrical lead(s) [Experimental group]
  2. No current delivered via the electrical lead(s) [Control group]

Randomization will be stratified by institution and anatomic lead location in a 1:1 ratio and in randomly chosen block sizes. Treatment group assignment will be conveyed to the enrolling sites via the same secure web-based system (RedCap) used to collect and collate all post-intervention endpoints. Stimulators are capable of programming to either (1) pass electrical current; or, (2) not pass electrical current. Importantly, these 2 modes (active and sham) are indistinguishable in appearance, and therefore investigators, subjects, and all clinical staff will be masked to treatment group assignment, with the only exception being the unmasked individual who programs the stimulator who will not have contact with the subject following randomization.

Subjects will be informed that often during postoperative active treatment with electrical current patients do not always have the sensations experienced during preoperative lead placement and once proper placement is confirmed with comfortable sensations, therapeutic levels of stimulation may be delivered sub-threshold (below the intensity required for sensation and still provide relief, which is factual/accurate). This protocol will ensure a randomized, double/triple-masked, sham/placebo-controlled trial. For the feasibility study (UG3), unmasking will occur 2 weeks following surgery to allow for protocol revisions, as necessary ("double masked" during initial data collection). In contrast, for the definitive pragmatic clinical trial (UH3) unmasking will not occur until statistical analysis for the entire investigation is complete (termed "triple masked").

Intraoperative course. The primary surgical anesthetic will be a general anesthetic, spinal anesthetic (bupivacaine) or exclusively the preoperative single-injection peripheral nerve block. Anesthetics that are also analgesics such as ketamine will not be used: the only permitted analgesic will be intravenous fentanyl, which will be minimal since all subjects will receive a single-injection peripheral nerve block immediately prior to surgery.

Postoperative course. Within the recovery room following surgery, the stimulators will be attached to the leads and activated, followed by end point assessment. Subjects who had a spinal anesthetic will have end points recorded following spinal resolution. Operating and recovery room pharmacologic analgesic requirements will be recorded.

Prior to discharge, subjects and their caretakers will be provided with verbal and written stimulator/lead instructions and the telephone and pager numbers of a local investigator available at all times. Subjects will be discharged home with their leads in situ. Subjects will be also be discharged with a prescription for an immediate-release oral opioid. Subjects will be contacted by telephone for end point collection (pain and analgesic consumption will be reported by phone on postoperative days 1, 2, 3, 4, 7, 11, and 15 as well as months 1 and 4). Lead removal will occur on postoperative day 14 (+/- 2 days) by healthcare providers. If the lead is removed following Day 14, the stimulator will be turned off on Day 14, and removed subsequently. Following study completion, the results will be mailed electronically or by the United States Postal Service to all enrolled subjects in written form using non-technical language.

Outcome measurements (end points). We have selected outcome measures that have established reliability and validity, with minimal inter-rater discordance, and are recommended for pain-related clinical trials by the World Health Organization and the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) consensus statement. Importantly, nearly all outcome measures are common data elements from the National Institute of Neurological Disorders and Stroke (NINDS). End points will be evaluated on postoperative days 0 (baseline), 1, 2, 3, 4, 7, 11, and 15 as well as months 1 and 4).

Demographic and medical history. Subjects will have demographic and anthropomorphic data collected based on NINDS case report form General Core and Demographics Modules and Guidelines, including age, sex, height, weight, educational level, employment status, marital status, and U.S. military service (e.g., none, discharged, active). In addition, the medical history based on the common data elements of the NINDS Medical, Family, Behavioral History, History of Disease/Injury Event, and Prior and Concomitant Medications Sub-Domains will be collected, and include the mechanism of original injury, medications (including analgesics), previous surgical procedures, comorbidities, existing sensory deficits of the target nerve distribution, preoperative pain levels measured on a Numeric Rating Scale for pain (including daily least, average, worst and current), and muscle strength if applicable (measured with a pressure transducer). In addition, since post-traumatic stress disorder (PTSD) may be associated with the severity of pain, at baseline we will apply the PTSD Checklist (PCL-C), a 20-item self-report measure reflecting symptoms of PTSD validated in military, Veteran, and civilian populations.

