Nerve of Arnold Block for Postoperative Pain

(NOA Trial)

KS
KS
Overseen ByKarthik Swamy
Age: < 18
Sex: Any
Trial Phase: Phase 4
Sponsor: University of South Alabama
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a potential new method to manage pain for children undergoing ear tube surgery. Current treatments involve opioids, which can cause side effects like nausea and breathing problems. The study examines the use of a Nerve of Arnold block, a numbing injection near the ear, which might control pain without those side effects. Children aged 6 months to 6 years scheduled for ear tube surgery, without allergies to the study drugs, might be suitable candidates. If successful, this could provide a safer pain relief option for children after surgery. As a Phase 4 trial, this research aims to understand how this FDA-approved treatment benefits more patients, offering a safer pain relief option for children.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have recently used analgesics (pain relievers) within 24 hours, you may not be eligible to participate.

What is the safety track record for the Nerve of Arnold Block?

Research has shown that nerve blocks, such as the Nerve of Arnold block, hold promise for managing post-surgical pain. They can reduce the need for opioids, which often cause side effects like nausea and drowsiness. Studies have found that these nerve blocks effectively lower pain and opioid use after surgeries, leading to better patient outcomes.

While specific data on the Nerve of Arnold block is lacking, its use as a type of regional anesthesia suggests it could offer targeted pain relief with fewer side effects than standard opioid treatments. This makes it a potentially safer option for children undergoing ear surgeries.12345

Why are researchers enthusiastic about this study treatment?

Researchers are excited about the Nerve of Arnold Block for postoperative pain because it offers a novel approach by targeting the nerves directly with a combination of bupivacaine, epinephrine, and dexmedetomidine. Unlike traditional treatments like intramuscular fentanyl and ketorolac, which primarily provide systemic pain relief, this nerve block aims to deliver localized, targeted pain control, potentially reducing the need for systemic opioids. This could mean fewer side effects and a quicker recovery for patients, making it an exciting development in pain management.

What evidence suggests that the Nerve of Arnold block is effective for postoperative pain in children undergoing BMT placement?

Research has shown that nerve blocks, such as the Nerve of Arnold block, can manage post-surgical pain and reduce opioid use, which often leads to side effects. In this trial, participants in the nerve block group will receive a bilateral Nerve of Arnold block with bupivacaine and dexmedetomidine. These nerve blocks are particularly promising for ear surgeries, providing targeted pain relief. The technique involves injecting a local anesthetic near specific nerves to numb the area, potentially offering longer-lasting pain relief with fewer side effects. Although high-quality evidence comparing this method to standard pain management in children is limited, it offers a safe and effective way to control pain without relying on opioids. Overall, the Nerve of Arnold block could serve as a valuable alternative to traditional opioid-based pain relief methods.12367

Are You a Good Fit for This Trial?

This trial is for children aged 6 months to 6 years undergoing ear surgery (BMT placement). It's not specified who can't join, but typically those with allergies or conditions that could interfere with the study might be excluded.

Inclusion Criteria

I am between 6 months and 6 years old.
I am scheduled for ear tube surgery in both ears.
ASA physical status I-II
See 1 more

Exclusion Criteria

My procedure will be on one side only.
I am not allergic to fentanyl, ketorolac, or bupivacaine.
I have a bleeding disorder or I am on blood thinners.
See 4 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either standard care with intramuscular fentanyl and ketorolac or bilateral Nerve of Arnold block with bupivacaine

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including pain assessment and adverse event monitoring

24 hours
Continuous monitoring in PACU

Data Analysis and Manuscript Preparation

Data analysis and preparation of the study manuscript

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • Nerve of Arnold Block

Trial Overview

The trial compares a standard pain relief method using fentanyl and ketorolac injections against a regional anesthesia technique called Nerve of Arnold block. The goal is to see if the nerve block controls pain just as well without opioid side effects.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: Nerve block armExperimental Treatment4 Interventions
Group II: IM Arm standard CareActive Control3 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of South Alabama

Lead Sponsor

Trials
44
Recruited
15,800+

Citations

Comparing Intramuscular Fentanyl and Ketorolac With ...

Study Objective: This study aims to determine whether the Nerve of Arnold block is non-inferior to the standard combination of IM fentanyl and ...

Comparing Intramuscular Fentanyl and Ketorolac With Nerve ...

Study Objective: This study aims to determine whether the Nerve of Arnold block is non-inferior to the standard combination of IM fentanyl and ...

Nerve Blocks for Post-Surgical Pain Management: A Narrative ...

Nerve blocks show great promise as effective alternatives for managing post-surgical pain. They can reduce the need for opioids and their side effects.

4.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/41324711/

Comparative Efficacy of Nerve Blocks for Post-Operative ...

Methods: A systematic review was conducted to evaluate the effectiveness of different nerve block techniques on post-operative pain control ...

Comparative Study of Superficial Cervical Plexus

We would like to compare the therapeutic and cost effectiveness of established therapies for postoperative nausea and vomiting to regional nerve blocks of the ...

Association of peripheral nerve blocks with increased ...

Peripheral nerve blocks are effective in reducing immediate postoperative pain and opioid use in orthopaedic surgeries, and potentially minimise ...

7.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40610285/

Association of peripheral nerve blocks with increased ...

Results: Among 22 956 patients, peripheral nerve block administration was associated with lower maximum pain scores and lower probability of ...