- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05386979
Multimodal Analgesic Management of Naborphine Combined With Opioid Free Anesthesia in OSA Patients Undergoing Bariatric Surgery
May 22, 2022 updated by: Lili Cao, Qianfoshan Hospital
Multimodal Analgesic Management of Naborphine Combined With Opioid Free Under General Anesthesia in OSA Patients Undergoing Weight Loss Surgery Under the Concept of ERAS: a Prospective, Randomized, Parallel Controlled Study
Comparative study to explore the effect of opioid free anesthesia technology in perioperative analgesia management, clarify the effect of naborphine instead of opioids on perioperative analgesia management in morbid obesity patients with moderate and severe OSA, reduce related adverse events, and explore the latest clinical anesthetic drugs.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
- The concept of enhanced recovery after surgery (ERAS) has been applied in the perioperative period of many operations. Reducing the dosage of opioids is an important part of the concept of ERAS.
- Opioid free anesthesia technology has been recognized in reducing nausea and vomiting, but whether it can meet the perioperative analgesic needs of patients undergoing bariatric surgery and obtain more clinical benefits still has no research supportment.
- This study is expected to clarify the clinical effect of opioid free anesthesia technology in perioperative analgesia management of morbid obesity patients with moderate and severe OSA, reduce adverse events, and explore the latest clinical anesthesia scheme.
Study Type
Interventional
Enrollment (Anticipated)
48
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Shandong
-
Jinan, Shandong, China, 250000
- Yongtao Sun
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- ASA grade I ~ III;
- Age from 18 - 65 years old;
- BMI ≥ 35kg / m2 in patients with OSA to undergo bariatric surgery; (4 provide written informed consent for participation.
Exclusion Criteria:
- Age < 18 years or age >65 years old;
- Pregnancy test was positive;
- Patients with a history of drug abuse or dependence on opioids;
- Patients with chronic pain or severe heart, lung, liver or nervous system diseases
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Opioid anesthesia group
Anesthesia induction with propofol 2.5mg/kg, rocuronium bromide 0.6mg/kg, sufentanil 0.3μg/kg, intubation was performed when BIS value reached 40-60.
Intraoperative pump injection of propofol 4-12 mg/kg·h and remifentanil 0.2-0.5 μg/kg·min to maintain anesthesia.
Ultrasound-guided transversus abdominis plane block (with 0.375% ropivacaine 40ml) will be implemented preoperatively.
Ondansetron 8mg and sufentanil 10 μg will be given after surgery.
For PCA, sufentanil 2μg/kg + dexmedetomidine 2μg/kg + ondansetron 24mg.
|
We have adopted a variety of methods to replace the use of opioids in the process of balanced anesthesia.
|
Experimental: Opioid free anesthesia group
Anesthesia induction with propofol 2.5mg/kg, rocuronium bromide 0.6mg/kg, naborphine 0.2mg/kg,esketamine 0.3mg/kg, intubation was performed when BIS value reached 40-60.
Intraoperative pump injection of propofol 4-12 mg/kg·h and esketamine 0.3~0.5mg/kg·h.
Ultrasound-guided transversus abdominis plane block (with 0.375% ropivacaine 40ml) will be implemented preoperatively.
Ondansetron 8mg and naborphine 0.2mg/kg will be given after surgery.
For PCA, naborphine 2mg/kg + dexmedetomidine 2μg/kg + ondansetron 24mg.
|
We have adopted a variety of methods to replace the use of opioids in the process of balanced anesthesia.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
postoperative NRS score
Time Frame: Score from the end of the operation and follow-up at the time point specified in the scoring form for a total of 27 hours.
|
A subjective psychometric response scale used to measure distinct behavioral or physiological phenomena based on linear numerical gradient or yes/no alternatives.
The Numeric Pain Scale (NRS) pain numerical score(0-10 score, 0: no pain, 10: worst imaginable pain).
