- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05206110
Low Dose Versus Normal Dose Ketorolac for Postoperative Pain After Prostatectomy and Hysterectomy
Low Dose Versus Normal Dose Ketorolac for Postoperative Pain After Prostatectomy and Hysterectomy: a Double-blind Randomized Controlled Non-inferiority Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Ketorolac, a non-steroidal anti-inflammatory drug (NSAID), is a commonly used and effective drug for moderate to severe postoperative pain. It is widely prescribed as one of the first steps in acute and postoperative pain since decades. Because of its non-opioid character, this type of drug is safe concerning the risk of addiction and respiratory depression in the postoperative setting, but other side-effects are well known.
Gastro-intestinal (GI) haemorrhage is the most feared complication. The risk of a GI-bleeding increases with age, higher doses and longer duration of therapy. Decrease in renal function seems less important than always assumed. Feldman et al proved that developing renal failure with the use of NSAIDs was rather rare (1,1%) and similar for ketorolac as for opioids. Nonetheless, the risk again increased in a linear fashion with the duration of use. Especially for the postoperative and trauma patient, the fear of platelet inhibition and subsequent bleeding has dominated restriction of its use. Other adverse effects of ketorolac, i.e. cardiovascular toxicity, asthma, allergic reaction, etc., are usually less of a concern for the physician.
In an attempt to reduce these unwanted side effects but still have the benefit of its highly effective analgesic activity, patients should be given the lowest effective dose. Several studies have already demonstrated that ketorolac analgesic efficacy at 10 mg is similar to that at higher doses due to a ceiling effect. Unfortunately, none of the published trials investigated pain scores of the alternative dose beyond 6 hours. Based on the pharmacokinetics of ketorolac, it is possible that the lower dose will loose its analgesic effect after a shorter period. To investigate whether this alternative dose of ketorolac will preserve its analgesic efficacy up to eight hours postoperative, the primary goal of this study will be the pain score after 8 hours, right before the next dose of ketorolac.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Björn Stessel
- Phone Number: 003211222107
- Email: bjorn.stessel@jessazh.be
Study Contact Backup
- Name: Ina Callebaut
- Phone Number: 003211339848
- Email: ina.callebaut@jessazh.be
Study Locations
-
-
Limburg
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Hasselt, Limburg, Belgium, 3500
- Recruiting
- Jessa Hospital
-
Contact:
- Björn Stessel, Dr.
- Phone Number: 003211222107
- Email: bjorn.stessel@jessazh.be
-
Contact:
- Ina Callebaut, PhD
- Phone Number: 003211339848
- Email: ina.callebaut@jessazh.be
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients between 18 and 70 years
- Patients undergoing RARP, LAVH or TLH
- ASA 1-3
- Scheduled as inpatient surgery (at least 1 night)
- Body weight > 60 kg
Exclusion Criteria:
- Refusal of the patient
- Cognitive impairment or no understanding of the Dutch language
- Allergy for salicylates or NSAID
- Pregnancy
- Active or history of peptic ulcer disease
- History of gastro-intestinal hemorrhage or perforation
- History of gastric bypass
- History of renal disease with creatinine > 1 mg/dl
- Haematological disease
- Tromboctopenia < 150000 / µl
- Current anticoagulant use
- Current clopidogrel use
- History of substance abuse or use of medication with a suppressive effect on the central nervous system
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Peri- and postoperative 10 mg Ketolorac
Patients undergoing LAVH, RARP or TLH will receive dosages of 10 mg ketolorac (IV).
|
Patients undergoing LAVH, RARP or TLH will receive half an hour before the end of surgery, 10 mg ketorolac (IV).
Also, 10 mg IV ketorolac will be given 8h and 16h after the surgery
|
Active Comparator: Peri- and postoperative standard-dose 30 mg Ketolorac
Patients undergoing LAVH, RARP or TLH will receive standard dosages of 30 mg ketolorac (IV).
|
Patients undergoing LAVH, RARP or TLH will receive half an hour before the end of surgery, 30 mg ketorolac (IV).
