- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT01836614
Intravenous Lidocaine Infusion in the Management of Post-operative Pain in Colorectal Patients
7. März 2016 aktualisiert von: Children's Hospital Medical Center, Cincinnati
The purpose of this study is to determine if an intravenous lidocaine infusion (compared to placebo) intraoperatively will decrease time to return of bowel function postoperatively, decrease postoperative pain, diminish postoperative opioid requirement, minimize inflammatory markers and shorten time to discharge after colorectal surgery.
Studienübersicht
Detaillierte Beschreibung
Lidocaine is an amide local anesthetic that has analgesic and anti-inflammatory properties.
Lidocaine infusion is a very useful pain medication that is underutilized to treat surgical, chronic, and cancer pain in children.
The investigators propose to examine the perioperative use of lidocaine infusion in children undergoing colorectal surgery that involves an abdominal incision.
The investigators plan to measure the following outcomes: length of stay in hospital following abdominal surgery, postoperative pain scores, cumulative morphine consumption, incidences of opioid adverse-effects: respiratory depression, sedation, nausea, vomiting, time to passage of flatus, time to first bowel movement and end-tidal Sevoflurane in operating room throughout surgery.
The following laboratory values will be measured: serial lidocaine levels of pharmacokinetics and safety levels, Pro- and anti-inflammatory cytokine measurements: IL-6, IL-8, IL-10, IL-1RA and genetic variants.
Studientyp
Interventionell
Phase
- Phase 2
- Phase 1
Kontakte und Standorte
Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.
Studienorte
-
-
Ohio
-
Cincinnati, Ohio, Vereinigte Staaten, 45229
- Cincinnati Children's Hospital Medical Center
-
-
Teilnahmekriterien
Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.
Zulassungskriterien
Studienberechtigtes Alter
1 Jahr bis 15 Jahre (Kind)
Akzeptiert gesunde Freiwillige
Nein
Studienberechtigte Geschlechter
Alle
Beschreibung
Inclusion Criteria:
- male or female children 1-15 years of age
- ASA physical status 1-3
- scheduled for colorectal surgery with abdominal incision
- scheduled for complex urology surgical case
Exclusion Criteria:
- ASA physical status > 3
- postoperative intubation planned ahead of surgery
- history of chronic use of opioid
- history of hepatic,renal, or cardiac failure
- history of organ transplant
- BMI > 30
- history of cardiac arrhythmia
- history of long QT syndrome
- history of allergic reaction to lidocaine or similar agents
- history of seizure disorder
- patient without Peripherally Inserted Central Catheter or other central access with contraindication to inhalation induction
- family history or know patient susceptibility to malignant hyperthermia
Studienplan
Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Verdreifachen
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Aktiver Komparator: Lidocaine
The treatment group will receive a 1.5mg/kg intravenous lidocaine bolus over 10 minutes.
The bolus will be followed by an intravenous lidocaine infusion of 1 mg/kg/hr.
The infusion will be stopped after extubation prior to leaving the operating room or after 5 hours from the start of the infusion
|
The treatment group will receive a 1.5mg/kg intravenous lidocaine bolus over 10 minutes after induction by means of an infusion pump.
This bolus will be followed by an intravenous lidocaine infusion of 1 mg/kg/hr.
The infusion will be stopped after extubation prior to leaving the operative room or after 5 hours from the start of the infusion, which ever comes first.
|
Placebo-Komparator: Saline
The saline will be administered over an infusion pump over 10 minutes and followed by a bolus.
The infusion will be stopped after extubation prior to leaving the operating room or after 5 hours from the start of the infusion.
|
The treatment group will receive a 1.5mg/kg intravenous lidocaine bolus over 10 minutes after induction by means of an infusion pump.
This bolus will be followed by an intravenous lidocaine infusion of 1 mg/kg/hr.
