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Comparison of Intensive and Conservative NOL®-Guided Analgesia Strategies During Opioid-free Anesthesia (OFANOL)

3 de noviembre de 2026 actualizado por: Prof Urs Zingg

Comparison of Intensive and Conservative NOL®-Guided Analgesia Strategies During Opioid-free Anesthesia for Bariatric Surgery: A Prospective Randomized Controlled Trial

Participants will be randomized to one of two predefined NOL®-guided analgesia strategies during bariatric surgery performed under OFA. In both groups the NOL® index will be continuously monitored intraoperatively and dexmedetomidine will be administered according to the assigned study algorithm based on the NOL® index using lean body weight (LBW) for dosing.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

The study aims to evaluate whether different intraoperative target ranges of the NOL® index during bariatric surgery performed under OFA are associated with differences in postoperative analgesic consumption and postoperative pain control without significant differences in intraoperative hemodynamics. Based on the physiological mechanisms outlined above, we hypothesize that during OFA with alpha-2 agonists such as dexmedetomidine, intensified NOL® target ranges (potentially 0-10) may be appropriate compared to the established range of 10-25 for opioid based TIVA. If this hypothesis is confirmed, clinical implications would include the need to establish OFA-specific NOL® target ranges to avoid under-treatment of nociception when applying TIVA-derived thresholds to OFA patients. Conversely, using inappropriately high NOL® targets derived from opioid-based anesthesia might lead to inadequate pain control and to excessive administration of analgesics postoperatively.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

400

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Signed informed consent
  • Age ≥ 18 years
  • bariatric surgery (sleeve/bypass/Re-Do)

Exclusion Criteria:

  • Patients with contraindications for dexmedetomidine or lidocaine
  • Lack of ability to follow the study procedure, e.g. due to severe language barriers, mental disorders, dementia - Patients requiring preoperative or postoperative treatment in the intensive care unit (ICU) (excluding Obstructive sleep apnea syndrome (OSAS))
  • Patients with conditions precluding the use of the NOL® sensor, such as neuromuscular deficits affecting hand function
  • BMI <25 kg/m2

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Ciencia básica
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Intensive NOL®-guided strategy

Induction: An initial dexmedetomidine bolus of 0.3ug/kg LBW will be administered, followed by a continuous infusion of 0.3 ug/kg LBW/h.

Induction: An initial dexmedetomidine bolus of 0.3ug/kg LBW will be administered, followed by a continuous infusion of 0.3 ug/kg LBW/h.

Experimental: Conservative NOL®-guided strategy

Induction: An initial dexmedetomidine bolus of 0.3ug/kg LBW will be administered, followed by a continuous infusion of 0.1 ug/kg LBW/h.

Induction: An initial dexmedetomidine bolus of 0.3ug/kg LBW will be administered, followed by a continuous infusion of 0.1 ug/kg LBW/h.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Postoperative pain intensity Measured by the numeric rating scale (NRS) in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

To evaluate whether an intensive NOL®-guided analgesia strategy reduces postoperative pain intensity in the post-anesthesia care unit (PACU) compared to a conservative NOL®-guided analgesia strategy in patients undergoing bariatric surgery under OFA.

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
Postoperative pain intensity Measured by the Behavioral Pain Scale (BPS) in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

To evaluate whether an intensive NOL®-guided analgesia strategy reduces postoperative pain intensity in the post-anesthesia care unit (PACU) compared to a conservative NOL®-guided analgesia strategy in patients undergoing bariatric surgery under OFA.

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Difference between postoperative pain intensity measurement using the Behavioral Pain Scale (BPS) (outcome 1) and numeric rating scale (NRS) (outcome 2) in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Difference between the outcome 1 and outcome 2

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
Total opioid consumption in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Morphin (mg), Oxynorm (mg), Oxycodon/Naloxon (mg)

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Total non-opioid analgesic consumption in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Paracetamol (mg), Metamizol (mg), Ketamin (mg)

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Total non-opioid analgesic consumption in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Lidocain-P (mg/kgLBW/h)

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Total non-opioid analgesic consumption in the Post-anesthesia care unit (PACU)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Ketamin-Perfusor (mg/h)

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Incidence of Postoperative nausea and vomiting (PONV)
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

The proportion of patients who experience at least one episode of postoperative nausea, retching, or vomiting, or who require the administration of any antiemetic rescue medication (such as Ondansetron, Metoclopramide, Domperidone, or Itinerol).

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Richmond Agitation-Sedation Scale (RASS) scores during Post-anesthesia care unit (PACU) stay
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
- Quality of Recovery-15 (QoR-15) score on postoperative day 1
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days
At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Safety endpoints
Periodo de tiempo: At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

- measures of intraoperative hemodynamic stability, including the incidence of hypotension, bradycardia, hypertension, tachycardia, and vasoactive medication use - occurrence of AEs and SAEs during the study period

At the Date of Surgery + 1 day after at Post-anesthesia care unit (PACU): two assessments within 2 consequent days

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de noviembre de 2026

Finalización primaria (Estimado)

1 de octubre de 2027

Finalización del estudio (Estimado)

1 de octubre de 2027

Fechas de registro del estudio

Enviado por primera vez

5 de octubre de 2026

Primero enviado que cumplió con los criterios de control de calidad

3 de noviembre de 2026

Publicado por primera vez (Actual)

4 de noviembre de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

4 de noviembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

3 de noviembre de 2026

Última verificación

1 de noviembre de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • 2026-01332

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .