Local Analgesia to Prevent Pain in Patient Undergoing Removal of the Uterus Through Vaginal Route

January 23, 2018 updated by: Eman Omran, Cairo University

Role of Ropivacaine Postincisional Infiltration With Intraperitoneal Instillation Analgesia in Postoperative Pain Relief in Patients Undergoing Non Descent Vaginal Hysterectomy: Randomized Controlled Trial

Following a hysterectomy, women tend to experience high levels of pain, and many require strong pain killers after the procedure. Ropivacaine is a local anaesthetic drug (injectable numbing medication) which works by blocking pain signals. The aim of this study is to find out whether injections of ropivacaine during surgery can help provide effective pain relief after surgery.Women aged between 45 and 70 who are having a vaginal hysterectomy can participate in the trial. Participants are randomly allocated to one of two groups. Those in the first group are given injections of ropivacaine at the site of the wound and in the peritoneum (space in the body that holds the organs in the abdomen) and those in the second group are given injections of a saline fluid in the same places that offers no pain relief before the end of their surgery. Participants in both groups are then regularly asked to rate their pain levels up to 24 hours after surgery. In addition, the pain killers they receive and length of hospital stay are recorded. There is a chance that the participants who receive the ropivacaine will benefit from lower pain levels after surgery. There are no notable risks of participating.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

At end of the vaginal hysterectomy operation, the gynecologist will inject the uterosacral, cardinal ligaments, adnexal areas and the vaginal edge with 15 ml of either the ropivacaine solution or the placebo fluid in each side, then 20 ml will be instilled inside the peritoneum. Analgesia will be given on request after operation. Visual analogue score of 0 to 100 mm will be used to assess the degree of pain, with 0 indicating no pain and 100 indicating worst pain.

Study Type

Interventional

Enrollment (Actual)

48

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Qalubia
      • Banha, Qalubia, Egypt, 13518
        • Banha University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

45 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  1. Female
  2. 45 to 70 years old
  3. Scheduled for NDVH (non descent vaginal hysterectomy) for benign indications without need for oophorectomy or vaginal reconstructive surgery

Exclusion Criteria:

  1. Patient weight less than 50 kg
  2. Allergy to amide local anesthetic
  3. Dementia or mental retardation to a degree which would interfere with data collection
  4. Contraindication to non descent vaginal hysterectomy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: intervention group
Participants are given ropivacaine (0.5%) at a total dose of 50 ml, 30 ml of which is injected locally and 20 ml into the peritoneum once before the end of operation as pre-emptive analgesia.
local anesthetic will be given locally at the site of operation to decrease the level of pain after operation
Placebo Comparator: control group
Participants are given a placebo in the form of fluid injection of saline (0.9%) at total of 50 ml, 30 ml of which is injected locally and 20 ml into the peritoneum once before the end of operation
placebo fluid will be given at the site of operation locally

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
pain score
Time Frame: At 2 hours post--operatively.
Pain is measured by the patient using the visual analogue score
At 2 hours post--operatively.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time in hours to get out of bed after operation
Time Frame: at 12 hours post--operatively
Time in hours to get out of bed after operation is measured by a nurse responsible for the patient
at 12 hours post--operatively
Hospital stay in days
Time Frame: Up to 4 weeks post-operatively
Hospital stay in days is measured by a nurse
Up to 4 weeks post-operatively
Total Narcotic dose (Nalbuphine)
Time Frame: Up to 24 hours post--operatively
Total Narcotic dose (Nalbuphine) is measured by a nurse
Up to 24 hours post--operatively
Total parenteral NSAID (diclofenac sodium) used in the first 24 hours after surgery
Time Frame: at 24 hours post-operatively
Total parenteral NSAID (diclofenac sodium) used in the first 24 hours after surgery is measured by a nurse
at 24 hours post-operatively
Proportion of patients with nausea and vomiting in the first 24 hours
Time Frame: At 24 hours post--operatively
Proportion of patients with nausea and vomiting in the first 24 hours is measured by a nurse
At 24 hours post--operatively
Time spent in the post-anesthesia care unit
Time Frame: Up to 24 hours post--operatively
Time spent in the post-anesthesia care unit is measured by a nurse
Up to 24 hours post--operatively

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain score
Time Frame: At half hour post-operatively
Pain is measured by the patient using the visual analogue score
At half hour post-operatively
Pain score
Time Frame: At one hour post-operatively
Pain is measured by the patient using the visual analogue score
At one hour post-operatively
Pain score
Time Frame: At 4 hours post-operatively
Pain is measured by the patient using the visual analogue score
At 4 hours post-operatively
Pain score
Time Frame: At 8 hours post-operatively
Pain is measured by the patient using the visual analogue score
At 8 hours post-operatively
Pain score
Time Frame: At 12 hours post-operatively
Pain is measured by the patient using the visual analogue score
At 12 hours post-operatively
Pain score
Time Frame: At 24 hours post-operatively
Pain is measured by the patient using the visual analogue score
At 24 hours post-operatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Eman Omran, M.D., Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 4, 2017

Primary Completion (Actual)

July 25, 2017

Study Completion (Actual)

September 25, 2017

Study Registration Dates

First Submitted

March 20, 2017

First Submitted That Met QC Criteria

March 28, 2017

First Posted (Actual)

April 4, 2017

Study Record Updates

Last Update Posted (Actual)

January 25, 2018

Last Update Submitted That Met QC Criteria

January 23, 2018

Last Verified

January 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

  • 3777

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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