- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04122196
Perioperative Pregabalin in Ureteroscopy
Perioperative Pregabalin as Part of a Multimodal Treatment Plan for Ureteral Stent Symptoms After Ureteroscopy: a Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The prevalence of urolithiasis is greater than 8% and increasing in the United States. For those who require surgery, ureteroscopic treatment is common, representing >120,000 procedures yearly in the United States. This does not include ureteroscopy for other, including diagnosis of structural anomaly and diagnosis and management of ureteral and renal pelvic tumors. Frequently, a ureteral stent is placed intraoperatively. There is post-operative pain in around 80% of patients, and 12% of those undergoing ureteroscopy will have an emergency department visit in the first 30 post-operative days, typically for stent related symptoms or post procedural pain. Aside from the short-term repercussions of ureteroscopy with stent placement there are long-term issues related to pain and the treatment thereof. Recent evidence suggests that approximately 6% of opioid naïve patients who undergo ureteroscopy will become new persistent opioid users.
A single perioperative dose of pregabalin has been shown in many surgical contexts to have analgesic, anxiolytic, and opioid sparing effects. A common regimen employed in the literature is a single preoperative dose of 300mg PO pregabalin 1hr before induction of anesthesia. Pregabalin is a well-tolerated gabapentinoid medication with temporary cognition/coordination changes being the most common side effects. There is currently no standard of care for the use of perioperative gabapentinoid medication in ureteroscopy. A pilot was performed looking at such use that demonstrated the safety of this use and the feasibility of studying this at our institution.
In this work, the efficacy and safety of perioperative pregabalin in ureteroscopy with stent placement will be evaluated by executing a prospective, double blind, randomized, placebo-controlled trial for the use of perioperative pregabalin in the management of post-ureteroscopy symptoms, with the hypothesis that this treatment is safe and efficacious. Emphasis will be placed on patient-centered outcomes, especially those related to opioid sparing effects, mainly within the first 30 days after the surgery and extending out to one year.
The study will be powered with an 80% probability to detect a 10% difference in the primary outcomes. It will also assume a loss to follow up rate of 50%. This will require approximately 200 total subjects with a planned 1:1 placebo to active treatment enrollment ratio. The necessary enrollment can be accomplished in 11 months, allowing for 30 days of follow up within the funding period.
The final goal of this project will be at least one paper in a top urology journal. This will contribute to the literature by helping to inform urologists and anesthesiologists on the efficacy and safety of perioperative pregabalin for ureteroscopy with stent placement and will provide data regarding opioid sparing management after ureteroscopy. Opioid related issues abound nationwide and are evident in Missouri. This study has the potential to influence opioid use both in this state and nationwide as it relates to this frequently performed procedure.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
- Name: Geoffrey H Rosen, MD
- Phone Number: 5738824141
- Email: rosenge@health.missouri.edu
Study Contact Backup
- Name: Katie Murray, DO
- Email: murraykat@health.missouri.edu
Study Locations
-
-
Missouri
-
Columbia, Missouri, United States, 65212
- University of Missouri-Columbia
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Subject Inclusion:
- Age >= 18 years
- Subject Population Undergoing elective ureteroscopy with stent placement at University of Missouri Hospital and affiliated facilities
Subject Exclusion:
- Renal insufficiency (eGFR < 60 mL/minute/1.73 m2)
- Chronic indwelling ureteral stent (>30 days in the previous year)
- Chronic opioid use
- History of opioid abuse
- Chronic gabapentinoid use
- History of gabapentinoid abuse
- Plan for inpatient hospitalization
- Pregnancy
- Inability of the patient to consent for themselves in English
- Allergy to gabapentinoid
- Liver failure or hepatic dysfunction
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 |
---|---|
Experimental: Pregabalin 300mg
Patient will receive a compounded version of 300mg pregabalin PO approximately one hour before surgery.
|
Patient will receive a compounded version of 300mg pregabalin PO approximately one hour before surgery.