The infusion will be stopped after extubation prior to leaving the operative room or after 5 hours from the start of the infusion, which ever comes first.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Length of stay in hospital following abdominal surgery
Zeitfenster: participants will be followed for the duration of hospital stay, an average of 1 week
|
The primary outcome measure will be to monitor the length of stay in hospital following abdominal surgery.
|
participants will be followed for the duration of hospital stay, an average of 1 week
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Postoperative pain scores
Zeitfenster: participants will be followed post-op, average 5 days
|
Study staff will monitor patients pain every 15 minutes in the PACU and record documentation every 4 hours while on the floor.
|
participants will be followed post-op, average 5 days
|
Cumulative morphine consumption
Zeitfenster: participants will be followed post-op, average 5 days
|
Staff will document how much morphine a patient uses post-operatively after abdominal surgery.
|
participants will be followed post-op, average 5 days
|
Incidences of opioid adverse-effects
Zeitfenster: participants will be followed post-op, average 5 days
|
Study staff will monitor nursing notes for respiratory depression, sedation, nausea and vomiting
|
participants will be followed post-op, average 5 days
|
Time to passage of flatus and bowel movement
Zeitfenster: participants will be followed post-op, average 5 days
|
Study staff will review nursing notes for time of passage of flatus and first bowel movement.
|
participants will be followed post-op, average 5 days
|
End-tidal Sevoflurane in operating room throughout surgery
Zeitfenster: participants will be measured until the end of the OR case, on average 6 hours
|
participants will be measured until the end of the OR case, on average 6 hours
|
|
Serial lidocaine levels for pharmacokinetics and safety levels
Zeitfenster: participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
2 samples will be drawn at time of baseline IV placement Blood draw 0-3 minutes after bolus is complete Blood draw 9-15 minutes after the bolus is complete 2 blood samples will be drawn at the end of continuous infusion (either at end of surgery after extubation prior to leaving OR or after 5 hours from the start of the infusion) Blood draw 1 hour following the infusion Blood draw 2-3 hours following the end of the infusion 2 blood samples will be drawn 24 hours after surgery dependent of necessary labs
|
participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
Pro- and anti-inflammatory cytokine measurements: IL-6, IL-8, IL-10, IL-1RA
Zeitfenster: participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
2 samples will be drawn at time of baseline IV placement Blood draw 0-3 minutes after bolus is complete Blood draw 9-15 minutes after the bolus is complete 2 blood samples will be drawn at the end of continuous infusion (either at end of surgery after extubation prior to leaving OR or after 5 hours from the start of the infusion) Blood draw 1 hour following the infusion Blood draw 2-3 hours following the end of the infusion 2 blood samples will be drawn 24 hours after surgery dependent of necessary labs
|
participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
Genetic variants
Zeitfenster: participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
2 samples will be drawn at time of baseline IV placement Blood draw 0-3 minutes after bolus is complete Blood draw 9-15 minutes after the bolus is complete 2 blood samples will be drawn at the end of continuous infusion (either at end of surgery after extubation prior to leaving OR or after 5 hours from the start of the infusion) Blood draw 1 hour following the infusion Blood draw 2-3 hours following the end of the infusion 2 blood samples will be drawn 24 hours after surgery dependent of necessary labs
|
participants will be measured until the end of the OR case, on average 6 hours and 24 hours post-operatively
|
Mitarbeiter und Ermittler
Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.
Ermittler
- Hauptermittler: Smokey J Clay, MD, Children's Hospital Medical Center, Cincinnati
Publikationen und hilfreiche Links
Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.
Allgemeine Veröffentlichungen
- Kuo CP, Jao SW, Chen KM, Wong CS, Yeh CC, Sheen MJ, Wu CT. Comparison of the effects of thoracic epidural analgesia and i.v. infusion with lidocaine on cytokine response, postoperative pain and bowel function in patients undergoing colonic surgery. Br J Anaesth. 2006 Nov;97(5):640-6. doi: 10.1093/bja/ael217. Epub 2006 Sep 4.
- Harvey KP, Adair JD, Isho M, Robinson R. Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review. Am J Surg. 2009 Aug;198(2):231-6. doi: 10.1016/j.amjsurg.2008.10.015. Epub 2009 Mar 12.
- Duedahl TH, Hansen EH. A qualitative systematic review of morphine treatment in children with postoperative pain. Paediatr Anaesth. 2007 Aug;17(8):756-74. doi: 10.1111/j.1460-9592.2007.02213.x.
- Kain ZN, Mayes LC, Caldwell-Andrews AA, Karas DE, McClain BC. Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery. Pediatrics. 2006 Aug;118(2):651-8. doi: 10.1542/peds.2005-2920.
- Bulloch B, Tenenbein M. Validation of 2 pain scales for use in the pediatric emergency department. Pediatrics. 2002 Sep;110(3):e33. doi: 10.1542/peds.110.3.e33.
