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Evaluation of effect of sedation on diagnostic cervical facet joint nerve blocks
ISRCTN ISRCTN52746887
ClinicalTrials.gov identifier
Public title Evaluation of effect of sedation on diagnostic cervical facet joint nerve blocks
Scientific title
Acronym N/A
Serial number at source Protocol #5
Study hypothesis To demonstrate sedation has no effect on the validity of diagnostic cervical facet joint nerve blocks.
Lay summary
Ethics approval Not provided at time of registration
Study design Randomised controlled trial
Countries of recruitment United States of America
Disease/condition/study domain Chronic neck pain
Participants - inclusion criteria 1. Subjects were between 18 and 90 years of age
2. Subjects had a history of chronic, function limiting, neck pain of at least 6 months duration
3. Subjects were able to give voluntary, written informed consent to participate in the investigation
4. Subjects who, in the opinion of the investigator, are able to understand the investigation, and/or cooperate with the investigational procedures
5. Subjects who had undergone diagnostic facet joint blocks and the diagnosis of cervical facet joint pain has been confirmed previously
Participants - exclusion criteria 1. Subjects without cervical facet joint pain
2. Subjects with uncontrollable major depression or uncontrolled psychiatric disorders
3. Pregnant or lactating women
4. Subjects with multiple complaints involving multiple other problems with overlapping pain complaints
5. Subjects unable to achieve appropriate positioning and inability to understand informed consent and protocol
6. Subjects with a history of adverse reaction to either midazolam or fentanyl
Anticipated start date 02/02/2004
Anticipated end date 30/04/2004
Status of trial Completed
Patient information material
Target number of participants 180 patients, randomized into 3 groups with equal distribution.
Interventions Intravenous injection of sodium chloride solution, midazolam, or fentanyl prior to cervical facet joint nerve blocks under fluoroscopy.
Primary outcome measure(s) The administration of sedation with midazolam or fentanyl could be a confounding factor in the diagnosis of cervical facet joint pain in patients with chronic neck pain. However, if ≥80% pain relief with the ability to perform prior painful movements is used as the diagnostic standard, the effect of sedation on validity may be extremely low. In contrast, a significant number of patients may present as false-positives if ≥50% pain relief with ability to perform prior painful movements is used as the diagnostic criteria.
Secondary outcome measure(s) Prudent administration of midazolam only to patients who are not relaxed may not have significant adverse effect on the diagnostic validity of controlled comparative local anesthetic blocks. On the other hand, fentanyl could confound the diagnosis with false-positive results in a significant proportion of patients.
Sources of funding Ambulatory Surgery Center and Pain Management Center of Paducah (USA)
Trial website
Publications 2004 results in http://www.ncbi.nlm.nih.gov/pubmed/16858481
Contact name Dr  Laxmaiah  Manchikanti
  Address 2831 Lone Oak Road
  City/town Paducah, KY
  Zip/Postcode 42003
  Country United States of America
  Tel +1 270 554 8373
  Fax +1 270 554 8987
  Email drm@asipp.org
Sponsor Ambulatory Surgery Center and Pain Management Center of Paducah (USA)
  Address 2831 Lone Oak Road
  City/town Paducah, KY
  Zip/Postcode 42003
  Country United States of America
  Tel +1 270 554 8373
  Fax +1 270 554 8987
  Email drm@asipp.org
  Sponsor website: http://www.thepainmd.com
Date applied 27/09/2005
Last edited 02/10/2008
Date ISRCTN assigned 17/11/2005
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