Pilot Study: Anti-inflammatory Effect of Peroperative Stimulation of the Vagus Nerve
Pilot Study: Anti-inflammatory Effect of Peroperative Stimulation of the Vagus Nerve: Potential New Therapeutic Intervention to Shorten Postoperative Ileus
Hypothesis:
Electrical stimulation of the abdominal vagus nerve has an anti-inflammatory effect and represents a new therapeutic approach to shorten postoperative ileus.
Aims:
In the present pilot study, the investigators want to evaluate the anti-inflammatory effect of peroperative electrical stimulation of the vagus nerve. To this end, the following aims are formulated:
- to optimize the technique of intra-operative electrical vagus nerve stimulation
- to show that electrical stimulation of the intra-abdominal vagus nerve reduces the inflammatory response to abdominal surgery
- to evaluate whether electrical stimulation of the vagus nerve leads to clinical improvement (collect pilot data)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Vlaams-Brabant
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Leuven, Vlaams-Brabant, Belgium, 3000
- University Hospitals Leuven
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with rectal carcinoma eligible for open rectal resection
- Age between 18 and 70 years
Exclusion Criteria:
- Preoperative therapeutic abdominal radiation
- Evident intra-abdominal inflammation (diagnosed by imaging and/or laboratory test results, including abscess or cholecystitis)
- American Society of Anesthesiologists physical-health status classification (ASA-PS) >3
- Poorly regulated diabetes (>200 mg/dl (=11mmol/l))
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Sham stimulation
No stimulation of nervus vagus
|
|
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Active Comparator: Vagus stimulation 1
2 times 2 minutes (beginning and end of surgery) stimulation at 5 Hz, 500 micro s, 2.5 mA
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2 times 2 minutes (beginning and end of surgery) stimulation at 5 Hz, 500 micro s, 2.5 mA
|
|
Active Comparator: Vagus stimulation 2
2 times 2 minutes (beginning and end of surgery) stimulation at 20 Hz, 500 micro s, 2.5 mA
|
2 times 2 minutes (beginning and end of surgery) stimulation at 20 Hz, 500 micro s, 2.5 mA
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
levels of pro-inflammatory cytokines in serum, peritoneal lavage and supernatant of stimulated PBMCs (peripheral blood mononuclear cell)
Time Frame: From date of surgery until the date of lab analysis (in short time period after taking the blood sample) .Blood samples will be taken before surgery, 2, 24 and 48 hrs after surgery.
|
From date of surgery until the date of lab analysis (in short time period after taking the blood sample) .Blood samples will be taken before surgery, 2, 24 and 48 hrs after surgery.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
gastric stasis (volume of gastric fluid produced by gastric tube on postoperative day 1)
Time Frame: From date of surgery until postoperative day 1.
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From date of surgery until postoperative day 1.
|
|
time to first flatus
Time Frame: From date of surgery until the date of discharge from the hospital.
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From date of surgery until the date of discharge from the hospital.
|
|
time to tolerance of oral food intake
Time Frame: From date of surgery until the date of discharge from the hospital
|
From date of surgery until the date of discharge from the hospital
|
|
time to tolerance of oral food intake AND first defecation
Time Frame: From date of surgery until the date of discharge from the hospital
|
From date of surgery until the date of discharge from the hospital
|
|
gastrointestinal symptoms (nausea, pain, bloating)
Time Frame: From date of surgery until the date of discharge from the hospital
|
From date of surgery until the date of discharge from the hospital
|
|
Time to first defecation
Time Frame: From date of surgery until the date of discharge from the hospital.
|
From date of surgery until the date of discharge from the hospital.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Peters EG, De Jonge WJ, Smeets BJ, Luyer MD. The contribution of mast cells to postoperative ileus in experimental and clinical studies. Neurogastroenterol Motil. 2015 Jun;27(6):743-9. doi: 10.1111/nmo.12579.
- Kalff JC, Buchholz BM, Eskandari MK, Hierholzer C, Schraut WH, Simmons RL, Bauer AJ. Biphasic response to gut manipulation and temporal correlation of cellular infiltrates and muscle dysfunction in rat. Surgery. 1999 Sep;126(3):498-509.
- Kalff JC, Schraut WH, Simmons RL, Bauer AJ. Surgical manipulation of the gut elicits an intestinal muscularis inflammatory response resulting in postsurgical ileus. Ann Surg. 1998 Nov;228(5):652-63. doi: 10.1097/00000658-199811000-00004.
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
Other Study ID Numbers
Other Study ID Numbers
- S53497
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