Data collection. Much of the surgical data from the day of surgery will be extracted from electronic health records to leverage data collection that occurs in health care delivery rather than requiring independent research data collection. Subject demographic, surgical and percutaneous PNS administration data will be uploaded from each enrolling center via the Internet to a secure, password-protected, encrypted central server (RedCap, Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio). All data collection following the day of enrollment (postoperative day 0)-regardless of enrolling center-will be collected by telephone from the University of California San Diego. Staff masked to treatment group assignment will perform all assessments.

UG3 Planning Phase Specific Aims. The investigation described above will accomplish the two Specific Aims of the UG3 Planning Phase:

Specific Aim 1 (UG3): To determine the feasibility and optimize the protocol of the Implementation Phase (UH3) multicenter clinical trial that will compare percutaneous PNS with usual and customary opioid-based analgesia following moderate-to-severely painful ambulatory surgery.

Specific Aim 2 (UG3): To estimate the treatment effect of percutaneous PNS on pain and opioid consumption following moderate-to-severely painful ambulatory surgery compared with usual and customary opioid-based analgesia. This will allow determination of the required sample size of the definitive multicenter clinical trial of the Implementation Phase (UH3).

** The primary end points will be cumulative opioid consumption and the mean value of the "average" daily surgical pain scores (measured with a Numeric Rating Scale) within the first 7 days following surgery (data collected Days 1, 2, 3, 4, and 7). In order to claim that percutaneous PNS is superior to usual and customary analgesia, at least one of Hypotheses 1 and 2 above must be superior while the other either superior or at least noninferior.

03

Conditions studied

  • Rotator Cuff Repair
  • Anterior Cruciate Ligament Reconstruction
  • Ankle Arthrodesis or Arthroplasty
  • Hallux Valgus Correction

Browse trials for

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. 18 years of age or older
  2. undergoing one of the following surgical procedures: rotator cuff repair, anterior cruciate ligament repair with a patellar autograph, ankle arthrodesis or arthroplasty, hallux valgus correction
  3. with a planned single-injection peripheral nerve block for postoperative analgesia

Exclusion criteria

Exclusion Criteria:

  1. chronic analgesic use including opioids (daily use within the 2 weeks prior to surgery and duration of use > 4 weeks)
  2. neuro-muscular deficit of the target nerve(s)
  3. compromised immune system based on medical history (e.g., therapies such as chemotherapy, radiation, sepsis, infection), or other conditions that places the subject at increased risk
  4. implanted spinal cord stimulator, cardiac pacemaker/defibrillator, deep brain stimulator, or other implantable neurostimulator whose stimulus current pathway may overlap
  5. history of bleeding disorder
  6. antiplatelet or anticoagulation therapies other than aspirin due to the risk of bleeding with a 20-gauge insertion needle
  7. allergy to skin-contact materials (occlusive dressings, bandages, tape etc.)
  8. incarceration
  9. pregnancy
  10. chronic pain of greater than 3 months of any severity in an anatomic location other than the surgical extremity
  11. anxiety disorder
  12. history of substance abuse
  13. inability to contact the investigators during the treatment period, and vice versa (e.g., lack of telephone access).
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
65 participants (actual)

Study arms

  • Experimental
    Peripheral Nerve Stimulation

    ACTIVE percutaneous peripheral nerve stimulation with an ultrasound-guided percutaneous lead (SPR Therapeutics, Cleveland, Ohio) and wearable stimulator (SPR Therapeutics, Cleveland, Ohio) that generates electrical current

    Device: ACTIVE peripheral nerve stimulation with a percutaneously inserted lead and wearable stimulator (SPR Therapeutics, Cleveland, Ohio)

  • Sham comparator
    Sham

    SHAM percutaneous peripheral nerve stimulation with an ultrasound-guided percutaneous lead (SPR Therapeutics, Cleveland, Ohio) and wearable stimulator (SPR Therapeutics, Cleveland, Ohio) that does NOT generate electrical current

    Device: SHAM peripheral nerve stimulation with a percutaneously inserted lead and wearable SHAM stimulator (SPR Therapeutics, Cleveland, Ohio)

Interventions

  • DeviceACTIVE peripheral nerve stimulation with a percutaneously inserted lead and wearable stimulator (SPR Therapeutics, Cleveland, Ohio)

    ACTIVE peripheral nerve stimulation with a percutaneously inserted lead and wearable stimulator (SPR Therapeutics, Cleveland, Ohio) that generates electric current for 14 days

