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A Fast-track Versus Conventional Recovery Protocol in Laparoscopic Hysterctomy

1. februar 2019 opdateret af: Päivi Päkarinen, Helsinki University Central Hospital

A Fast-track Versus Conventional Recovery Protocol in Laparoscopic Hysterctomy.

Factors affecting to length of hospital stay after fast-track recovery program in laparoscopic hysterectomy compared to conventional recovery program

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Factors affecting to length of hospital stay after laparoscopic hysterectomy in fast-track recovery program group compared to conventional recovery group.

The pimary outcome is time to discharge from the end of operation to discharge.

The second outcomes are amount of opioid used and NSAID, postoperative paine, nousea and vomiting, patients satisfaction, anxiety and stress-coping test, operative bleeding, operative time, postoperative complications, the cost of the laparoscopic hysterectomy.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

120

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

  • Finland
      • Helsinki, Finland, 00140
        • Päivi Pakarinen

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

20 år til 70 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inclusion Criteria:

  • uterine size less than uterine size at 14 weeks of pregnancy
  • at list one friend or family available to care to care after discharge.

Exclusion criteria:

  • endometriosis
  • contraindications to any of medications used in the study (oxycodone, ketoprofen, or paracetamol)
  • language difficulties (inability to understand and speak Finnish or Swedish)
  • age older that 70 years
  • mental health disability that limit autonomy

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: fast-track recovery program

Pre-operative Verbal and video information Tobacco cessation Daily physical activity Light meal 6 hours and clear liquids up to 2 hours before surgery No bowel preparation A warm blanket Premedication paracetamol 1g and tematsepam 20mg

Intraoperatively For nausea and voimiting dexamethasone 10mg, dehydrobensperidol 1mg and ondancetron 4mg before emergence Analgesia: ropivacain at port sites before incision and at vaginal vault Opioids intravenously at discretion of anesthesiologist supplemented with Dexketoprofen 50mg Urinary catheter early removal Postoperative Pain: tramadol 50mg and ketoprofen100mg i.v., oral opioid if needed; patients with normal pain control receive oral pregabalin 25mg every 8 hours, paracetamol 1000mg every 8 hours, ibuprofen 600mg every 8 hours until discharge Out of bed after 2 hours from the end of surgery A liquid diet, if tolerated regular normal diet. For emesis ondansetron 4mg
Procedure: fast-track recovery program

Pre-operative: fast-track management counseling, fast-track educational video,tobacco cessation, daily physical activity, light meal 6 hours and clear liquids up to 2 hours before surgery, no bowel preparation, a warm blanket, medication.

Intra-operative: vaginal wound infiltrative anesthesia, early remove of urine catheter.

Post-operative: early oral intake liquids and food, early mobilization, avoiding opioids by use of pregabaline for postoperative pain.
Ingen indgriben: conventional recovery program

Preoperative preparation Verbal and written information Cessation of oral intake after previous midnight. Premedication paracetamol 1g+ diatsepam 5mg.

Intraoperative A warm blanket at the start of procedure. Prophylaxis for nausea and vomiting: Dexamethasone 5mg at induction, and Dehydrobenzperidol 1mg, ondancetron 4mg before emergence. Analgesia: injection of ropivacain 5% 20ml at port sites at the end of surgery, Opioids i.v. (oxycodone)

Postoperative Pain medication:Opioids i.v. (oxycodone), paracetamol 1000mg every 8 hours, ibuprofen 600mg every 8 hours Urinary catheter removal on next morning. Prolonged bowel and bed rest and gradual reintroduction of feeding.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
length of hospitalisation
Tidsramme: up to one week
time from end of operation until discharge
up to one week

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
postoperative pain score
Tidsramme: change in 24 hours after surgery
Visual analog score (VAS) for pain. The scale is from 0 to 10. 0 is no pain and 10 is worst imaginable pain.
change in 24 hours after surgery
nausea
Tidsramme: change in 24 hours after surgery
Visual analog score (VAS) for nausea. the scale is from 0 to 10. 0 is no nausea and 10 is worst imaginable nausea.
change in 24 hours after surgery
vomiting
Tidsramme: change in 24 hours after surgery
Visual analog score (VAS) for vomiting. The scale is from 0 to 10. 0 is no vomiting and 10 is worst imaginable vomiting´.
change in 24 hours after surgery
complications
Tidsramme: Up to one week.
Frequency of complications.Values are given as n (%) and eventual complications are spesified.
Up to one week.
The use of anelgesics for posoperative pain.
Tidsramme: change in 24 hours after surgery
Postoperative pain defined as total amount (mg) of analgesics used. Amount of use oxycodone (mg).
change in 24 hours after surgery
Patient quality of life
Tidsramme: 1 month before the surgery, in the morning of surgery day and one month after surgery
Measurement quality of life by questionnaire 15D
1 month before the surgery, in the morning of surgery day and one month after surgery
Patient subjective psychological stress level by general health questionnaire(GHQ12)
Tidsramme: 1 month before the surgery, in the morning of surgery day and one month after surgery
Measurement of psychological stress
1 month before the surgery, in the morning of surgery day and one month after surgery
patient quality of life
Tidsramme: 1 month before the surgery, in the morning of surgery day and one month after surgery
Measurement quality of life by questionnaires WHOQO-BREF
1 month before the surgery, in the morning of surgery day and one month after surgery

Samarbejdspartnere og efterforskere

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

Sponsor

Helsinki University Central Hospital

Efterforskere

  • Studieleder: Olga Kilpiö, MD, Helsinki University Central 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 (Faktiske)

31. maj 2016

Primær færdiggørelse (Faktiske)

30. maj 2018

Studieafslutning (Faktiske)

30. maj 2018

Datoer for studieregistrering

Først indsendt

21. januar 2019

Først indsendt, der opfyldte QC-kriterier

1. februar 2019

Først opslået (Faktiske)

4. februar 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. februar 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. februar 2019

Sidst verificeret

1. februar 2019

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Unique Protocol ID: 98/13/03/0

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

no plan to share a data

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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