Clinical trial NCT01094912: Procedures of Locoregional Analgesia and Quality of Life in Palliative Care Units
Official title: Procedures of Locoregional Analgesia and Quality of Life in Palliative Care
Study type: INTERVENTIONAL
Overall status: SUSPENDED
Phase: NA
Conditions: Pain
Keywords: Cancer pain
Lead sponsor: University Hospital, Limoges
Sponsor class: OTHER
First posted: 2010-03-29
Enrollment: 38
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SUPPORTIVE_CARE

Brief summary: Number of patients in mobile palliative care units have pain of both nociceptive and neuropathic origin. In certain cases, procedures of locoregional analgesia can be helpful.

The Purpose of this study is to evaluate the impact of techniques of locoregional analgesia in a palliative population

Detailed description: Cancer pain is a serious problem in the palliative population. In particular, pain due to compression or invasion of nerve tissue by metastasis is frequent and often unresponsive to oral drug therapy and even to epidural administration of opioids. In such refractory pain in a palliative setting, one modality that could be helpful is the use of technics of locoregional analgesia. Currently, they are routinely used for the management of acute postoperative pain and become to be more widely used for cancer surgery. For example, intrapleural intercostal nerve blocks after major lung resection or preincisional paravertebral blocks after breast surgery have been shown to improve pain control. However, locoregional analgesia is only occasionally used in chronic cancer pain.

The procedures used are epidural analgesia, rachianesthesia, or continuous nerve blocks. L-bupivacaine will be used. The procedure will be performed only if the injection test is positive.

The patients will be evaluated before and after the procedure, the patient being his/her own control. Evaluations will take place immediately before the procedure, then at 48 hours, 1 week and 1 month after the procedure.

Eligibility criteria: Inclusion Criteria:

* Patient ≥ 18 years-old, male or female, whatever his/her ethnic group
* Patient with untreatable cancer
* Patient hospitalized in a palliative care unit, with a life expectancy ≥ 1 week
* Pain unresponsive to conventional treatments
* Effectiveness of the injection test
* Signed informed consent

Exclusion Criteria:

* Patients \> 18 years-old
* Patients with pain other than cancer pain
* Patient's refusal
* Coagulation disorders
* Local infection
* Known hypersensitivity to local analgesics
* Inefficacy of the injection test.
* Contraindication for analgesics

Primary outcomes:
measure: Change in patients global quality of life
timeFrame: 1 week after first injection
Secondary outcomes:
measure: change in patient's global quality of life
timeFrame: 2 days and 1 week after procedure
Other outcomes:
Locations:
city: Bordeaux
country: France
facility: Centre Hospitalier Universitaire - Hôpital Saint André
city: Châteauroux
country: France
facility: Centre Hospitalier de Châteauroux
city: Guéret
country: France
facility: Centre Hospitalier de Guéret
city: Liomges
country: France
facility: CHU Limoges
city: Saint Leonard de Noblat
country: France
facility: Centre Hospitalier Local
city: Tulle
country: France
facility: Centre Hospitalier de Tulle
Study officials:
affiliation: CHU Limoges
name: Gérard TERRIER, MD
role: STUDY_CHAIR
References: