A Study to Evaluate the Safety and Efficacy of Ultiva (Remifentanil Hydrochloride) in Pediatric Participants General Anesthetised

An Open-Label Study to Evaluate the Efficacy and Safety of JNJ-268229 in Pediatric Subjects General Anesthetised

The purpose of this study is to evaluate the efficacy and safety of JNJ-268229 (Ultiva /Remifentanil Hydrochloride) in pediatric participants between 1 and 15 years of age during maintenance of general anesthesia.

Study Overview

• Status: Completed
• Conditions: Anesthesia
• Intervention / Treatment: Drug: Remifentanil

Detailed Description

This is multicenter, open-label (identity of assigned study drug will be known) one-arm study in pediatric participants receiving general anesthesia. The participants are children aged 1-15 years old, planned to undergo head and neck, thoracic (except heart), urological, orthopedic or plastic surgery. Approximately 80 participants will be enrolled in this study. These participants are divided into two groups by age (1-6 and 7-15 years old). Pharmacokinetic (what the body does to the drug,) blood samples will be collected from at least 3 participants between the ages of 1 and 6 years and at least 3 participants between the ages of 7 and 15 years from 15 minutes after the start of infusion to the end of infusion of the study drug . The study consists of 4 phases: screening phase, treatment phase, recovery phase and follow-up phase. Screening for eligible participants will be performed within 14 days before administration of the study drug. The safety and tolerability of study drug will be evaluated by physical examinations, electrocardiogram (ECG), clinical laboratory tests, vital signs, and adverse events (AEs) according to the Time and Events Schedule. Participants safety will be monitored throughout the study.

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Phase 3

Contacts and Locations

Study Locations

• Japan
  • Asahikawa, Japan
  • Kobe, Japan
  • Kure, Japan
  • Kurume, Japan
  • Ohmura, Japan
  • Osaka, Japan
  • Shimajiri, Japan
  • Shimotsuke, Japan
  • Tokyo, Japan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year to 15 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participants scheduled to receive surgery under general anesthesia, necessitating airway securing with tracheal intubation and analgesia with opioid analgesics
• American Society of Anesthesiologists (ASA) Physical Status Classification is I or II at the time of operation planning
• Participants scheduled to receive operations estimated to take 30 minutes or more from skin incision i.e. Head and neck, thoracic (except heart), intraperitoneal, ophthalmological, otorhinolaryngological, urological, orthopedic or plastic surgery
• Girls having undergone menarche are eligible only if the urine pregnancy test at the time of screening is negative Exclusion Criteria:-
• Chronic use of opioid analgesics or their use within 12 hours before the planned start of general anesthesia - Hypersensitivity to opioid analgesics or local anesthetics
• History of jaundice or unexplained fever induced by halogenated anesthetics
• Unstable hemodynamics (eg. congenital heart disease, congenital diaphragmatic hernia) Ideal body weight is not within the 10th to 90th percentile received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 90 days before the planned first dose of study drug or is currently enrolled in an investigational study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Remifentanil (0.25 µg/kg/min)

Drug: Remifentanil; After intubation, continuous intravenous infusion of remifentanil (0.25 µg/kg/min) is started, while anesthesia is maintained with inhaled or intravenous anesthetics. In cases where sedation by general anesthetics and analgesia by lidocaine does not seem to provide a sufficient means of analgesia at the time of intubation, remifentanil may be used, beginning before intubation. The rate of infusion may be adjusted while monitoring the subject's general condition in 25% to 100% increments or in 25% to 50% decrements every 2 to 5 minutes, but should not exceed 1.3 µg/kg/min.; Other Names: remifentanil hydrochloride (JNJ-268229)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with positive response to skin incision	Positive response is defined by the presence of at least one of below listed conditions: Heart rate increased >20% above baseline (that is measured under stable hemodynamics after intubation, and 1-5 minutes before the planned start of skin incision) for >1 minute); Systolic blood pressure increased >20% above baseline (that is measured under stable hemodynamics after intubation, and 1-5 minutes before the planned start of skin incision) for >1 minute; Gross movement, swallowing, eye opening (if there are patches on the eyes, this assessment might be not evaluated) or grimacing and sweating, lachrymation or mydriasis.	5-minute assessment period after skin incision

