CoolStick-Block

  • Research type

    Research Study

  • Full title

    A comparison of CoolStick and ethyl chloride spray for the assessment of sensory Block to light touch and cold before caesarean section under spinal or combined spinal-epidural anaesthesia.

  • IRAS ID

    331686

  • Contact name

    Matthew Wikner

  • Contact email

    matthew.wikner@nhs.net

  • Clinicaltrials.gov Identifier

    NCT06596486

  • Duration of Study in the UK

    0 years, 6 months, 0 days

  • Research summary

    In the NHS up to 35% of deliveries are by caesarean section. Over 90% of these are performed under neuraxial anaesthesia, as this considered to carry less risk of morbidity for both the mother and neonate. To minimise the risk of intra-operative pain, current consensus guidance states that a patient should not be able to feel light touch below the dermatomal level of T5 prior to commencing surgery. Anaesthetists will commonly also test for sensation to cold not being felt below the dermatomal level of T4. Ethyl chloride spray is the most commonly used method of testing in the UK, as it can be used to test for the sensation of both touch and cold. There are however significant environmental and financial burdens associated with its used throughout the NHS. Along with the emissions associated with the transport of ethyl chloride bottles, the spray itself is toxic to the environment. Each spray can also only has a finite number of uses before it runs and needs to be replaced. With this in mind, Theophany Limited created the CoolStick device to check block height to cold. The CoolStick consists of a stainless-steel head and a plastic handle. It is kept in the fridge before use and is cleaned with an antibacterial wipe between patients. It appears to be a more sustainable and cost-effective alternative to ethyl chloride spray for the assessment of cold, however there are no studies that demonstrate its clinical application as an alternative assessment of block. Our study is seeking to compare the CoolStick with Ethyl Chloride for the assessment of light touch, to see if the CoolStick could be an environmentally friendly and cost-effective replacement for ethyl chloride.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    24/LO/0656

  • Date of REC Opinion

    13 Sep 2024

  • REC opinion

    Favourable Opinion