Comparing Epidural Versus General Anesthesia for LESS Cholecystectomies

August 8, 2017 updated by: Alexander Rosemurgy, Florida Hospital Tampa Bay Division

Epidural Versus General Anesthesia for Laparoendoscopic Single Site Cholecystectomy: A Prospective, Comparative, Controlled, Blinded Study

This study is a prospective, comparative, controlled, blinded study that will enroll a total of 70 adults that will undergo elective laparoendoscopic single-site incision gallbladder removal. The objective of this study is to compare Epidural versus General Anesthesia for postoperative pain, length of hospital stay, outcomes, and cost of post-cholecystectomy patients.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

This is a prospective, comparative, controlled, blinded study that will enroll a total of 70 adult patients that require an elective cholecystectomy.

Patients will be randomized 1:1 to receive either general anesthesia (Group A) or epidural anesthesia (Group B) for their laparoendoscopic single site incision (LESS) gallbladder removal surgery (cholecystectomy). Randomization will be achieved using a computer-generated list. The patient will know what are they are randomized to before entering the operating room because an epidural will need to be placed preoperatively. Standards for basic anesthetic monitoring approved by the American Society of Anesthesiologists will occur intraoperatively.

Postoperative evaluations will be completed by a medical professional that is blinded to the type of anesthesia used during the LESS surgery. Postoperative evaluations include a physical exam, adverse events, medication administration, vital signs and post-anesthesia recovery score for ambulatory patients (PARSAP) scores will be taken every 15 minutes until the patient has a score of at least 18.

Patients will be followed 90 days postoperatively to collect pain scores, analgesic use, adverse events, and quality of life questionnaires.

Study Type

Interventional

Enrollment (Actual)

70

Phase

  • Not Applicable

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

    • Florida
      • Tampa, Florida, United States, 33613
        • Florida Hospital Tampa

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

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients aged between 18 and 65 years of age
  • ASA I or II
  • Patient has a diagnosis of biliary colic with documented cholecystitis, symptomatic gallstones, polyps by imaging or biliary dyskinesia with documented EF < 30%
  • No cardiopulmonary disease
  • Normal coagulation profile

Exclusion Criteria:

  • Any female patient, who is pregnant, suspected pregnant, or nursing
  • Contraindication for pneumoperitoneum
  • Contraindication for epidural anesthesia
  • Allergy to local anesthetic agents
  • Any patient with acute calculus or acalculous cholecystitis
  • Any patient who has had an upper midline or right sub costal incision
  • Any patient with preoperative indication for a cholangiogram
  • Any patient with ASA ≥ 3
  • Any patient who is undergoing Peritoneal Dialysis (PD)
  • History of long term analgesic use requiring pain management (>1 week)
  • Any patient who has an unrepaired umbilical hernia or has had prior umbilical hernia repair
  • Any patient with obstructive sleep apnea (OSA), history of OSA or at high risk of OSA as determined by the STOP Questionnaire
  • BMI > 35 kg/m2
  • Any patient with a history of severe, uncontrolled GERD

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: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group A: General Anesthesia
35 patients will be randomized to receive general anesthesia during their laparoendoscopic single site incision cholecystectomy.
Patients will be put under general anesthesia for cholecystectomy
Other Names:
  • IV propofol
Active Comparator: Group B: Epidural Anesthesia
35 patients will be randomized to receive epidural anesthesia during their laparoendoscopic single site incision cholecystectomy.
Patients will receive Epidural Anesthesia for cholecystectomy
Other Names:
  • Epidural lidocaine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post Anesthesia Recovery Score for Ambulatory Patients
Time Frame: Immediately postoperative
PARSAP scores in the post-anesthesia recovery unit
Immediately postoperative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
SF-12 Health survey scores
Time Frame: Postoperative days 1, 6, 7/8/9 or 10, 30, 90
scale of 12-47
Postoperative days 1, 6, 7/8/9 or 10, 30, 90
Pain
Time Frame: Immediately postoperative through postoperative day 90
VAS 0-10 scale
Immediately postoperative through postoperative day 90
Opioid requirement
Time Frame: Preoperative through postoperative day 90
Opioid use in milligrams through postoperative day 90 will be recorded.
Preoperative through postoperative day 90

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Sharona Ross, MD, Florida Hospital Tampa
  • Principal Investigator: Alexander Rosemurgy, MD, Florida Hospital Tampa

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

February 1, 2015

Primary Completion (Anticipated)

December 1, 2018

Study Completion (Anticipated)

April 1, 2019

Study Registration Dates

First Submitted

July 26, 2017

First Submitted That Met QC Criteria

August 8, 2017

First Posted (Actual)

August 11, 2017

Study Record Updates

Last Update Posted (Actual)

August 11, 2017

Last Update Submitted That Met QC Criteria

August 8, 2017

Last Verified

August 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • 482717 revised

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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