Analgesia With Transdermal Buprenorphine Patch in Adults Undergoing Video-Assisted Thoracoscopic Surgery
Analgesia With a 5 mcg/Hour Transdermal Buprenorphine Patch as Part of Multimodal Analgesia in Adults Undergoing Unilateral Video-Assisted Thoracoscopic Surgery: A Triple-Blind Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Video-assisted thoracoscopic surgery (VATS) is associated with moderate to severe postoperative pain that may impair respiratory function, delay recovery, prolong hospitalization, and contribute to the development of persistent postoperative pain. Current guidelines recommend multimodal analgesia, including non-opioid analgesics and regional anesthesia techniques, while opioids are generally reserved for rescue analgesia.
Transdermal buprenorphine is a long-acting partial μ-opioid receptor agonist that has demonstrated efficacy in reducing postoperative pain and opioid consumption in several surgical settings. However, evidence regarding its use in thoracic surgery is currently lacking.
This is a single-center, randomized, triple-blind, placebo-controlled clinical trial conducted at Clínica Dávila, Santiago, Chile. Adult patients undergoing unilateral video-assisted thoracoscopic surgery will be randomized in a 1:1 ratio to receive either a 5 mcg/hour transdermal buprenorphine patch plus standard multimodal analgesia or placebo plus standard multimodal analgesia. Randomization will be computer-generated using sequentially numbered opaque sealed envelopes. Participants, investigators, outcome assessors, and the statistician will remain blinded to treatment allocation.
The primary outcome is postoperative pain intensity measured using the Numeric Rating Scale (0-10) at 24, 48, and 72 hours and 7 days after surgery. Secondary outcomes include opioid rescue consumption expressed as morphine equivalents, postoperative nausea and vomiting, pruritus, urinary retention, and length of hospital stay. The planned sample size is 90 participants (45 per group).
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Santiago Metropolitan
-
Santiago, Santiago Metropolitan, Chile, 8431657
- Recruiting
- Clínica Dávila
-
Contact:
- Alejandra Sofía Rivera, MsC Epidemiology
- Phone Number: 930363776
- Email: alejandra.rivera@davila.cl
-
Contact:
- Bernarda Miranda, Bibliotecary
- Phone Number: +56930363776
- Email: bmiranda@davila.cl
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults aged 18 years or older.
- Scheduled for elective unilateral video-assisted thoracoscopic surgery (VATS).
- American Society of Anesthesiologists (ASA) physical status I-III.
- Able to understand the study procedures and provide written informed consent.
Exclusion Criteria:
- Known allergy or hypersensitivity to buprenorphine or any component of the transdermal patch.
- Chronic opioid use before surgery.
- Severe hepatic impairment.
- Pregnancy or breastfeeding.
- Inability to complete postoperative pain assessments.
- Any condition that, in the investigator's opinion, could interfere with study participation or outcome assessment.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Buprenorphine Patch
Participants will receive a 5 mcg/hour transdermal buprenorphine patch before surgery in addition to standard multimodal analgesia.
|
Transdermal buprenorphine patch (5 mcg/hour) administered preoperatively as part of multimodal analgesia.
|
|
Placebo Comparator: Placebo Patch
Participants will receive a placebo transdermal patch before surgery in addition to standard multimodal analgesia.
|
Placebo transdermal patch identical in appearance to the active patch and administered preoperatively as part of multimodal analgesia.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative Pain Intensity Measured Using the Numeric Rating Scale
Time Frame: 24, 48, and 72 hours and 7 days after surgery
|
Postoperative pain intensity will be assessed using the Numeric Rating Scale, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
Pain scores will be compared between the buprenorphine and placebo groups across the postoperative assessment time points.
|
24, 48, and 72 hours and 7 days after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative Rescue Opioid Consumption
Time Frame: From the end of surgery through 7 days after surgery
|
Total rescue opioid consumption will be obtained from the clinical record and expressed in milligrams of intravenous morphine equivalents.
Opioid consumption will be compared between the study groups.
|
From the end of surgery through 7 days after surgery
|
|
Incidence of Postoperative Nausea and Vomiting
Time Frame: 24, 48, and 72 hours and 7 days after surgery
|
The presence or absence of postoperative nausea or vomiting will be recorded at each postoperative assessment.
The outcome will be reported as the number and percentage of participants experiencing nausea or vomiting in each study group.
|
24, 48, and 72 hours and 7 days after surgery
|
|
Incidence of Postoperative Pruritus
Time Frame: 24, 48, and 72 hours and 7 days after surgery
|
The presence or absence of postoperative pruritus will be recorded at each assessment.
The outcome will be reported as the number and percentage of participants experiencing pruritus in each study group.
|
24, 48, and 72 hours and 7 days after surgery
|
|
Incidence of Postoperative Urinary Retention Requiring Bladder Catheterization
Time Frame: 24, 48, and 72 hours and 7 days after surgery
|
Postoperative urinary retention will be defined as the need for bladder catheterization.
The outcome will be reported as the number and percentage of participants requiring catheterization in each study group.
|
24, 48, and 72 hours and 7 days after surgery
|
|
Length of Hospital Stay
Time Frame: From the day of surgery until hospital discharge, assessed up to 30 days
|
Length of hospital stay will be calculated as the number of complete days from the postoperative period until hospital discharge, based on the electronic clinical record.
|
From the day of surgery until hospital discharge, assessed up to 30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Postoperative Complications
- Pathologic Processes
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Pain, Postoperative
- Acute Pain
- Heterocyclic Compounds
- Heterocyclic Compounds, Fused-Ring
- Alkaloids
- Polycyclic Aromatic Hydrocarbons
- Polycyclic Compounds
- Heterocyclic Compounds, 4 or More Rings
- Morphinans
- Opiate Alkaloids
- Heterocyclic Compounds, Bridged-Ring
- Phenanthrenes
- Buprenorphine
Other Study ID Numbers
Other Study ID Numbers
- CD2025/035
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
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