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hemodynamics stability	Heart Rate and Blood Pressure increased >20% above baseline that is measured under stable hemodynamics after intubation, and 1-5 minutes before the planned start of skin incision for less than or equal to 1 minute.	5-60 minutes before the start of intubation, 1-5 minutes before the planned start of the first skin incision. and 240 minutes after completion of anesthesia or skin closure
Drugs used to deal with insufficient anesthesia (inadequate anesthesia) or excessive anesthesia	The time interval between completion of anesthesia and extubation is calculated based on both the time upon completion of general anesthesia and the time upon completion of extubation and recorded.	Time interval between completion of anesthesia and extubation
Assessment on analgesic effect	Assess an analgesic effect of JNJ-268229 during operation on 3-point ranging from "effective / not effective / undeterminable" generally.	240 minutes after completion of anesthesia
Total dose level of remifentanil	The overall use (including dose increase/decrease, time of dose increase/decrease and start time of single supplemental bolus injection, etc) of remifentanil will be recorded.	1-5 minutes before the planned start of the first skin incision. and 240 minutes after completion of anesthesia or skin closure
Total concomitant anesthetic dose level	The overall use (drug name, dose and start time, etc) of the inhaled or intravenous anesthetics used for general anesthesia	1-5 minutes before the planned start of the first skin incision. and 240 minutes after completion of anesthesia or skin closure
Time from completion of anesthesia to resumption of spontaneous respiration	The time taken from completion of anesthesia to resumption of spontaneous respiration is calculated based on both the time upon completion of general anesthesia and the time upon confirmation of resumed spontaneous respiration and recorded.	1-5 minutes before the planned start of the first skin incision. and 240 minutes after completion of anesthesia or skin closure
Time until arrival of Steward Postanesthetic Recovery Score at 6	Recovery Score is rated as Consciousness,Airway and Movement	240 minutes after completion of anesthesia or skin closure
Time from completion of anesthesia to discharge from the recovery room	Anesthesia is calculated based on both the time upon completion of general anesthesia and the time upon discharge from the operating /recovery room.	240 minutes after completion of anesthesia or skin closure
Respiratory stability	Heart Rate and Blood Pressure increased >20% above baseline that is measured under stable hemodynamics after intubation, and 1-5 minutes before the planned start of skin incision for less than or equal to 1 minute.	5-60 minutes before the start of intubation, 1-5 minutes before the planned start of the first skin incision. and 240 minutes after completion of anesthesia or skin closure

Collaborators and Investigators

• Sponsor: Janssen Pharmaceutical K.K.

Publications and helpful links

Helpful Links

• An Open-Label Study to Evaluate the Efficacy and Safety of JNJ-268229 in Pediatric Subjects General Anesthetised

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Actual): November 1, 2014
• Study Completion (Actual): November 1, 2014

Study Registration Dates

• First Submitted: November 15, 2013
• First Submitted That Met QC Criteria: November 25, 2013
• First Posted (Estimate): November 28, 2013

Study Record Updates

• Last Update Posted (Estimate): November 16, 2015
• Last Update Submitted That Met QC Criteria: November 13, 2015
• Last Verified: November 1, 2015

More Information

Terms related to this study

• Keywords: Remifentanil; Anesthesia; Ultiva
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Peripheral Nervous System Agents; Analgesics; Sensory System Agents; Analgesics, Opioid; Narcotics; Remifentanil
• Other Study ID Numbers: CR102524; ULTIVAANS3001 (Other Identifier: Janssen Pharmaceutical K.K., Japan)