Effects of Perioperative Intravenous Dexamethasone on the Severity of Persistent Postsurgical Pain After Total Knee Arthroplasty : A Prospective, Randomized, Double-blind, Placebo-controlled Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Forventet)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Nitchanant Kitcharanant, MD
- Telefonnummer: +66871071133
- E-mail: nk_win@hotmail.com
Studiesteder
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ChiangMai, Thailand, 50200
- Rekruttering
- Department of Orthopedics, Chiang Mai University
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Kontakt:
- Nitchanant Kitchatanant
- Telefonnummer: +66871071133
- E-mail: nk_win@hotmail.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age > 40 years (45)
- Primary knee osteoarthritis diagnosed using the American College of Rheumatology criteria (46)
- Undergoing elective, primary and unilateral total knee arthroplasty
- American Society of Anesthesiology (ASA) physical status class 1-3
- BMI < 40 kg/m2
Exclusion Criteria:
- History of active rheumatic diseases
- History of previous musculoskeletal injury of the same knee for excluding patients with secondary knee osteoarthritis
- History of previous surgery on the same knee
- History of adverse effects from medications to be used in this study
- Contraindication to spinal anesthesia
- History of psychiatric disorders or cognitive impairment
- Contraindication to corticosteroid agents
- Poorly controlled diabetes mellitus (HbA1C > 7.5)
- Poorly controlled hypertension
- History of ischemic heart disease or peripheral arterial disease or cerebrovascular disease
- Hepatic insufficiency (Child-Pugh score > 5)
- Renal insufficiency (Creatinine clearance < 30 mL/min)
- History of cataracts or glaucoma or ocular hypertension
- History of steroid or immunosuppressive drug use within 6 months of surgery
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: Dexamethasone
The steroid group will receive Dexamethasone 10 mg IV immediately prior to induction of spinal anesthesia and will receive a second and third dose of Dexamethasone 10 mg IV postoperatively at 24 and 48 hrs.
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Placebo komparator: Placebo
The control group will receive sterile normal saline solution, serving as placebo, IV immediately prior to induction of spinal anesthesia and will receive a second and third dose of placebo IV postoperatively 24 and 48 hrs.
Both Dexamethasone and normal saline solution will be administered as an IV push.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Modified WOMAC scores for pain at 12 weeks postoperative
Tidsramme: 12 weeks
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using the modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis questionnaire
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12 weeks
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Visual analogue scales for pain during a five-meter walk (0-100)
Tidsramme: postoperatively at 24, 30, 48, 54, 72 hrs
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postoperatively at 24, 30, 48, 54, 72 hrs
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Visual analogue scales for pain during 45 degree active knee flexion (0-100)
Tidsramme: postoperatively at 6, 24, 30, 48, 54, 72 hrs
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postoperatively at 6, 24, 30, 48, 54, 72 hrs
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Visual analogue scales for current pain at rest in a supine position (0-100)
Tidsramme: postoperatively at 6, 24, 30, 48, 54, 72 hrs
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postoperatively at 6, 24, 30, 48, 54, 72 hrs
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Visual analogue scales for maximum pain at rest over the last 24 hours and minimum pain at rest over the last 24 hours (0-100)
Tidsramme: postoperatively at 0-24, 24-48, 48-72 hrs
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postoperatively at 0-24, 24-48, 48-72 hrs
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Visual analogue scale values for nausea (0-100)
Tidsramme: postoperatively at 6, 24, 30, 48, 54, 72 hrs
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postoperatively at 6, 24, 30, 48, 54, 72 hrs
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Opioid consumption (mg.)
Tidsramme: during the first 0-24, 24-48, and 48-72 hrs
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during the first 0-24, 24-48, and 48-72 hrs
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Anti-emetic medicine consumption (mg.)
Tidsramme: during the first 0-24, 24-48, and 48-72 hrs
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during the first 0-24, 24-48, and 48-72 hrs
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Maximum degree of active knee flexion
Tidsramme: postoperatively at 24, 48, 72 hrs, 2 weeks, 6 weeks, and 12 weeks
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postoperatively at 24, 48, 72 hrs, 2 weeks, 6 weeks, and 12 weeks
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Modified WOMAC scores for pain
Tidsramme: postoperatively at weeks 2 and 6
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using the modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis questionnaire
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postoperatively at weeks 2 and 6
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Wound complications
Tidsramme: evaluated postoperatively at weeks 2, 6 and 12
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evaluated postoperatively at weeks 2, 6 and 12
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Nitchanant Kitcharanant, MD, Department of Orthopedics, Faculty of Medicine, Chiang Mai University
Publikationer og nyttige links
Generelle publikationer
- 1. Callahan CM, Drake BG, Heck DA, Dittus RS. Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994;271(17):1349-57. 2. Grosu I, Lavand'homme P, Thienpont E. Pain after knee arthroplasty: an unresolved issue. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1744-58.
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Patologiske processer
- Postoperative komplikationer
- Smerte
- Neurologiske manifestationer
- Ledsygdomme
- Muskuloskeletale sygdomme
- Reumatiske sygdomme
- Gigt
- Slidgigt
- Smerter, postoperativ
- Slidgigt, knæ
- Lægemidlers fysiologiske virkninger
- Autonome agenter
- Agenter fra det perifere nervesystem
- Anti-inflammatoriske midler
- Antineoplastiske midler
- Antiemetika
- Gastrointestinale midler
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Antineoplastiske midler, hormonelle
- Dexamethason
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- ORT-2558-03245
- 054/2559 (Andet bevillings-/finansieringsnummer: Faculty of medicine, Chiangmai university fund)
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