Paracetamol Metabolism Research in Postoperative Hepatic Surgery (PARAFOI)
The main objective of this study was to evaluate the 5-day kinetics of plasma paracetamol levels in postoperative major hepatic surgery (resection greater than or equal to three hepatic segments) compared with less extensive liver resection and hepatic re-intervention. The clearance of indocyanine green is a marker of hepatic perfusion but also of the proper hepatocyte functioning, if hemodynamic conditions are stable.
Some patients may be operated on up to four or five times in the liver. Moreover, these patients probably present an increased risk of postoperative hepatocellular insufficiency due to a quantitative and qualitative decrease in their hepatic parenchyma. It is therefore interesting to evaluate the use of paracetamol in this situation.
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 Contact
Study Contact
- Name: Gilles Lebuffe, MD,PhD
- Phone Number: +33 3 20 44 41 12
- Email: gilles.lebuffe@chru-lille.fr
Study Locations
-
-
-
Lille, France
- Hôpital Huriez, CHRU
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients requiring surgery for hepatic resection by initiation under chest or laparoscopic without hepatocellular insufficiency,
- ASA score 1 to 3 (American Society of Anesthesiologists score ranging from 1 to 5 evaluating the preoperative health status of a patient),
- Verification of the understanding of the protocol,
Exclusion Criteria:
- Patients classified ASA 4 or 5,
- Allergy or intolerance to indocyanine green
- Allergy or intolerance to paracetamol,
- Taking of paracetamol the week before the intervention,
- Patient less than 60 Kgs (because decrease of doses of paracetamol),
- Emergency surgery, palliative surgery and surgical recovery,
- Psychic disorder,
- Contra-indication to a treatment used during the study,
- incapable major,
- Intellectual incapacity preventing proper understanding of the protocol,
- Pregnant or nursing woman,
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: major hepatic surgery
resection greater than or equal to three hepatic segments
|
Paracetamol 1000 mg will be administered 30 minutes before the end of the procedure and then every 6 hours systematically at the following times: 6h / 12h / 18h / 00h. The analgesic treatment after hepatectomy with paracetamol will be maintained for at least 5 days in all patients in parenteral form |
|
Experimental: hepatic surgery
resection less than three hepatic segments
|
Paracetamol 1000 mg will be administered 30 minutes before the end of the procedure and then every 6 hours systematically at the following times: 6h / 12h / 18h / 00h. The analgesic treatment after hepatectomy with paracetamol will be maintained for at least 5 days in all patients in parenteral form |
|
Experimental: hepatic surgery recovery
|
Paracetamol 1000 mg will be administered 30 minutes before the end of the procedure and then every 6 hours systematically at the following times: 6h / 12h / 18h / 00h. The analgesic treatment after hepatectomy with paracetamol will be maintained for at least 5 days in all patients in parenteral form |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dosing and kinetics of paracetamolemia
Time Frame: during the 5 post-operative days
|
this determination of the plasma paracetamol dosage on D0 (H6: 6 hours after the end of the procedure) and D1 D2 D3 D4 D5 (samples taken at 6 am each day just before the injection of paracetamol whose administration hours will be 6h 12h 18h and midnight)
|
during the 5 post-operative days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dosage of urinary metabolites of paracetamol (paracetamol sulphate, paracetamol glucuronide)
Time Frame: At Day 1, day 3, day 5 post operative
|
At Day 1, day 3, day 5 post operative
|
|
|
Dosage of N-acetyl-cysteinyl paracetamol ( NAPQI)
Time Frame: At Day 1, day 3, day 5 post operative
|
At Day 1, day 3, day 5 post operative
|
|
|
Percentage of patients with paracetamolemia greater than 60 mg / mL
Time Frame: during the 5 post-operative days
|
60mj/ml = paracetamol toxicity threshold according to Prescott diagram to 6 hours
|
during the 5 post-operative days
|
|
Plasma Disappearance Rate of indocyanine green (TDP-ICG) by LiMon®
Time Frame: At Day 1, day 3, day 5 post operative
|
At Day 1, day 3, day 5 post operative
|
|
|
Rate of postoperative hepatocellular insufficiency
Time Frame: at day 5
|
The postoperative hepatocellular insufficiency according to the 50/50 criteria (TP <50% and bilirubinemia> 50 μmol / L on the 5th day) according to the type of hepatic resection (with or without clamping, continuous or discontinuous, duration intervention).
|
at day 5
|
|
Occurrence of complications related to hepatic failure
Time Frame: at day 5
|
the complications related to hepatic failure not falling within the "50/50" criteria: jaundice, hepatic encephalopathy, coagulation disorders, ascites, cytolysis, cholestasis. Other medical and surgical. Duration of hospitalization in perioperative intensive care and duration of total hospitalization. Mortality at 30 days. |
at day 5
|
|
Duration of hospitalization in perioperative intensive care
Time Frame: at 30 days
|
at 30 days
|
|
|
Duration of total hospitalization.
Time Frame: at 30 days
|
at 30 days
|
|
|
Mortality
Time Frame: at 30 days
|
at 30 days
|
|
|
Composite characteristics of surgery.
Time Frame: at 30 days
|
Characteristics of surgery: duration of intervention, numbers, duration and types of vascular clamping, detailed description of the type of liver resection performed, quantification of bleeding.
|
at 30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Gilles Lebuffe, MD,PhD, University Hospital, Lille
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
- 2015_61
- 2016-002632-32 (Other Identifier: ID-RCB number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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