Also, 30 mg ketorolac will be given 8h and 16h after the surgery
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain at rest 8 hours after surgery: Numeric Rating Scale (NRS)
Time Frame: At 8 hours after surgery
|
Pain at rest 8 hours after surgery (measured via an 11-point Numeric Rating Scale where 0 = no pain and 10 is worst pain imaginable)
|
At 8 hours after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain at rest at PACU, 2, 4, 6, 12, 16 and 24 hours after surgery: Numeric Rating Scale (NRS)
Time Frame: At PACU, 2, 4, 6, 12, 16 and 24 hours after surgery
|
Pain at rest at PACU, 2, 4, 6, 12, 16 and 24 hours after surgery (measured via an 11-point Numeric Rating Scale where 0 = no pain and 10 is worst pain imaginable)
|
At PACU, 2, 4, 6, 12, 16 and 24 hours after surgery
|
Pain at movement at PACU, 2, 4, 6, 8, 12, 16 and 24 hours after surgery: Numeric Rating Scale
Time Frame: At PACU, 2, 4, 6, 8, 12, 16 and 24 hours after surgery
|
Pain at movement at PACU, 2, 4, 6, 12, 16 and 24 hours after surgery (measured via an 11-point Numeric Rating Scale where 0 = no pain and 10 is worst pain imaginable)
|
At PACU, 2, 4, 6, 8, 12, 16 and 24 hours after surgery
|
Piritramide consumption at PACU (mg)
Time Frame: At PACU until 2 hours after surgery
|
Mean total postoperative intravenous piritramide consumption at PACU (milligram)
|
At PACU until 2 hours after surgery
|
Piritramide consumption first 24 hours postoperative (mg): PCIA pump
Time Frame: First 24 hours after surgery
|
Total amount of intravenous piritramide used in the first 24h postoperative.
Use of piritramide will be objectified by a patient controlled intravenous analgesia (PCIA) pump.
Information on piritramide consumption will be extracted from the PCIA-system and analyzed using 4-hour intervals.
|
First 24 hours after surgery
|
Quality of sleep during the first postoperative night: Numeric Rating Scale
Time Frame: First postoperative night
|
Quality of sleep during the first postoperative night, as measured by an 11-point NRS (where 0 = no sleep at all, and 10 = sleeping very well)
|
First postoperative night
|
Patient satisfaction: Numeric Rating Scale
Time Frame: 1week postoperatively assessed with telephone-call
|
Overall patient satisfaction with pain therapy, as assessed with an 11-point NRS scale (where 0 = not satisfied at all and 10 = extremely satisfied).
|
1week postoperatively assessed with telephone-call
|
Global Surgical Recovery Index
Time Frame: Before surgery (baseline) and 1 week postoperatively assessed with telephone-call
|
General health status at that moment, as assessed with a scale (where 0=worst imaginable health status, and 100 = best imaginable health status)
|
Before surgery (baseline) and 1 week postoperatively assessed with telephone-call
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EQ-5D
Time Frame: Before surgery (baseline) and 1 week postoperatively assessed with telephone-call
|
Quality of life concerning mobility, self-care, pain/discomfort and anxiety/depression, as assessed with a score (where 0 = lowest quality of life, and 1 = highest quality of life)
|
Before surgery (baseline) and 1 week postoperatively assessed with telephone-call
|
Adverse effects of ketorolac use or suspected by the use of ketorolac
Time Frame: During study completion, i.e. 1 week after the surgery
|
Possible adverse effects related to ketolorac are: GI-bleeding, acute kidney failure (defined as an increase in serum creatinine by 1,5), postoperative bleeding (defined as the necessity of packed cells transfusion or surgical relook), allergic reaction and asthma exacerbation.
|
During study completion, i.e. 1 week after the surgery
|
Fear of the surgical procedure: Surgical fear questionnaire
Time Frame: Before surgery (baseline)
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Fear of the surgical procedure using an 8-item Surgical Fear Questionnaire.
|
Before surgery (baseline)
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Expected pain after surgery: Numeric Rating Scale
Time Frame: Before surgery (baseline)
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Expected pain after surgery measured via an 11-point Numeric Rating Scale where 0 = no pain and 10 is worst pain imaginable)
|
Before surgery (baseline)
|
Pain before surgery: Numeric Rating Scale
Time Frame: Before surgery (baseline)
|
Pain before surgery measured via an 11-point Numeric Rating Scale where 0 = no pain and 10 is worst pain imaginable)
|
Before surgery (baseline)
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
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
- Postoperative Complications
- Pain
- Neurologic Manifestations
- Pain, Postoperative
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Cyclooxygenase Inhibitors
- Ketorolac
- Ketorolac Tromethamine
Other Study ID Numbers
- f/2021/129
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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