An observational study in Intensive Care Unit, sponsored by University Hospital, Clermont-Ferrand. Completed at 19 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-02-17.
Sponsored by University Hospital, Clermont-Ferrand · Observational
Pain is a major problem in Intensive Care Unit (ICU). Adequate pain management not only means decreasing the pain intensity, but also improving the functionality and allowing the early mobilization that is a prerequisite for improving recovery and decreasing the risk of complications in ICU. The complex problems involved in pain, analgesic interventions, and outcome have been emphasized in several surveys over the past decades, but apparently with only small improvements, despite the existence of several guidelines for perioperative pain management.
Regional analgesia techniques (peripheral and neuraxial nerve blocks) have the potential to decrease the physiological stress response to trauma or surgery, reducing the possibility of surgical complications and improving the outcomes. Recent studies suggested that surgical and trauma ICU patients receive opioid-hypnotics continuous infusions to prevent pain and agitation that could increase the risk of posttraumatic stress disorder and chronic neuropathic pain symptoms, and chronic opioid use. Also they may reduce the total amount of opioid analgesics necessary to achieve adequate pain control and the development of potentially dangerous side effects. The use of the regional anesthesia technique in the ICU, however, can, in part, be limited by the presence of hemodynamic instability, bleeding diathesis, and by the fear of the performing procedures potentially associated with significant side effects in heavily sedated patients.
Although regional anesthesia emerges as a new and very interesting player for pain management in ICU, today very few data exists about the use of RA (including PNB and neuraxial nerves blocks) by the practicians in ICU/stepdown units. The main objective of this study is to assess the use of RA for pain management both initiates in the operative room for surgical patients then transferred in ICU/stepdown units and performs directly by the practicians in ICU/stepdown units, in several french units.
Taken together, previous data indicate that regional anesthesia emerges as a new and very interesting player for pain management in ICU.
Because very few data exist about the use of RA (including PNB and neuraxial nerves blocks) by the practicians in ICU we, therefore, design this multicentric professional practice evaluation to :
This study will have no effect on the management of the ICU/stepdown units patients.
University Hospital, Clermont-Ferrand is the lead sponsor of 841 studies on the registry; 178 are open to participants now.
Counted across the registry records on this site, refreshed daily.
All medical, surgical, and trauma patients hospitalized in the participating centers and receiving RA during the one-week study period.
○ All medical, surgical, and trauma patients hospitalized in the participating centers and receiving RA during the one-week study period.
Exclusion Criteria:
Our primary objective is to assess the global use of RA in ICU/stepdown units
. Number (prevalence) of RA performed in ICU over 1 week.
Time frame: During 1 week of the study
assess the use, in ICU/stepdown units patients, of RA previously initiated in the operative room by an anesthesiologist
.Number of RA performed in operative room and then transferred in ICU over a week. . Prevalence of RA performed in the operative room and then transferred in ICU over a week
Time frame: During 1 week of the study
Type of RA
Nerves block or spinal anesthesia or epidural anesthesia
Time frame: During 1 week of the study
Location of RA
ICU or step-down unit or operating room
Time frame: During 1 week of the study
Who perform RA
Resident or senior and intensivist or anesthesiologist
Time frame: During 1 week of the study
Name of local anesthetics used
Name of local anesthetics used
Time frame: During 1 week of the study
Concentration of local anesthetics used
Concentration in mg/ml
Time frame: During 1 week of the study
Indications for RA
Analgesia or anesthesia or mobilization or nursing or weaning from mechanical ventilation
Time frame: During 1 week of the study
Technical management to perform RA
Type of needle
Time frame: During 1 week of the study
Technical management to perform RA
Use of sonography (yes / no)
Time frame: During 1 week of the study
Technical management to perform RA
Use of electrical nerve stimulator (yes / no)
Time frame: During 1 week of the study
Technical management to perform RA
Use of continuous catheter (yes / no)
Time frame: During 1 week of the study
Evaluation of analgesia
Visual Analog Score for pain)
Time frame: During 1 week of the study
Evaluation of success or not in RA
Sensitive and/or motor block
Time frame: During 1 week of the study
Contraindication for RA
Type of contraindication
Time frame: During 1 week of the study
Complication of RA
Type of complication
Time frame: During 1 week of the study
Reason for removal cathete
Type of reason
Time frame: During 1 week of the study
Duration of catheter
Duration in days
Time frame: During 1 week of the study
ICU/stepdown units length of stay
Length in days
Time frame: Day 28 after the RA
Hospital length of stay
Length in days
Time frame: Day 28 after the RA
Evaluation of vital status: on ICU/stepdown units discharge
Time frame: Day 28 after the RA
Evaluation of vital status at day 28
Death or alive
Time frame: Day 28 after the RA
Ventilator-free days to day 28
Unit : days
Time frame: Day 28 after the RA
This study is completed, as verified in Feb 2023. You cannot join it, but the record below documents what was studied.
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University Hospital, Clermont-Ferrand