- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05485480
Nociception Level During Opioid-sparing Anaesthesia Versus Conventional Opioid-based Anaesthesia (NOL_Basel)
Nociception Level During Opioid-sparing Anaesthesia Versus Conventional Opioid-based Anaesthesia: a Randomised Controlled Non-inferiority Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Oliver Bandschapp
- Phone Number: +41 61 328 6513
- Email: oliver.bandschapp@usb.ch
Study Locations
-
-
-
Basel, Switzerland, 4031
- Recruiting
- Department of Anaesthesiology, University Hospital Basel
-
Contact:
- Oliver Bandschapp, PD Dr. med.
- Phone Number: +41 61 328 6513
- Email: oliver.bandschapp@usb.ch
-
Principal Investigator:
- Oliver Bandschapp, PD Dr. med.
-
Sub-Investigator:
- Luzius Steiner, Prof. Dr. med.
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Sub-Investigator:
- Ann-Kathrin Popp
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Sub-Investigator:
- Bigna Buddeberg, Dr. med.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Informed Consent as documented by signature
- Age older than 18 years
- Ability to give informed consent
- Undergoing scheduled general surgical, gynaecological or urological laparoscopic surgery
- American Society of Anesthesiology Score (ASA) status I, II, III
Exclusion Criteria:
- Inability to give informed consent
- ASA status IV and V
- Pregnant or breastfeeding women
- Allergy to one of the study drugs
- Urgent surgery
- Surgery with planned regional anaesthesia
- Outpatient surgery
- Atrioventricular block, intraventricular or sinoatrial block
- Atrial fibrillation
- Sinus bradycardia
- Cardiac insufficiency with a reduced left ventricular ejection fraction of below 40%
- Coronary artery disease
- Epilepsy
- Liver cirrhosis
- Chronic kidney disease (Clearance < 50ml/h)
- Chronic opioid therapy
- Chronic pain
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Opioid-sparing: Lidocaine, Ketamine, Magnesium, Clonidine, Fentanyl, Remifentanil, Propofol
Ketamine: started at 5mg/h; continued until 30min before end of surgery, then reduced to 1mg/h until discharge from recovery. Fentanyl: bolus of 50mcg before skin incision (in case of insufficient analgesia further boluses of 25mcg, upper limit is 100mcg). Lidocaine: bolus of 1.5mg/kg of ideal body weight (IBW),(maximum 100mg) at induction of anaesthesia, then continuous infusion of 1.5mg/kg IBW/h (maximum 100mg/h) until discharge from recovery. Magnesium: infusion of 2g/h for a maximum of 2h after induction of anaesthesia (maximum dose 4g). In case of bradycardia or hypotension, rate is reduced to 1g/h. Clonidine: bolus of 15mcg if needed. Maximum amount 150mcg. Remifentanil: started at time of induction of anaesthesia until end of surgery. |
In addition to propofol as a hypnotic and rocuronium as a muscle relaxant, patients in the opioid-sparing group will receive Ketamine, Fentanyl, Lidocaine, Magnesium, Clonidine, Remifentanil
|
ACTIVE_COMPARATOR: Conventional group: Fentanyl, Remifentanil, Propofol
Control Intervention: Remifentanil: Remifentanil is given as a target controlled infusion using the Minto-model. It is started at the timepoint of induction of anaesthesia and given until the end of surgery. Fentanyl: 2mcg/kg i.v. is given at the time of induction of anaesthesia and another 1-2mcg/kg is given prior to incision. Further fentanyl boluses (1-2mcg/kg boluses) are given in case there seems to be insufficient analgesia. |
In addition to propofol as a hypnotic and rocuronium as a muscle relaxant, patients in the conventional opioid-based group will receive the following drugs: Remifentanil and Fentanyl
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean of the nociception level as measured by the PMD-200
Time Frame: From the timepoint of skin incision until skin closure (within 1 day)
|
The PMD-200 device consists of a finger probe which continuously assesses pulse rate, pulse rate variability, pulse wave amplitude, skin conductance level, skin conductance fluctuations, skin temperature, and finger motion.
A value of 0 corresponds to no pain and a value of 100 to maximal pain.
A value will be measured every minute from the timepoint of skin incision until skin closure.
|
From the timepoint of skin incision until skin closure (within 1 day)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Aldrete score
Time Frame: Every 15 minutes in recovery until patient discharge to the ward (within 1 day)
|
Fitness for discharge to ward is checked every 15 minutes with the Aldrete score.
The Aldrete score assigned a number of 0, 1, or 2 to 5 variables: activity, respiration, circulation, consciousness, and color.
A score of 9 out of 10 is considered adequate for discharge from the recovery.
|
Every 15 minutes in recovery until patient discharge to the ward (within 1 day)
|
Amount of morphine needed
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Amount of morphine needed
|
From the stay in recovery before discharge from the ward (average of 1 week)
|
Amount of ketamine needed
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Amount of ketamine needed
|
From the stay in recovery before discharge from the ward (average of 1 week)
|
Change in pain score at rest by numeric rating scale
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Change in pain score at rest by numeric rating scale (to assess pain severity using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable)
|
From the stay in recovery before discharge from the ward (average of 1 week)
|
Change in pain score at movement by numeric rating scale
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Change in pain score at movement by numeric rating scale (to assess pain severity using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable)
|
From the stay in recovery before discharge from the ward (average of 1 week)
|
Quality of night's sleep
Time Frame: From the first postoperative day until discharge from ward (average of 1 week)
|
Quality of night's sleep assessed with a verbal numerical scale from 0 (very poor quality of sleep) to 10 (excellent quality of sleep)
|
From the first postoperative day until discharge from ward (average of 1 week)
|
Occurrence of nausea and vomiting
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Occurrence of postoperative nausea and vomiting (PONV)
|
From the stay in recovery before discharge from the ward (average of 1 week)
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Change in level of sedation
Time Frame: At 4 hours and then twice daily until discharge from the ward (average of 1 week)
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Change in level of sedation
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At 4 hours and then twice daily until discharge from the ward (average of 1 week)
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Perceived quality of recovery by QoR40 questionnaire
Time Frame: At the first postoperative day
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40-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain
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At the first postoperative day
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Time to return of gastrointestinal function
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
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Time to return of gastrointestinal function as defined as the time from the end of surgery to the first passage of flatus and to the first bowel movement
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From the stay in recovery before discharge from the ward (average of 1 week)
|
Time to return of spontaneous micturition
Time Frame: From the stay in recovery before discharge from the ward (average of 1 week)
|
Time to return of spontaneous micturition
|
From the stay in recovery before discharge from the ward (average of 1 week)
|
Collaborators and Investigators
Investigators
- Study Director: Thierry Girard, Prof. Dr. med., Department of Anaesthesiology, University Hospital Basel
- Principal Investigator: Oliver Bandschapp, PD Dr. med., Department of Anaesthesiology, University Hospital Basel
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2022-00283; qu20Bandschapp
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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