Diclofenac vs. Ropivacaine for Cesarean Section
The Analgesic Efficacy of Continuous Wound Instillation With Diclofenac or Ropivacaine Following Cesarean Section: a Randomized, Double-blind, Placebo Controlled Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Objective: To assess the analgesic efficacy of diclofenac or ropivacaine when administered via wound infusion.
Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: Large referral hospital. Patients: 75 women recovering from Cesarean section performed via a Pfannenstiel incision.
Interventions: On completion of the surgical procedure, a 15 cm 19G infusion catheter (PAINfusor™, Baxter) will be placed below the fascia. According to a computer generated randomization schedule, patients will be divided into one of three treatment groups (n = 25).
- In Group Control water for injection will be administered.
- In Group Ropivacaine 0.2 % ropivacaine will be administered.
- In Group Diclofenac diclofenac (300 mg/240 ml of water for injection) will be administered.
During the first 6 postoperative hours, a co-investigator will administer "rescue" analgesia (10 ml bolus of infusion drug or rescue morphine). Thereafter, the catheter will be connected to an elastometric pump (LV 10 Infusor, Baxter) filled with either water for injection, ropivacaine 0.2 %, or diclofenac (300 mg/240 ml water for injection). The fluid will be administered as a constant infusion rate (10 mL/hr). Continuous wound infusion will be continued for the subsequent 18 postoperative hours. During this 18 hour period, subcutaneous morphine 4 mg will be administered on patient request for additional analgesia.
Measurements and Main Results: The following parameters will be assessed and recorded:
- Demographic data
- Surgical milestones(Anesthetic time, surgical time etc).
- Incidence of failed intrathecal anesthesia
- VAS for pain every 15 min during first 6 postoperative hours
- Time to first pain (intrathecal anesthesia to VAS > 60 mm)
- Number of infusion events (10 mL and 5 mL)
- Rescue morphine administration during first 6 postoperative hours.
- Subcutaneous morphine administration during subsequent 18 postoperative hours.
- VAS for pain.
- The incidence of nausea and vomiting.
- Patient satisfaction at 24 hours, postoperatively.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Kfar-Saba, Israel, 44281
- Meir Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing Cesarean section
Exclusion Criteria:
A history of clinically significant disease:
- cardiovascular
- pulmonary
- hepatic
- renal
- neurologic
- psychiatric
- metabolic disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Ropivacaine
Continuous wound instillation of ropivacaine 0.2 % at a rate set of 10 mL/hr
|
Ropivacaine 0.2 %, or diclofenac (300 mg/240 ml water for injection) or water for injection will be administered as a constant instillation rate set of 10 mL/hr for the subsequent 18 postoperative hours.
|
|
ACTIVE_COMPARATOR: Diclofenac
Continuous wound instillation of diclofenac (300 mg/240 ml water for injection) at a rate set of 10 mL/hr
|
Ropivacaine 0.2 %, or diclofenac (300 mg/240 ml water for injection) or water for injection will be administered as a constant instillation rate set of 10 mL/hr for the subsequent 18 postoperative hours.
|
|
PLACEBO_COMPARATOR: Water for injection
Continuous wound instillation of water for injection at a rate set of 10 mL/hr
|
Ropivacaine 0.2 %, or diclofenac (300 mg/240 ml water for injection) or water for injection will be administered as a constant instillation rate set of 10 mL/hr for the subsequent 18 postoperative hours.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
1)Pain intensity 2)"Rescue" analgesia requirements
Time Frame: 24 hours
|
24 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anesthetics
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Cyclooxygenase Inhibitors
- Anesthetics, Local
- Ropivacaine
- Diclofenac
Other Study ID Numbers
Other Study ID Numbers
- MMC-0202-07
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