Other Names:
|
Placebo Comparator: Placebo
Patient will receive a compounded version of inactive placebo PO approximately one hour before surgery.
|
Patient will receive a compounded version of inactive placebo PO approximately one hour before surgery.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Visual analog scale of pain score
Time Frame: 1 hour after arrival to post anesthesia care unit
|
1 hour after arrival to post anesthesia care unit
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oral morphine equivalents of opioids prescribed
Time Frame: Within the first 30 days post-operation
|
Within the first 30 days post-operation
|
|
Proportion of patients with narcotic prescription
Time Frame: Within the first 30 days post-operation
|
Within the first 30 days post-operation
|
|
Number of unplanned healthcare interactions
Time Frame: Within the first 30 days post-operation
|
Unplanned healthcare interactions include unplanned visits, emergency room visits, admissions to the hospital, and phone calls
|
Within the first 30 days post-operation
|
Number of serious adverse events
Time Frame: Within the first 30 days post-operation
|
Composite of unplanned serious adverse events including intensive care unit stay and death
|
Within the first 30 days post-operation
|
Proportion of patients reporting nausea or vomiting
Time Frame: 1 hour after arrival to post anesthesia care unit
|
1 hour after arrival to post anesthesia care unit
|
|
Watson clock drawing test score
Time Frame: 1 hour after arrival to post anesthesia care unit
|
1 hour after arrival to post anesthesia care unit
|
Other Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Baseline visual analog scale of pain score
Time Frame: In the pre-operative area before medication administration
|
In the pre-operative area before medication administration
|
Baseline Watson clock drawing test score
Time Frame: In the pre-operative area before medication administration
|
In the pre-operative area before medication administration
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Katie Murray, DO, Assistant professor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Kidney Diseases
- Urologic Diseases
- Postoperative Complications
- Pain
- Neurologic Manifestations
- Pathological Conditions, Anatomical
- Urolithiasis
- Urinary Calculi
- Calculi
- Nephrolithiasis
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Male Urogenital Diseases
- Pain, Postoperative
- Kidney Calculi
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Membrane Transport Modulators
- Anti-Anxiety Agents
- Anticonvulsants
- Calcium-Regulating Hormones and Agents
- Calcium Channel Blockers
- Pregabalin
Other Study ID Numbers
- 2017676
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.
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.
Clinical Trials on Pain, Postoperative
-
Dr. Negrin University HospitalCompletedPostoperative Pain, Acute | Postoperative Pain, ChronicSpain
-
Atatürk Chest Diseases and Chest Surgery Training...RecruitingPostoperative Pain | Thoracotomy | Postoperative Pain, Acute | Postoperative Pain, ChronicTurkey
-
Ankara City Hospital BilkentRecruitingPostoperative Pain | Postoperative Pain, Acute | Postoperative Pain, Chronic | SternotomyTurkey
-
Atatürk Chest Diseases and Chest Surgery Training...RecruitingPostoperative Pain | Postoperative Pain, Acute | Postoperative Pain, Chronic | VATSTurkey
-
Aydin Adnan Menderes UniversityCompleted
-
Aydin Adnan Menderes UniversityCompletedAcute Postoperative Pain | Chronic Postoperative PainTurkey
-
Maimonides Medical CenterCompletedPOSTOPERATIVE PAINUnited States
-
University Hospital, AntwerpUnknown
-
VA Office of Research and DevelopmentRecruitingTotal Knee Arthroplasty (Postoperative Pain) | Total Hip Arthroplasty (Postoperative Pain)United States
-
VA Office of Research and DevelopmentCompletedTotal Knee Arthroplasty (Postoperative Pain) | Total Hip Arthroplasty(Postoperative Pain)United States
Clinical Trials on Pregabalin 300mg
-
Yousra Hisham Abdel FattahCompletedFibromyalgia, PrimaryEgypt
-
GL Pharm Tech CorporationCompleted
-
Yuhan CorporationCompletedPeripheral Neuropathy PainKorea, Republic of
-
Yuhan CorporationCompletedPeripheral Nueropathy Pain
-
Suzhou Zelgen Biopharmaceuticals Co.,LtdCompleted
-
Viatris Specialty LLCCompletedAbuse PotentialUnited States
-
Grupo Español de Tumores Huérfanos e InfrecuentesTakedaTerminatedMetastatic or Advanced Non-resectable Granulosa Cell Ovarian TumorsSpain
-
Yale UniversityNational Institute on Drug Abuse (NIDA); US Department of Veterans AffairsCompleted
-
Hôpital Universitaire Fattouma BourguibaCompleted
-
Chelsea and Westminster NHS Foundation TrustMerck Sharp & Dohme LLCRecruiting