Forebyggelse af vedvarende smerter med LidocAine-infusioner i brystkræftkirurgi (PLAN)
Phase III, international multicentre, parallel group, blinded, 1:1 randomized controlled trial to determine the effect of an intraoperative intravenous lidocaine infusion on reducing the development of persistent pain 3-months after breast cancer surgery.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
PLAN is a multicentre, parallel-group, blinded, randomized controlled trial of 1,602 patients undergoing breast cancer surgery. Consented eligible patients will be randomized to receive an intravenous lidocaine: 1.5 mg/kg bolus with induction of general anesthesia followed by a 2.0 mg/kg/hour infusion until the end of surgery (and up to 30 minutes into recovery room). Patients in the control group will receive a placebo bolus and infusion with normal saline (0.9% sodium chloride solution). Study medications will be prepared in blinded 50 mL syringes and labelled as per Regulatory requirements. Patients will follow up on the first 3 days after surgery, and at 3 and 12-months postoperatively to report on pain, analgesic consumption, functional, mood, and quality of life outcomes
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
-
-
Alberta
-
Calgary, Alberta, Canada
- Foothills Medical Centre
-
Edmonton, Alberta, Canada
- Sturgeon Community Hospital
-
-
Newfoundland and Labrador
-
St. John's, Newfoundland and Labrador, Canada
- Eastern Health- Health Sciences Centre
-
-
Nova Scotia
-
Halifax, Nova Scotia, Canada
- IWK
-
-
Ontario
-
Hamilton, Ontario, Canada
- Juravinski Hospital
-
North York, Ontario, Canada
- North York General Hospital
-
Ottawa, Ontario, Canada
- The Ottawa Hospital
-
Thunder Bay, Ontario, Canada
- Thunder Bay Regional Health Sciences Centre
-
Toronto, Ontario, Canada
- Mount Sinai Hospital
-
Toronto, Ontario, Canada
- Humber River Hospital
-
Toronto, Ontario, Canada
- St. Michael's Hospital
-
Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre
-
Toronto, Ontario, Canada
- University Health Network
-
Toronto, Ontario, Canada
- Women's College Hospital
-
-
Quebec
-
Montreal, Quebec, Canada
- Hôpital Maisonneuve-Rosemont
-
-
-
-
-
Dharān, Nepal
- B.P. Koirala Institute of Health Sciences
-
-
-
-
-
Ile-Ife, Nigeria
- Obafemi Awolowo University Teaching Hospitals Complex
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age ≥18 years old
- Undergoing a unilateral or bilateral lumpectomy or mastectomy, inclusive of all pathologies, including prophylactic surgery (e.g., family history or BRCA gene mutation)
Exclusion Criteria:
- Previous breast surgery within 6 months of index surgery
- Undergoing any autologous flap procedure during index surgery
- Presence known chronic pain disorder involving surgical site or ipsilateral chest wall, shoulder, or arm during the 3-months prior to index surgery
- Documented hypersensitivity or allergy to lidocaine
- Surgery not planned to be performed under general anesthesia and/or planned use of regional or neuraxial anesthetic techniques before surgery (i.e., epidural, paravertebral, serratus plane block, pectoralis or modified pectoralis block)
- History of ventricular tachycardia, ventricular fibrillation, or atrioventricular block without a pacemaker
- Known cirrhotic liver disease
- Pregnant
- Unlikely to comply with follow-up (e.g. no fixed address, language difficulties that would impede valid completion of questionnaires, plans to move out of town)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Intervention
Intraoperative intravenous lidocaine/placebo infusion |
Patients in the intervention group will receive an IV lidocaine infusion using a dosage regimen of 1.5 mg/kg bolus of a 2% lidocaine solution with induction of general anesthesia followed by a 2.0 mg/kg/hour infusion until the end of surgery (and up to 30 minutes into recovery room).
Andre navne:
|
|
Placebo komparator: Control
Intraoperative intravenous lidocaine/placebo infusion |
Patients in the control group will receive a placebo bolus and infusion with normal saline (0.9% sodium chloride solution) until the end of surgery (and up to 30 minutes into recovery room).
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Development of persistent pain 3-months after breast cancer surgery
Tidsramme: 3- months
|
Persistent pain at 3-months |
3- months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Pain intensities
Tidsramme: 3 and 12 months
|
Pain intensities measured on the Numeric Rating Scale (NSR) at rest and movement. |
3 and 12 months
|
|
Opioid consumption
Tidsramme: 3 and 12 months
|
Morphine-equivalent opioid consumption |
3 and 12 months
|
|
Moderate-to-severe persistent pain
Tidsramme: 3 and 12 months
|
Defined as persistent pain with an NRS pain score of ≥4 at rest 24-hours |
3 and 12 months
|
|
Persistent neuropathic pain
Tidsramme: 3 and 12 months
|
Measured using the Douleur Neuropathique 4-symptoms interview |
3 and 12 months
|
|
Sensory and affective qualities of pain
Tidsramme: 3 and 12 months
|
Quality of pain is reported using the Short Form McGill Pain Questionnaire |
3 and 12 months
|
|
Emotional functioning
Tidsramme: 3 and 12 months
|
Emotional functioning is reported using the Profile of Mood States (POMS) |
3 and 12 months
|
|
Physical functioning
Tidsramme: 3 and 12 months
|
Physical functioning measured by the interference scale of the Brief Pain Inventory-Short Form. |
3 and 12 months
|
|
Health-related quality of life quality of life
Tidsramme: 3 and 12 months
|
Health-related quality of life will be assessed using EQ-5D-5L |
3 and 12 months
|
|
Cancer Recurrence
Tidsramme: 3 and 12 months
|
Cancer recurrence will be assessed as a secondary outcome |
3 and 12 months
|
|
Adverse events
Tidsramme: 3 and 12 months
|
Adverse Events will be monitored as a secondary safety outcome |
3 and 12 months
|
|
Cost Effectiveness
Tidsramme: 3 months
|
Healthcare Costs associated with the burden of chronic post-surgical pain will be assessed |
3 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: James Khan, MD, University Health Network, Toronto
- Ledende efterforsker: PJ Devereaux, MD.PhD, Population Health Research Institute
- Ledende efterforsker: Ian Gilron, MD, Kingston Health Sciences Centre
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
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
- Smerte
- Neurologiske manifestationer
- Postoperative komplikationer
- Patologiske processer
- Neoplasmer efter sted
- Neoplasmer
- Hudsygdomme
- Brystsygdomme
- Patologiske tilstande, tegn og symptomer
- Hud- og bindevævssygdomme
- Tegn og symptomer
- Smerter, postoperativ
- Kronisk smerte
- Brystneoplasmer
- Organiske kemikalier
- Anilider
- Amider
- Anilinforbindelser
- Aminer
- Acetanilider
- Uorganiske kemikalier
- Klorforbindelser
- Natriumforbindelser
- Chlorider
- Hydrochlorsyre
- Lidokain
- Natriumchlorid
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 21-5021
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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