- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01492075
A Comparison Between Continuous and Intermittent Intraabdominal Analgesia Using Local Anaesthetics (PoPuLAR)
Phase IV Study of Postoperative Pain Management
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Open abdominal hysterectomy is a common procedure performed for many benign and malignant gynaecological diseases and is associated with moderate to severe pain. Traditional methods for postoperative pain management include patient controlled intravenous analgesia (PCA) using morphine, epidural analgesia and spinal analgesia with opiates but recently, even local aesthetic (LA) has been used intra-abdominally and into the abdominal wall. Although epidural analgesia may be considered by some to be gold standard for pain relief following abdominal surgery, a recent publication and past experience over several years may question the use of invasive techniques for lower abdominal surgery. Thus, there is a trend towards movement from central blocks towards other non-invasive methods for pain relief.
PCA with morphine is now commonly used for management of pain following major surgery and compared to central blocks, has advantages in being relatively safe, easy to use and associated with a high degree of patient satisfaction. However, the large doses of morphine necessary to ensure adequate postoperative analgesia means that side effects such as postoperative nausea and vomiting (PONV), tiredness, pruritus, headache and constipation may be a major problem in this group of patients. Therefore, alternative techniques to reduce morphine requirements are increasingly being used. These include the use of paracetamol, non-steroidal anti-inflammatory drugs (NSAID) and recently local anaesthetics (LA). The latter have been found to result in morphine sparing by 30 - 40 % and even a reduction in postoperative nausea (PON). LA infused intraperitoneally is safe and effective and a recent study showed that using 12.5 mg/h levobupivacaine could attain adequate analgesia. Thus, efficacy of LA has been established as well as the dose. However, the method of administration of LA intraperitoneally remains unclear.
This study is designed with the primary aim of studying whether morphine consumption can be reduced postoperatively using the patient-controlled administration system for intraperitoneal LA compared to a continuous infusion, and whether this translates into improved recovery parameters or reduced side effects and improved patient satisfaction.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
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Örebro, Sweden, 701 85
- University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18 -65 year old patients undergoing open abdominal hysterectomy.
- ASA I - II (Appendix 1).
- Have signed and dated Informed Consent.
- Willing and able to comply with the protocol for the duration of the trial.
Exclusion Criteria:
- Patients undergoing open abdominal hysterectomy due to suspected cancer.
- Patients with chronic pain who are taking analgesics regularly.
- Allergy to components in levobupivacaine (Chirocaine)/Saline (Sodium Chloride).
- Participation in other clinical trials.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Continuous infusion
Continuous infusion of LA intraabdominally
|
Intermittent injection of LA intraabdominally
|
Experimental: PCRA (Intermittent injection)
Patient controlled LA intraabdominally
|
Intermittent injection of LA intraabdominally
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Morphine consumption
Time Frame: 0-24 h
|
Total morphine consumption 0 - 24 h postoperatively
|
0-24 h
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postoperative pain
Time Frame: 0 - 48 h postoperatively
|
Post-operative pain assessed on the basis of NRS (Numeric Rating Score).
|
0 - 48 h postoperatively
|
PONV
Time Frame: 0 - 48 h postoperatively
|
Incidence of nausea and vomiting and anti-emetic requirement
|
0 - 48 h postoperatively
|
Home discharge
Time Frame: 0-10 days
|
Time to home readiness and time to return to work.
|
0-10 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Andrea Perniola, MD, Örebro University, Sweden
- Principal Investigator: Anil Gupta, PhD, Örebro University, Sweden
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 20100101 (Helse Sorost)
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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