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Assessing the Efficacy of Intravenous Acetaminophen Versus the Oral Formulation for Perioperative Pain Treatment

12. august 2014 opdateret af: Jingping Wang, MD, Ph.D., Massachusetts General Hospital

To compare oral (PO) to intravenous (IV) acetaminophen with postoperative pain scores, and consumptions of opiates, among orthopedic surgery patients undergoing total knee replacement with spinal anesthesia.

Our hypothesis is that IV acetaminophen patients will have improved analgesia, less opioid consumption, a lower percentage of patients rescuing, or a longer time to first rescue with IV acetaminophen. The investigators will compare the efficacies of oral and intravenous acetaminophen for postoperative pain control, and utilization of opiates as rescue agents.

Studieoversigt

Status

Ukendt

Betingelser

Detaljeret beskrivelse

Intravenous acetaminophen has rapid onset and potent analgesic properties. Recent studies have shown several advantages of using intravenous acetaminophen perioperatively. However, due to its relatively high cost and limited clinical data concerning its efficacy compared with other agents, physicians are hesitant to use intravenous acetaminophen in the perioperative period.

174 adult patients from the orthopedic surgeons undergoing total knee replacement with spinal anesthesia will be enrolled. The study will be double blind, randomized; placebo controlled comparing oral and IV acetaminophen to each other and a control (placebo). At the time patients arrive in the post-anesthesia care unit (PACU), Group 1 will receive IV 1 gram acetaminophen, and PO placebo; Group 2 will receive PO 1 gram acetaminophen and IV placebo; Group 3 will receive IV placebo and PO placebo.

The primary outcome that will be assessed is pain scores, which will be recorded by using the numeric rating scale 1-10 every 15 minutes. Secondary outcomes include time to rescue analgesia (measured in minutes), time to PACU discharge (measured in minutes), and the total amount of hydromorphone (PO or IV) consumed within 6 hours postoperatively for adequate analgesia (total measured in milligrams) will be collected.

The difference in pain scores will be assessed by a chi-square test. A multivariable regression model will be performed with the clinical and statistically significant variables to remove confounding.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

174

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
        • Massachusetts General Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

174 adult patients from the orthopedic surgeons undergoing total knee replacement with spinal anesthesia will be enrolled. Patients will be enrolled for the study the morning of their surgery. Subjects will randomly receive one of the three treatments. The study will be double blind, randomized; placebo controlled comparing PO and IV acetaminophen to each other and a control (placebo). At the time patients arrive in the PACU, Group 1 will receive IV 1 gram acetaminophen, and PO placebo; Group 2 will receive PO 1 gram acetaminophen and IV placebo; Group 3 will receive IV placebo and PO placebo.

Beskrivelse

Inclusion Criteria:

  • Patients undergoing total knee replacement
  • Successful spinal placement
  • ≥18 years old

Exclusion Criteria:

  • Failed spinal anesthesia
  • Chronic opiate users
  • Liver disease patients
  • Allergy/hypersensitivity to acetaminophen
  • Patients with baseline dementia
  • Patients weighing less than 50kg, history of alcohol dependence, renal impairment, opiate allergy, and pregnancy.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: Case-Control
  • Tidsperspektiver: Fremadrettet

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain scores assessed and recorded by using the numeric rating scale
Tidsramme: Participants will be followed for the duration of their inpatient hosptial stay, an expected average of one week.
The primary outcome that will be assessed is pain scores, which will be recorded by using the numeric rating scale, from 1-10, every 15 minutes.
Participants will be followed for the duration of their inpatient hosptial stay, an expected average of one week.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to rescue analgesia
Tidsramme: Participants will be followed for the duration of their hospital stay, an expected average of one week
The amount of time after the surgery is completed until a patient receives rescue analgesia will be measured in minutes.
Participants will be followed for the duration of their hospital stay, an expected average of one week
Time to post-anesthesia care unit (PACU) discharge
Tidsramme: Participants will be followed for the duration of their PACU stay, an expected average of 5 hours.
The time from arrive in the PACU to discharge will be measured in minutes.
Participants will be followed for the duration of their PACU stay, an expected average of 5 hours.
Opioid Use
Tidsramme: Participants will be followed for six hours postoperatively.
The investigators will collect total amount of oral and/ or intravenous hydromorphone that is consumed by for adequate analgesia.
Participants will be followed for six hours postoperatively.
Postoperative nausea and vomiting
Tidsramme: Participants will be followed for six hours postoperatively.
The investigators will collect information on postoperative nausea and vomiting.
Participants will be followed for six hours postoperatively.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Massachusetts General Hospital

Efterforskere

  • Ledende efterforsker: Jingping Wang, MD, Ph.D., Massachusetts General Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2014

Primær færdiggørelse (Forventet)

1. august 2015

Studieafslutning (Forventet)

1. oktober 2015

Datoer for studieregistrering

Først indsendt

11. august 2014

Først indsendt, der opfyldte QC-kriterier

12. august 2014

Først opslået (Skøn)

15. august 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

15. august 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. august 2014

Sidst verificeret

1. august 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2014P001139

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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