Remifentanil vs Fentanyl During Cardiac Surgery and Chronic Thoracic Pain (REFLECT)
A Randomised Clinical Trial Evaluating the Effect of Remifentanil vs Fentanyl During Cardiac Surgery on the Incidence of Chronic Thoracic Pain
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Phase 4
Kontakte und Standorte
Studienorte
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-
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Nieuwegein, Niederlande
- St. Antonius Hospital
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-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Patients undergoing cardiac surgery via sternotomy (Coronary artery bypass graft (CABG) and/or valve replacement)
- Patients admitted to the ICU or PACU in the St. Antonius hospital
- Patients between 18 and 85 years old
- Patients weighing between 45 and 140 kg
- Written informed consent
Exclusion Criteria:
- Pregnancy/ breastfeeding
- Language barrier
- History of drug abuse
- Neurologic condition such as peripheral neuropathy
- Known remifentanil, fentanyl, morphine or paracetamol allergy
- Body Mass Index (BMI) > 35 kg/m2
- Prior cardiac surgery (re-operations);
- Patients with chronic pain conditions.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Verhütung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Aktiver Komparator: Fentanyl
fentanyl bolus injections on an "as needed" base, next to the fentanyl bolus injections on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
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fentanyl bolus injections on an "as needed" base, NEXT TO the fentanyl bolus injections on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
Andere Namen:
fentanyl bolus injections on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
Andere Namen:
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Aktiver Komparator: Remifentanil
remifentanil, starting with 0.15 ug/Ideal Body Weight(IBW)(kg)/min, next to fentanyl bolus injections (200-500 ug) on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
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fentanyl bolus injections on an "as needed" base, NEXT TO the fentanyl bolus injections on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
Andere Namen:
fentanyl bolus injections on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
Andere Namen:
starting with 0.15 ug/IBW(kg)/min, next to fentanyl bolus injections (200-500 ug) on predetermined times; before incision, at sternotomy, at aorta canulation and at opening of the pericardium.
Andere Namen:
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Chronic thoracic pain
Zeitfenster: 1 year
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The percentage of patients reporting chronic thoracic pain one year after cardiac surgery.
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1 year
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Chronic thoracic pain
Zeitfenster: 3 and 6 months
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The percentage of patients reporting chronic thoracic pain three months and six months after cardiac surgery
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3 and 6 months
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Mean Numerical Rating Scale (NRS) score
Zeitfenster: 3, 6 and 12 months
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The mean NRS score of patients with chronic thoracic pain three months and six months after cardiac surgery.
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3, 6 and 12 months
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Quality of life
Zeitfenster: 3, 6 and 12 months
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The quality of life (QoL) three months, six months and one year after surgery.
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3, 6 and 12 months
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Thermal detection and pain thresholds
Zeitfenster: preoperative, 3 days postoperative and 1 year after surgery
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The difference in postoperative pain thresholds three days and one year after cardiac surgery compared to the preoperative pain threshold (baseline)
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preoperative, 3 days postoperative and 1 year after surgery
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Pain variability
Zeitfenster: preoperative, 3 days and 1 year postoperative
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Pain variability measured with a paradigm with electrical stimuli in only a part of the participants.
The difference in pain variability preoperative, three days postoperative and one year after cardiac surgery.
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preoperative, 3 days and 1 year postoperative
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Use of analgesics during and after hospitalization
Zeitfenster: 3 days during hospitalization and 3,6,12 months post surgery
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The required amounts of analgesics (morphine/paracetamol) during hospital stay; The use of analgesics three months, six months and one year after cardiac surgery, measured with questionnaires;
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3 days during hospitalization and 3,6,12 months post surgery
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Genetic variances
Zeitfenster: Blood sample at time of surgery
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Genetic variances involved in pain sensitivity (e.g.
GTP-cyclohydrolase 1 (GCH-1), WDFY4, Zinc Finger gene Family (ZNF), Melanocortin 1 Receptor (MC1R)) and pharmacokinetics and pharmacodynamics of opiates (e.g.
glucuronosyl transferase (UGT), Multidrug Resistance-associated Protein (MRP), mu-opioid receptor gene 1 (OPRM1), Catechol-O-methyltransferase (COMT))
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Blood sample at time of surgery
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Total medical costs and productivity costs during one year, including costs of hospitalization days (ICU and non-ICU) and costs of medications
Zeitfenster: 1 year after surgery
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1 year after surgery
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Mean pain NRS (Numerical Rating Scale)
Zeitfenster: 3-5 days during hospitalization
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Mean NRS score during intensive care unit (ICU) stay and hospitalization.
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3-5 days during hospitalization
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: CAJ Knibbe, Prof. Dr., St. Antonius Hospital
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- de Hoogd S, Valkenburg AJ, van Dongen EPA, Daeter EJ, van Rosmalen J, Dahan A, Tibboel D, Knibbe CAJ. Short- and long-term impact of remifentanil on thermal detection and pain thresholds after cardiac surgery: A randomised controlled trial. Eur J Anaesthesiol. 2019 Jan;36(1):32-39. doi: 10.1097/EJA.0000000000000887.
- de Hoogd S, Ahlers SJGM, van Dongen EPA, van de Garde EMW, Daeter EJ, Dahan A, Tibboel D, Knibbe CAJ. Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery. Pain Pract. 2018 Apr;18(4):443-451. doi: 10.1111/papr.12615. Epub 2017 Sep 28.
- de Hoogd S, Ahlers SJ, van Dongen EP, Tibboel D, Dahan A, Knibbe CA. Remifentanil versus fentanyl during cardiac surgery on the incidence of chronic thoracic pain (REFLECT): study protocol for a randomized controlled trial. Trials. 2014 Nov 27;15:466. doi: 10.1186/1745-6215-15-466.
Nützliche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Schmerzen
- Neurologische Manifestationen
- Chronischer Schmerz
- Brustschmerzen
- Physiologische Wirkungen von Arzneimitteln
- Depressiva des zentralen Nervensystems
- Agenten des peripheren Nervensystems
- Analgetika
- Agenten des sensorischen Systems
- Anästhetika, intravenös
- Anästhesie, Allgemein
- Anästhetika
- Analgetika, Opioide
- Betäubungsmittel
- Adjuvantien, Anästhesie
- Remifentanil
- Fentanyl
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- REFLECT study
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