Opioid-free Anesthesia and Thoracoscopy Surgery (OFAT)
Evaluation of an "Opioid Free Anesthesia" Protocol in Thoracoscopic Carcinological Thoracic Surgery
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
A service protocol based on opioid-free anesthesia in patients undergoing pulmonary carcinologic surgery under video-thoracoscopy will be evaluated.
The investigative team want to recruit 100 patients prospectively. These patients will be randomly assigned on the day of surgery between OFA (Opioid Free Anesthesia) and OBA (Opioid Based Anesthesia).
Anesthesia and analgesia of patients in the OFA group will be performed without morphine according to the validated local protocol. We will use level 1 and 2 analgesics (paracetamol, NSAIDs and nefopam) associated with an erector spine block and anesthesia under propofol, dexmedetomidine and ketamine ivse.
Patients in the OBA group will have so-called "basic" anesthesia and analgesia with opioids according to usual practice.
Postoperative pain by collecting morphine consumption in the first 48 hours postoperatively between the two groups will be compared.
Chronic neuropathic postoperative pain will also be collected by a telephone questionnaire at 3 months postoperative.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Julien CADIET, PH
- Phone Number: 33 2 44 76 86 86
- Email: julien.cadiet@chu-nantes.fr
Study Contact Backup
- Name: Marjorie Cheraud-Carpentier
- Phone Number: 33244768597
- Email: marjorie.cheraudcarpentier@chu-nantes.fr
Study Locations
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Nantes, France, 44093
- CHU de Nantes
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Adult patients undergoing lung oncology surgery under video-thoracoscopy lasting more than 2 hours.
Patients will be randomly assigned to a group without a random draw. Only the anesthesiologist trained at the OFA will be able to do the OFA
Description
Inclusion Criteria:
- Adult patient
- Patient operated on pulmonary carcinologic surgery by thoracoscopy of a foreseeable duration greater than 2 hours
Exclusion Criteria:
- Patient with unstable unstable unstable coronary artery disease,
- Patient contraindicated for the use of dexmedetomidine: heart rate<50 / min, High degree atrioventricular block (2 and 3) unless fitted (carrier of a pacemaker),
- Patient on beta-blocker, allergy to Dexdor®,
- Patient allergic to other drugs used in OFA (Paracetamol and NSAIDs).
- Renal insufficiency patient with creatinine clearance<30ml/min will not be excluded but will not receive NSAIDs.
- Minor patient,
- Adult patient under guardianship or curators.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
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OFA : Opioid Free Anesthesia
Opioid-free surgery.
Analgesia provided by attenuation analgesic 1, dexmedetomidine, ketamine and general anesthesia by propofol.
Regional loco anesthesia is performed in the OFA group and possible in the OBA group.
It's local service protocol used since 1 year.
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OBA : Opioid Based Anesthesia
Conventional anesthesia with Propofol and Sufentanil boli with the possibility of regional loco anesthesia.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Morphine consumption
Time Frame: Day 2
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Total morphine consumption over the first 48 post operative hours in milligrammes
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Day 2
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Preoperatory haemodynamic tolerance
Time Frame: Day 0
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Maximum doses of norepinephrine intraoperatively in µg/kg/min.
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Day 0
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Quality of intraoperative anesthesia
Time Frame: Day 0
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Duration of surgery (time between entering the operating room and leaving the room) in minutes.
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Day 0
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Ileus Postoperative
Time Frame: Day 4
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Presence of postoperative ileus (defined by the presence 2 of the following criteria from the 4th postoperative day: nausea and vomiting, absence of food recovery, no stool or gas in the last 24 hours, abdominal meteorism, radiological arguments)
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Day 4
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Duration of hospitalization
Time Frame: Day 10
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Length of hospitalization (Time between arrival at the hospital and discharge) in days.
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Day 10
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Chronic neuropathic pain
Time Frame: Month-3
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Evaluation of neuropathic pain (assessed by the DN 4 score:diagnosis of neuropathic pain)
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Month-3
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Long-term morphine consumption
Time Frame: Month-3
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Morphine consumption at 3-month (yes/no)
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Month-3
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Physical form recovery
Time Frame: Month-3
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Time between surgery and resumption of physical activity in days.
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Month-3
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Julien CADIET, PH, CHU de Nantes
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 (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
Other Study ID Numbers
Other Study ID Numbers
- RC22_0112
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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