  • DeviceSHAM peripheral nerve stimulation with a percutaneously inserted lead and wearable SHAM stimulator (SPR Therapeutics, Cleveland, Ohio)

    SHAM peripheral nerve stimulation with a percutaneously inserted lead and wearable stimulator (SPR Therapeutics, Cleveland, Ohio) that does not generate electric current for 14 days

06

What researchers measure

Primary outcomes

  1. Opioid Consumption During First Postoperative Week

    Cumulative opioid dose from days 0-7, collected on days 0, 1, 2, 3, 4, and 7 for the previous 24 hours at each time point measured in morphine equivalents

    Time frame: Postoperative days 0-7

  2. Average Pain During First Postoperative Week

    Mean value of the "average" pain scores measured using the numeric rating scale, collected on days 0, 1, 2, 3, 4, and 7 for the previous 24 hours at each time point. This is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain

    Time frame: Postoperative days 0-7

Secondary outcomes

  1. Opioid Consumption Individual Time Points

    Cumulative opioid dose of previous 24 hours (measured in morphine equivalents)

    Time frame: Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4

  2. Brief Pain Inventory, Short Form (Interference Domain)

    The Brief Pain Inventory (short form) interference domain is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0 = no interference; 10 = complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. The score is calculated by adding the responses for each individual question resulting in a possible range of 0-70 (higher = worse).

    Time frame: Postoperative days 3, and 7; as well as Months 1 and 4

  3. Average Pain at Individual Time Points

    Mean of the "average" pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

    Time frame: Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4

  4. Worst Pain at Individual Time Points

    Median of the worst pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

    Time frame: Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4

  5. Least Pain at Individual Time Points

    Least pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain. Participants were asked "what was the lowest pain within the last 24 hours measured using the 0 to 10 scale, with 0 equal to no pain and 10 equal to the worst imaginable pain"?

    Time frame: Postoperative days 3 and 7; as well as Months 1 and 4

  6. Current Pain at Individual Time Points

    Current pain scores at the time of the data-collection phone call measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

    Time frame: Postoperative days 3 and 7; as well as Months 1 and 4

  7. Defense and Veterans Pain Rating Score

    Instrument designed to assess pain level specifically for active duty military and Veteran patient populations. It is a Likert scale from 0 (no pain) to 10 (worst imaginable pain).

    Time frame: Postoperative days 3, and 7; as well as Months 1 and 4

07

Results

Posted Mar 18, 2021

Participant flow

Participant flow — Overall Study
MilestonePeripheral Nerve StimulationSham
Started3134
Completed3034
Not completed10
Withdrew: Withdrawal by subject10

Outcome measures

PrimaryOpioid Consumption During First Postoperative Week

Cumulative opioid dose from days 0-7, collected on days 0, 1, 2, 3, 4, and 7 for the previous 24 hours at each time point measured in morphine equivalents

Time frame:
Postoperative days 0-7
Reported as:
Median · mg
Opioid Consumption During First Postoperative Week
mgPeripheral Nerve StimulationSham
Opioid Consumption During First Postoperative Week5.0 (0 to 30.0)47.5 (25 to 90)
PrimaryAverage Pain During First Postoperative Week

Mean value of the "average" pain scores measured using the numeric rating scale, collected on days 0, 1, 2, 3, 4, and 7 for the previous 24 hours at each time point. This is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain

Time frame:
Postoperative days 0-7
Reported as:
Mean · score on a scale
Average Pain During First Postoperative Week
score on a scalePeripheral Nerve StimulationSham
Average Pain During First Postoperative Week1.1 ± 1.13.1 ± 1.7
SecondaryOpioid Consumption Individual Time Points

Cumulative opioid dose of previous 24 hours (measured in morphine equivalents)

Time frame:
Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4
Reported as:
Median · mg
Opioid Consumption Individual Time Points
mgPeripheral Nerve StimulationSham
Postoperative Day 10 (0 to 100)15 (0 to 20)
Postoperative Day 25 (0 to 10)20 (10 to 30)
Postoperative Day 30 (0 to 0)10 (0 to 20)
Postoperative Day 40 (0 to 0)5 (0 to 20)
Postoperative Day 70 (0 to 0)0 (0 to 10)
Postoperative Day 110 (0 to 0)0 (0 to 5)
Postoperative Day 150 (0 to 0)0 (0 to 0)
Postoperative Month 10 (0 to 0)0 (0 to 0)
Postoperative Month 40 (0 to 0)0 (0 to 0)
SecondaryBrief Pain Inventory, Short Form (Interference Domain)

The Brief Pain Inventory (short form) interference domain is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0 = no interference; 10 = complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. The score is calculated by adding the responses for each individual question resulting in a possible range of 0-70 (higher = worse).