A pain measurement list about quiet NRS score and cough NRS score at different postoperative time will be used.
|
Score from the end of the operation and follow-up at the time point specified in the scoring form for a total of 27 hours.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Dosage of remedial analgesics postoperatively
Time Frame: It takes about 24 hours.
|
If the participant still feels severe pain after operation and needs additional analgesic drugs for treatment, we will record the type and dose of drugs used by the patient.
|
It takes about 24 hours.
|
Hemodynamic fluctuation
Time Frame: From the beginning of the general anesthesia induction to the time leaving PACU, it takes about 4 hours.
|
Hemodynamic fluctuation during perioperative period.
The levels of SBP in mmHg, DBP in mmHg, MAP in mmHg and HR in times/minute in basic(T0), after induction(T1), preoperative(T2) and after establishing pneumoperitoneum(T3) 1h after the pneumoperitoneum(T4) and Immediately after operation(T5), Before(T6) and after(T7) extubation were recorded.
|
From the beginning of the general anesthesia induction to the time leaving PACU, it takes about 4 hours.
|
Ramsay scale
Time Frame: Score from the end of the operation and follow-up at the time point specified in the scoring form for a total of 27 hours.
|
Ramsay scale is the most widely used sedation scoring standard in clinic, which is simple and practical.
This scale has multiple advantages: it is reproducible, easily executed and has good applicability.
This has made the scale the most widely used to assess level of sedation for procedures in pediatrics.
It is divided into six levels(1-6): 1 shows patient is anxious and agitated or restless, or both; 2 shows patient is co-operative, oriented, and tranquil; 3 shows patient responds to commands only; 4 shows patient exhibits brisk response to light tactile stimuli or loudauditory stimulus; 5 shows patient exhibits sluggish response to light tactile stimuli or loud auditory stimulus; 6 shows patient exhibits no response.
|
Score from the end of the operation and follow-up at the time point specified in the scoring form for a total of 27 hours.
|
recovery time
Time Frame: It will take up to 1 hour or 2 hours.
|
From the time when the patient entered PACU to the time when the participant meets the standard of leaving the PACU.
|
It will take up to 1 hour or 2 hours.
|
The levels of C-reactive protein (CRP)
Time Frame: It takes about 24 hours.
|
We will collect the participant's blood at the time before surgery(T0), after surgery(T1), and 24h after surgery(T2) to obtain the levels of C-reactive protein (mg/L).
|
It takes about 24 hours.
|
The levels of cortisol (COR).
Time Frame: It takes about 24 hours.
|
We will collect the participant's blood at the time before surgery(T0), after surgery(T1), and 24h after surgery(T2) to obtain the levels of cortisol (nmol/L).
|
It takes about 24 hours.
|
The levels of blood glucose (BG)
Time Frame: It takes about 24 hours.
|
We will collect the participant's blood at the time before surgery(T0), after surgery(T1), and 24h after surgery(T2) to obtain the levels of blood glucose (mmol/L).
|
It takes about 24 hours.
|
The levels of interleukin-6 (IL-6).
Time Frame: It takes about 24 hours.
|
We will collect the participant's blood at the time before surgery(T0), after surgery(T1), and 24h after surgery(T2) to obtain the levels of IL-6 (pg/mL).
|
It takes about 24 hours.
|
Scores of 15-item Quality of Recovery (QoR-15) scale 24 hours postoperatively of participants.
Time Frame: One day after the surgery.
|
The QoR-15 scale is a validated tool to assess the quality of postoperative recovery (QoR) from 0 to 150.
The QoR was classified as excellent (QoR-15 > 135), good (122 ≤ QoR-15 ≤ 135), moderate (90 ≤ QoR-15 ≤ 121) or poor (QoR-15 < 90).
|
One day after the surgery.
|
Rate of postoperative nausea and vomiting
Time Frame: It takes about 24 hours.
|
Postoperative nausea and vomiting will be recorded if it happens.
|
It takes about 24 hours.
|
Acceptability of participants with laryngeal mask 24 hours after surgery.
