Spinal Morphine Provides an Effective Pain Control in Patients Undergoing Transurethral Resection of Prostate Gland
Spinal Morphine (0.05 mg) Provides an Effective Pain Control in Patients Undergoing Transurethral Resection of Prostate Gland- a Randomized Double-blinded Control Trial
Pain after transurethral resection of prostate is considered mild to moderate severity from detrusor muscle spasm and traction from urinary catheter. Numerous pain relieve methods have been studied including spinal opioids, spinal anesthesia with local anesthetic and dexmedetomidine, periprostatic nerve blockade with bupivacaine and mixing of prilocaine with distilled water irrigation while undergoing a procedure. Most of patients having this procedure are in elderly period, thus many anesthetists avoided spinal morphine which may cause respiratory depressant effect postoperatively. Although previous studies showed effectiveness of spinal morphine 25-200 mcg, some patients suffered from neuraxial opioid side effects.
The aim of this study is to demonstrate efficacy of local anesthetic with intrathecal morphine 50 mcg providing pain relieve after transurethral resection of prostate compare to spinal anesthesia with sole local anesthetic.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > or = 18 years old
- Undergoing transurethral resection of prostate gland
Exclusion Criteria:
- Contraindication for spinal anesthesia for any reasons eg. infection, bleeding disorder
- Refuse spinal anesthesia
- Allergic to study drugs
- History of cerebrovascular disease or stroke
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Morphine
0.5%Bupivacaine 2 ml with morphine 50 mcg for spinal anesthesia
|
0.5%Hyperbaric bupivacaine 2 ml add morphine 50 mcg for spinal anesthesia
Other Names:
|
|
Placebo Comparator: Placebo
0.5%Bupivacaine 2 ml for spinal anesthesia
|
0.5%Hyperbaric bupivacaine 2 ml for spinal anesthesia
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Numerical rating scale (0-10)
Time Frame: 24 hours postoperatively
|
Pain score rating by numerical rating scale in 24-hr postoperative
|
24 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Requirement of rescue pain
Time Frame: 24 hours postoperatively
|
requirement of pain control medication
|
24 hours postoperatively
|
|
Adverse effects
Time Frame: 24 hours postoperatively
|
incidence of side effects e.g.
nausea and vomiting, itching and sedation
|
24 hours postoperatively
|
|
Satisfaction score
Time Frame: 24 hours postoperatively
|
Satisfaction score rated from 0-100
|
24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Pawinee Pangthipampai, M.D., Siriraj Hospital
Publications and helpful links
General Publications
- Kose O, Saglam HS, Altun ME, Sonbahar T, Kumsar S, Adsan O. Prilocaine irrigation for pain relief after transurethral resection of the prostate. J Endourol. 2013 Jul;27(7):892-5. doi: 10.1089/end.2013.0001. Epub 2013 Jun 12.
- Gorur S, Inanoglu K, Akkurt BC, Candan Y, Kiper AN. Periprostatic nerve blockage reduces postoperative analgesic consumption and pain scores of patients undergoing transurethral prostate resection. Urol Int. 2007;79(4):297-301. doi: 10.1159/000109712.
- Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low-dose bupivacaine spinal anesthesia in elderly patients undergoing transurethral prostatectomy. Biol Pharm Bull. 2013;36(6):959-65. doi: 10.1248/bpb.b12-01067.
- Suksompong S, Pongpayuha P, Lertpaitoonpan W, von Bormann B, Phanchaipetch T, Sanansilp V. Low-dose spinal morphine for post-thoracotomy pain: a prospective randomized study. J Cardiothorac Vasc Anesth. 2013 Jun;27(3):417-22. doi: 10.1053/j.jvca.2012.12.003. Epub 2013 Mar 29.
- Duman A, Apiliogullari S, Balasar M, Gurbuz R, Karcioglu M. Comparison of 50 microg and 25 microg doses of intrathecal morphine on postoperative analgesic requirements in patients undergoing transurethral resection of the prostate with intrathecal anesthesia. J Clin Anesth. 2010 Aug;22(5):329-33. doi: 10.1016/j.jclinane.2009.09.006.
- Kirson LE, Goldman JM, Slover RB. Low-dose intrathecal morphine for postoperative pain control in patients undergoing transurethral resection of the prostate. Anesthesiology. 1989 Aug;71(2):192-5. doi: 10.1097/00000542-198908000-00004.
- Ozbek H, Deniz MN, Erakgun A, Erhan E. Comparison of 75 and 150 mug doses of intrathecal morphine for postoperative analgesia after transurethral resection of the prostate under spinal anesthesia. J Opioid Manag. 2013 Nov-Dec;9(6):415-20. doi: 10.5055/jom.2013.0184.
- Sakai T, Use T, Shimamoto H, Fukano T, Sumikawa K. Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate. Can J Anaesth. 2003 Dec;50(10):1027-30. doi: 10.1007/BF03018367.
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 (Actual)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 019/2558(EC2)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Analgesia
-
NCT07191938Not yet recruitingPostoperative Care | Postoperative Analgesia | Analgesia Assessment | Posthectomy
-
NCT07395622Enrolling by invitationEpidural Analgesia | Learning Curve | Epidural Analgesia for Labour and Delivery
-
NCT05905510Recruiting
-
NCT05477641Recruiting
-
NCT04446715Recruiting
-
NCT04011839Completed
-
NCT05763810Active, not recruiting
Clinical Trials on Morphine
-
NCT07386353RecruitingAnalgesia | Patient Satisfaction | Post Operative Pain | Cesarean Section Pain | Analgesia Obstetrical
-
NCT04298853CompletedNeonatal Abstinence Syndrome | Neonatal Opioid Withdrawal Syndrome | Neonatal Opioid Withdrawal
-
NCT07238179Active, not recruitingAnalgesia | Nausea and Vomiting, Postoperative | Morphine | Morphine Adverse Reaction | Morphine Induced Pruritis | Spinal Analgesia
-
NCT00390039Completed
-
NCT00388011Completed
-
NCT01236495Completed
-
NCT07629323Enrolling by invitationGastreoesophageal Reflux Disease | Perioperative Pain Management
-
NCT00880607CompletedScoliosis | Pain Management | Spinal Fusion
-
NCT00390312CompletedPost-Operative Pain | Third Molar Extraction
-
NCT02200185CompletedTitrated Versus High and Low Dose Nebulized Morphine to Reduce Pain in Emergency Settings (TIMORNEB)Acute Pain | Post-Traumatic Headache