Time frame:
Postoperative days 3, and 7; as well as Months 1 and 4
Reported as:
Mean · units on a scale
Brief Pain Inventory, Short Form (Interference Domain)
units on a scalePeripheral Nerve StimulationSham
Postoperative Day 32.6 ± 4.521.5 ± 17.9
Postoperative Day 72.5 ± 4.919.0 ± 17.0
Postoperative Month 14.0 ± 7.76.2 ± 10.4
Postoperative Month 41.6 ± 3.75.8 ± 12.3
SecondaryAverage Pain at Individual Time Points

Mean of the "average" pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

Time frame:
Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4
Reported as:
Mean · score on a scale
Average Pain at Individual Time Points
score on a scalePeripheral Nerve StimulationSham
Postoperative Day 11.8 ± 1.84.0 ± 2.6
Postoperative Day 21.3 ± 1.43.9 ± 2.1
Postoperative Day 30.9 ± 1.23.1 ± 2.3
Postoperative Day 40.7 ± 1.22.3 ± 2.0
Postoperative Day 70.6 ± 1.11.9 ± 2.1
Postoperative Day 110.3 ± 0.21.7 ± 1.4
Postoperative Day 150.9 ± 0.61.9 ± 1.6
Postoperative Month 10.5 ± 0.81.3 ± 1.8
Postoperative Month 40.3 ± 0.90.8 ± 1.7
SecondaryWorst Pain at Individual Time Points

Median of the worst pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

Time frame:
Postoperative days 1, 2, 3, 4, 7, 11, and 15; as well as Months 1 and 4
Reported as:
Median · score on a scale
Worst Pain at Individual Time Points
score on a scalePeripheral Nerve StimulationSham
Postoperative Day 14 (0 to 6)7.8 (3 to 9)
Postoperative Day 24 (2 to 6)7.5 (5 to 9)
Postoperative Day 33 (0 to 4)6 (4 to 8)
Postoperative Day 41.3 (0 to 4)4.3 (3 to 7)
Postoperative Day 71.8 (0 to 3.5)3.5 (3 to 5)
Postoperative Day 110.5 (0 to 2)3 (1 to 5)
Postoperative Day 151.0 (0 to 5)2 (0 to 4.5)
Postoperative Month 13.0 (0 to 4)2 (0 to 4)
Postoperative Month 40 (0 to 1)1.5 (0 to 3)
SecondaryLeast Pain at Individual Time Points

Least pain scores of previous 24 hours measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain. Participants were asked "what was the lowest pain within the last 24 hours measured using the 0 to 10 scale, with 0 equal to no pain and 10 equal to the worst imaginable pain"?

Time frame:
Postoperative days 3 and 7; as well as Months 1 and 4
Reported as:
Mean · score on a scale
Least Pain at Individual Time Points
score on a scalePeripheral Nerve StimulationSham
Postoperative Day 30.2 ± 0.61.4 ± 1.8
Postoperative Day 70.2 ± 0.70.7 ± 1.6
Postoperative Month 10.1 ± 0.30.5 ± 1.0
Postoperative Month 40.3 ± 0.20.4 ± 1.2
SecondaryCurrent Pain at Individual Time Points

Current pain scores at the time of the data-collection phone call measured on a 0-10 Numeric Rating Scale with 0=no pain and 10=worst imaginable pain

Time frame:
Postoperative days 3 and 7; as well as Months 1 and 4
Reported as:
Mean · score on a scale
Current Pain at Individual Time Points
score on a scalePeripheral Nerve StimulationSham
Postoperative Day 30.4 ± 0.72.3 ± 2.3
Postoperative Day 70.3 ± 0.81.5 ± 2.2
Postoperative Month 10.3 ± 0.81.0 ± 1.8
Postoperative Month 40.1 ± 0.60.4 ± 0.9
SecondaryDefense and Veterans Pain Rating Score

Instrument designed to assess pain level specifically for active duty military and Veteran patient populations. It is a Likert scale from 0 (no pain) to 10 (worst imaginable pain).

