Impact of Maxigesic on Delirium After Minimally Invasive Lung Surgery in Elderly Patients
The Impact of Intravenous Administration of Perioperative Acetaminophen and Ibuprofen Combination (Maxigesic®) on Postoperative Delirium in Elderly Patients Undergoing Minimally Invasive Lung Segmentectomy or Lobectomy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Hye Bin Kim, MD, PhD
- Phone Number: 82-10-9183-5617
- Email: aneshbkim@gmail.com
Study Contact Backup
- Name: Heezoo KIM, MD, PhD
- Phone Number: 82-2-2626-1437
- Email: kimheezoo@gmail.com
Study Locations
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Seoul, South Korea, 08308
- Korea University Guro Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients aged 65 years or older undergoing minimally invasive lung lobectomy or segmentectomy
Exclusion Criteria:
- Hypersensitivity to the main ingredients and additives of Maxigesic
- Hypersensitivity to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
- Alcoholism / Alcohol intoxication
- Severe hematological abnormalities
- Bleeding tendency (e.g., Spontaneous bleeding)
- Severe hepatic dysfunction (AST, AST ≥2.5 * upper normal limit(UNL) or Total bilirubin ≥3.0 mg/dl)
- Severe renal dysfunction (eGFR <30 ml/min/1.73m2 or Dialysis)
- Severe heart failure (Left ventricle ejection fraction <30%)
- Uncontrolled hypertension(HTN) (Systolic blood pressure >180 mmHg)
- Symptomatic asthma in need of treatment
- Anticoagulants or antiplatelet agents are maintained for up to 5 days before surgery
- Barbiturates or tricyclic antidepressants (TCAs)
- High-dose methotrexate (MTX) for cancer treatment
- Preoperative cognitive impairment, dementia, or delirium
- Inability to understand the research and instructions for this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Placebo Comparator: Control group
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Patients in the control group will be administered equal amounts of normal saline at the same time points.
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Experimental: Maxigesic group
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Patients in the Maxigesic group will be administered a total of 5 doses of the drug (20mg/kg, maximum dose per serving: 1g) every 6 h from immediately after anesthetic induction.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Incidence of postoperative delirium(POD)
Time Frame: From immediately after surgery to 5 days after surgery
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Confusion assessment method(CAM)/Confusion Assessment Method for the ICU (CAM-ICU) or delirium record on electrical medical record(EMR) will be used for the evaluation of POD.
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From immediately after surgery to 5 days after surgery
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Duration of POD
Time Frame: From immediately after surgery to 5 days after surgery
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CAM/CAM-ICU or delirium record on EMR will be used to estimate the duration of POD.
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From immediately after surgery to 5 days after surgery
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Preoperative cognition
Time Frame: 1 day before surgery
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Mini-mental state examination(MMSE) will be used to evaluate the participants' preoperative cognition.
(*MMSE is measured on 0-30 scale, and the lower the score, the more cognitively impaired the patient is.)
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1 day before surgery
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Preoperative cognition
Time Frame: 1 day before surgery
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Montreal cognitive assessment(MoCA) will be used to evaluate the participants' preoperative cognition.
(*MoCA is measured on 0-30 scale, and the lower the score, the more cognitively impaired the patient is.)
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1 day before surgery
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Preoperative frailty
Time Frame: 1 day before surgery
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Clinical frailty scale(CFS) will be utilized to assess the preoperative frailty (*CFS is used to determine comprehensive geriatric assessment.
It is measured on 1-9 scale, and the higher the scale, the more frail the patient is.)
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1 day before surgery
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Postoperative pain
Time Frame: Immediately after surgery to postoperative 48 hours
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Numerical rating scale (NRS) or Visual analogue scale (VAS) will be used to determine the postoperative pain severity (*NRS and VAS are measured on a 0-10 scale, and the higher the score, the more severe the patient's pain.
If the patient can verbalize their pain, use the NRS; otherwise, use the VAS to assess pain).
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Immediately after surgery to postoperative 48 hours
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Consumption of opioids
Time Frame: Immediately after surgery to postoperative 48 hours
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Opioid consumption is measured by converting them into morphine equivalents.
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Immediately after surgery to postoperative 48 hours
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Postoperative nausea, vomiting
Time Frame: Immediately after surgery to postoperative 48 hours
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Nausea is measured by scoring on a scale of 0-10.
The higher the score, the more severe the symptom.
Whether the patients vomit or not is observed and recorded.
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Immediately after surgery to postoperative 48 hours
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ICU stay
Time Frame: Immediately after surgery to ICU discharge(usually within about 5 days after surgery)
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Determine how many days the participant stays in the ICU.
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Immediately after surgery to ICU discharge(usually within about 5 days after surgery)
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Hospital stay
Time Frame: Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Determine how many days the participant stays in the hospital.
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Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Postoperative complications
Time Frame: Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Investigate all kinds of complications that occur after surgery.
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Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Drug side effects
Time Frame: Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Investigate complications suspected to be side effects caused by the study drug.
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Immediately after surgery to hospital discharge(usually within about 30 days after surgery)
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Severity of POD
Time Frame: From immediately after surgery to 5 days after surgery
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CAM-S(severity) will be utilized to assess the severity of POD.
(*CAM-S is measured on 0-7 (short form) and 0-19 (long form) scale, and the higher the score, the greater the POD severity.)
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From immediately after surgery to 5 days after surgery
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Heezoo Kim, MD, PhD, Korea University Guro Hospital
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
Keywords
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Nervous System Diseases
- Mental Disorders
- Postoperative Complications
- Pathologic Processes
- Neoplasms by Site
- Neoplasms
- Respiratory Tract Diseases
- Confusion
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Lung Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Emergence Delirium
- Delirium
- Lung Neoplasms
- Organic Chemicals
- Pharmaceutical Preparations
- Carboxylic Acids
- Anilides
- Amides
- Aniline Compounds
- Amines
- Acetanilides
- Crystalloid Solutions
- Isotonic Solutions
- Solutions
- Acids, Carbocyclic
- Phenylpropionates
- Acetaminophen
- Ibuprofen
- Saline Solution
Other Study ID Numbers
Other Study ID Numbers
- 2023GR0023
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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