Time Frame: One day after the surgery.
|
One day after surgery, we will record the acceptability of laryngeal mask and the degree of postoperative pharyngeal pain of the participants.
Acceptability of participants with laryngeal mask will be assessed by whether the participant was willing to receive laryngeal mask anesthesia again.
Pharyngeal pain can be evaluated using the Numeric Pain Scale (NRS) pain numerical score.
A subjective psychometric response scale used to measure distinct behavioral or physiological phenomena based on linear numerical gradient or yes/no alternatives.
The Numeric Pain Scale (NRS) pain numerical score(0-10 score, 0: no pain, 10: worst imaginable pain).
|
One day after the surgery.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Yongtao Sun, doctor, Qianfoshan Hospital, The First Hospital affiliated of Shandong First Medical University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
May 15, 2022
Primary Completion (Anticipated)
January 31, 2023
Study Completion (Anticipated)
October 31, 2023
Study Registration Dates
First Submitted
May 10, 2022
First Submitted That Met QC Criteria
May 22, 2022
First Posted (Actual)
May 24, 2022
Study Record Updates
Last Update Posted (Actual)
May 24, 2022
Last Update Submitted That Met QC Criteria
May 22, 2022
Last Verified
May 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- YXLL-KY-2022(035)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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 Analgesics,Opioid
-
matthieu clanetCompletedAnalgesics, OpioidBelgium
-
University of North Carolina, Chapel HillNorth Carolina Department of Health and Human ServicesCompleted
-
Massachusetts General HospitalCompletedPregnancy | Cesarean Section | Analgesics, Opioid | PrescriptionsUnited States
-
Jagiellonian UniversityRecruitingAnesthesia, General | Analgesics, Opioid | Anesthesia, EndotrachealPoland
-
The University of Texas Health Science Center,...WithdrawnMorphine | Analgesics, Opioid | Peripheral Nervous System Agents | AnalgesicsUnited States
-
The University of Texas Health Science Center,...CompletedMorphine | Analgesics, Opioid | Central Nervous System Depressants | Analgesics | Narcotics | Physiological Effect of DrugsUnited States
-
Alza Corporation, DE, USACompletedPain | Analgesics, Opioid
-
Alza Corporation, DE, USACompleted
-
Ludwig-Maximilians - University of MunichUniversity Hospital Heidelberg; University of Witten/Herdecke; University Hospital... and other collaboratorsRecruitingAntipsychotic Agents | Antidepressive Agents | Analgesics, Opioid | Deprescriptions | Hypnotics and Sedatives | Cholinergic AntagonistsGermany
-
University of SaskatchewanRecruitingLaparoscopic Surgery | Analgesia | Colorectal Surgery | Anesthesia | Ketamine | General Anesthesia | Dexmedetomidine | Postoperative Ileus | Analgesics, Opioid | Lidocaine | Opioid Free AnesthesiaCanada
Clinical Trials on Opioid free anesthesia technology
-
University of SheffieldUniversity of HuddersfieldCompleted
-
Peking University People's HospitalCompleted
-
University of CreteRecruitingSystemic Inflammatory Response Syndrome | Non-small Cell Lung Cancer | Anesthesia | Opioid Use | Postoperative Pain, Acute | Postoperative Pain, Chronic | Infections PostoperativeGreece
-
University of CreteUniversity Hospital of CreteRecruitingPostoperative Pain | Anesthesia | Opioid Use | Interleukin 6 | Elective Surgical Procedures | Abdominal Aortic Aneurysm Without Rupture | Vascular Surgical Procedure | ImmunomodulatorsGreece
-
AZ Sint-Jan AVCompletedDecreased Lung Compliance | Oxygen RequirementBelgium
-
Northwell HealthRecruiting
-
Instituto de Investigación Hospital Universitario...CompletedBreast Cancer | Ovarian Cancer | Cervix Cancer | Endometrial CancerSpain
-
Lebanese American UniversityCompletedPostoperative Pain | Opioid Use | Spine DiseaseLebanon
-
Zulekha HospitalsCompleted