- Groudine SB, Fisher HA, Kaufman RP Jr, Patel MK, Wilkins LJ, Mehta SA, Lumb PD. Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. Anesth Analg. 1998 Feb;86(2):235-9. doi: 10.1097/00000539-199802000-00003.
- Ash-Bernal R, Wise R, Wright SM. Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals. Medicine (Baltimore). 2004 Sep;83(5):265-273. doi: 10.1097/01.md.0000141096.00377.3f.
- McGrath PA, Seifert CE, Speechley KN, Booth JC, Stitt L, Gibson MC. A new analogue scale for assessing children's pain: an initial validation study. Pain. 1996 Mar;64(3):435-443. doi: 10.1016/0304-3959(95)00171-9.
- Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, Joris JL. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007 Jan;106(1):11-8; discussion 5-6. doi: 10.1097/00000542-200701000-00007.
- Candiotti KA, Yang Z, Morris R, Yang J, Crescimone NA, Sanchez GC, Bird V, Leveillee R, Rodriguez Y, Liu H, Zhang YD, Bethea JR, Gitlin MC. Polymorphism in the interleukin-1 receptor antagonist gene is associated with serum interleukin-1 receptor antagonist concentrations and postoperative opioid consumption. Anesthesiology. 2011 May;114(5):1162-8. doi: 10.1097/ALN.0b013e318216e9cb.
- Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesth Analg. 2009 Nov;109(5):1464-9. doi: 10.1213/ANE.0b013e3181bab1bd.
- Annabi EH, Barker SJ. Severe methemoglobinemia detected by pulse oximetry. Anesth Analg. 2009 Mar;108(3):898-9. doi: 10.1213/ane.0b013e318172af73.
- LUND PC, CWIK JC. PROPITOCAINE (CITANEST) AND METHEMOGLOBINEMIA. Anesthesiology. 1965 Jul-Aug;26:569-71. doi: 10.1097/00000542-196507000-00020. No abstract available.
Studienaufzeichnungsdaten
Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.
Haupttermine studieren
Studienbeginn
1. Januar 2015
Primärer Abschluss (Voraussichtlich)
1. März 2018
Studienabschluss (Voraussichtlich)
1. April 2018
Studienanmeldedaten
Zuerst eingereicht
8. April 2013
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
17. April 2013
Zuerst gepostet (Schätzen)
22. April 2013
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
8. März 2016
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
7. März 2016
Zuletzt verifiziert
1. März 2016
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Pathologische Prozesse
- Postoperative Komplikationen
- Schmerzen
- Neurologische Manifestationen
- Schmerzen, postoperativ
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Anti-Arrhythmie-Mittel
- Depressiva des zentralen Nervensystems
- Agenten des peripheren Nervensystems
- Agenten des sensorischen Systems
- Anästhetika
- Membrantransportmodulatoren
- Anästhetika, lokal
- Spannungsgesteuerte Natriumkanalblocker
- Natriumkanalblocker
- Lidocain
Andere Studien-ID-Nummern
- CCHMC 2012-0674
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
Klinische Studien zur Darmerkrankungen
-
Hospices Civils de LyonAbgeschlossenNeuromyelitis-Optica-Spektrum-Erkrankungen | Neuromyelitis optica Spectrum Related DisordersFrankreich
Klinische Studien zur Lidocaine
-
Ohio State UniversityAbgeschlossen
-
Khon Kaen UniversityNoch keine RekrutierungIntubation | Hämodynamik | Laryngoskopie | Neurochirurgie | LidocainThailand
-
McMaster UniversitySt. Joseph's Healthcare HamiltonZurückgezogenKandidat für bariatrische Chirurgie
-
Benha UniversityAbgeschlossenSchmerzlinderung nach Kaiserschnitt
-
Oregon Health and Science UniversityAbgeschlossen
-
Chung-Ang University Hosptial, Chung-Ang University...UnbekanntPostoperative SchmerzenKorea, Republik von
-
Mansoura UniversitySuspendiertFettleibigkeit | Kandidat für bariatrische ChirurgieÄgypten
-
Second Xiangya Hospital of Central South UniversityZurückgezogen
-
Scilex Pharmaceuticals, Inc.Abgeschlossen
-
Hopital FochAbgeschlossen