Time frame:
Postoperative days 3, and 7; as well as Months 1 and 4
Reported as:
Mean · score on a scale
Defense and Veterans Pain Rating Score
score on a scalePeripheral Nerve StimulationSham
Postoperative Day 31.4 ± 1.54.2 ± 2.3
Postoperative Day 71.1 ± 1.52.9 ± 2.5
Postoperative Month 11.3 ± 1.41.5 ± 2.0
Postoperative Month 40.6 ± 1.41.2 ± 1.7

Adverse events

Collected over 4 months following surgery. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Peripheral Nerve Stimulation0/31 (0%)0/31 (0%)2/31 (6.5%)
Sham0/34 (0%)0/34 (0%)1/34 (2.9%)
Most frequent other events
Most frequent other events
EventPeripheral Nerve StimulationSham
Lead fracture during purposeful removalMusculoskeletal and connective tissue disorders1/311/34
Adhesive reactionMusculoskeletal and connective tissue disorders1/310/34

Baseline characteristics

Age, Continuous
Age, Continuous(years)Peripheral Nerve StimulationShamTotal
Mean57 ± 1655 ± 1656 ± 16
Sex: Female, Male
Sex: Female, Male(Participants)Peripheral Nerve StimulationShamTotal
Female151732
Male161733
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Peripheral Nerve StimulationShamTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Peripheral Nerve StimulationShamTotal
United States313465
Height
Height(cm)Peripheral Nerve StimulationShamTotal
Mean172 ± 11174 ± 10173 ± 10
Weight
Weight(kg)Peripheral Nerve StimulationShamTotal
Mean80 ± 1686 ± 2083 ± 18
Body Mass Index
Body Mass Index(kg/m^2)Peripheral Nerve StimulationShamTotal
Mean27 ± 429 ± 528 ± 5
Years of education
Years of education(years)Peripheral Nerve StimulationShamTotal
Mean17 ± 316 ± 317 ± 3

6 further baseline measures are reported on the registry.

08

Study locations

6 sites
  • University California San Diego
    San Diego, California 92103, United States
  • Naval Medical Center San Diego
    San Diego, California 92134, United States
  • Walter Reed National Military Medical Center
    Bethesda, Maryland 20889, United States
  • Womack Army medical Center
    Fort Bragg, North Carolina 28310, United States
  • Cleveland Clinic
    Cleveland, Ohio 44195, United States
  • Brooke Army Medical Center
    Fort Sam Houston, Texas 78234, United States
09

References and documents

Publications

  • Ilfeld BM, Gelfand H, Dhanjal S, Hackworth R, Plunkett A, Turan A, Vijjeswarapu AM, Cohen SP, Eisenach JC, Griffith S, Hanling S, Mascha EJ, Sessler DI. Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation: A Pragmatic Effectiveness Trial of a Nonpharmacologic Alternative for the Treatment of Postoperative Pain. Pain Med. 2020 Dec 12;21(Suppl 2):S53-S61. doi: 10.1093/pm/pnaa332. PubMed 33313729 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jul 2018 to primary completion in Sep 2020, 25 months.

Results were first posted in Mar 2021, 6 months after primary completion.

Of 51 non-industry interventional studies with no phase under Hallux Valgus, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 55. This study's 25 months is close to that.

Counting every sponsor, half of 56 studies reached it within 26 months; a quarter within 11 and three quarters within 55.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 15, 2018
First posted
Mar 29, 2018
StartActual
Jul 14, 2018
Primary completionActual
Sep 11, 2020
CompletionActual
Jan 7, 2021
Results first posted
Mar 18, 2021
Last update
Mar 18, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 18, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03481725
Collaborators
Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Wake Forest University Health Sciences, Augusta University, The Cleveland Clinic, Brooke Army Medical Center, United States Naval Medical Center, San Diego, VA Palo Alto Health Care System, Womack Army Medical Center, SPR Therapeutics, Inc.
Responsible party
Brian M. Ilfeld, MD, MS (Professor of Anesthesiology, In Residence, University of California, San Diego) — Principal investigator
First posted
Mar 29, 2018
Start date
Jul 14, 2018
Primary completion
Sep 11, 2020
Completion
Jan 7, 2021
Results posted
Mar 18, 2021
Last update
Mar 18, 2021

Study contacts

Brian M Ilfeld, MD, MS
principal investigator · University California San Diego

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

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Discussion

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