Epidural Analgesia Versus IV Analgesia in Lumbar Spine Fusions
A Comparison of Epidural Analgesia With Standard Care Following Lumbar Spinal Fusion: A Prospective Randomized Study
- Protocol Title - A Comparison of Epidural Analgesia with Standard Care Following Lumbar Spinal Fusion: A Prospective Randomized Study
- Purpose of the Study - This prospective randomized study will enroll 200 patients undergoing elective Lumbar Spinal Fusion at Duke University Hospital. The primary objective is to determine the effect of epidural analgesia, as compared with standard care, on post-operative analgesia.
Hypothesis:
The investigators hypothesize that patients undergoing Lumbar Spinal Fusion surgery with epidural catheter placement will have superior post-operative analgesia compared to patients undergoing standard care.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
-
-
North Carolina
-
Durham, North Carolina, Stati Uniti, 27710
- Duke University Hospital
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Adult patients who are scheduled for elective Transforaminal Lumbar Interbody Fusion surgery
Exclusion Criteria:
- Baseline cognitive deficits sufficient to make objective pain self-assessments unreliable in the estimation of the Study Investigators.
- Inability to follow directions or comprehend the English language.
- Females who are pregnant as determined by positive pregnancy test on or before the day of surgery.
- Prisoners.
- Patient refusal to provide informed consent.
- Allergy to amide local anesthetics (lidocaine, bupivacaine, ropivacaine).
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Intravenous opioids
This is the standard of care method for post-operative analgesia following lumbar spine fusion surgery.
Participants randomly assigned to this arm will receive Intravenous Patient-Controlled Analgesia (IVPCA) with dilaudid (or other opioid) for post-operative pain control.
|
Patients in this arm will receive intravenous patient-controlled opioid analgesia (Dilaudid).
|
|
Sperimentale: Epidural Catheter
The intervention to be tested in this study against standard intravenous opioids is infusion of local anesthetic and dilaudid via epidural catheter for post-operative pain control in patients undergoing lumbar spine fusion surgery.
|
Placement of an epidural catheter to administer local anesthetic and opioid (dilaudid) to the epidural space will be studied as compared to use of intravenous opioid (dilaudid) for pain control following lumbar spine fusion surgery.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Post-operative Pain as Assessed by Visual Analogue Scale (VAS)
Lasso di tempo: Postoperative day 1
|
The VAS scale ranges from 0 to 100 mm with the lower score indicating less pain and the higher score indicating greater pain.
|
Postoperative day 1
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Patient Satisfaction With Perioperative Analgesia
Lasso di tempo: Post-operative Day 1
|
Patients will be assessed for satisfaction with their peri-operative analgesia in the recovery room and each day of their epidural infusion or intravenous opioid infusion by the Acute Pain Service, and at their surgical follow-up visit.
Likert scale ranges from 1 to 5 (1=very satisfied and 5=Very Dissatisfied).
|
Post-operative Day 1
|
|
Patient Satisfaction With Perioperative Analgesia
Lasso di tempo: 6-Week Follow up Visit
|
Patients will be assessed for satisfaction with their peri-operative analgesia in the recovery room and each day of their epidural infusion or intravenous opioid infusion by the Acute Pain Service, and at their surgical follow-up visit.
Likert scale ranges from 1 to 5 (1=very satisfied and 5=Very Dissatisfied).
|
6-Week Follow up Visit
|
|
Patient Satisfaction With Overall Care
Lasso di tempo: 6-Week Follow up Visit
|
Likert scale ranges from 1 to 5 (1=very satisfied and 5=Very Dissatisfied).
|
6-Week Follow up Visit
|
|
Number of Participants With Events of Special Interest
Lasso di tempo: Post-operative Day 30
|
Patients will be assessed for development of a deep vein thrombosis after surgery, and surgical site infection.
|
Post-operative Day 30
|
|
Number of Participants With Adverse Events Related to the Study
Lasso di tempo: 6-week Follow up Visit
|
Patients will be assessed in the recovery room and each day of their epidural or intravenous opioid infusions, and at their surgical follow-up visit.
|
6-week Follow up Visit
|
|
Total Post-operative Opioid Consumption
Lasso di tempo: during hospitalization (approximately 3-8 days)
|
during hospitalization (approximately 3-8 days)
|
|
|
Number of Participants Experiencing Delirium
Lasso di tempo: Post-operative Day 1
|
Post-operative Day 1
|
|
|
Number of Participants Experiencing Delirium
Lasso di tempo: Post-operative Day 2
|
Post-operative Day 2
|
|
|
Number of Participants Experiencing Delirium
Lasso di tempo: Post-operative Day 3
|
Post-operative Day 3
|
|
|
Number of Participants Readmitted to Hospital Within 30 Days of Surgery
Lasso di tempo: Post-operative Day 30
|
Post-operative Day 30
|
|
|
Length of Hospital Stay
Lasso di tempo: during hospitalization (approximately 3-8 days)
|
during hospitalization (approximately 3-8 days)
|
|
|
Wound Infection Rates
Lasso di tempo: during hospitalization (approximately 3-8 days)
|
during hospitalization (approximately 3-8 days)
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Erin L Manning, MD/PhD, Duke University Hospital Department of Anesthesiology
- Investigatore principale: Carlos Bagley, MD, Duke University Hospital Department of Neurosurgery
Pubblicazioni e link utili
Pubblicazioni generali
- Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA Jr, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003 Nov 12;290(18):2455-63. doi: 10.1001/jama.290.18.2455.
- Yukawa Y, Kato F, Ito K, Terashima T, Horie Y. A prospective randomized study of preemptive analgesia for postoperative pain in the patients undergoing posterior lumbar interbody fusion: continuous subcutaneous morphine, continuous epidural morphine, and diclofenac sodium. Spine (Phila Pa 1976). 2005 Nov 1;30(21):2357-61. doi: 10.1097/01.brs.0000184377.31427.fa.
- Cohen BE, Hartman MB, Wade JT, Miller JS, Gilbert R, Chapman TM. Postoperative pain control after lumbar spine fusion. Patient-controlled analgesia versus continuous epidural analgesia. Spine (Phila Pa 1976). 1997 Aug 15;22(16):1892-6; discussion 1896-7. doi: 10.1097/00007632-199708150-00016.
- Abrishamkar S, Eshraghi N, Feizi A, Talakoub R, Rafiei A, Rahmani P. Analgesic effects of ketamine infusion on postoperative pain after fusion and instrumentation of the lumbar spine: a prospective randomized clinical trial. Med Arh. 2012;66(2):107-10. doi: 10.5455/medarh.2012.66.107-110.
- Sekar C, Rajasekaran S, Kannan R, Reddy S, Shetty TA, Pithwa YK. Preemptive analgesia for postoperative pain relief in lumbosacral spine surgeries: a randomized controlled trial. Spine J. 2004 May-Jun;4(3):261-4. doi: 10.1016/j.spinee.2003.11.009.
- Sucato DJ, Duey-Holtz A, Elerson E, Safavi F. Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis: a comparison of continuous epidural analgesia and patient-controlled analgesia. Spine (Phila Pa 1976). 2005 Jan 15;30(2):211-7. doi: 10.1097/01.brs.0000150832.53604.64.
- Parker SL, Lerner J, McGirt MJ. Effect of minimally invasive technique on return to work and narcotic use following transforaminal lumbar inter-body fusion: a review. Prof Case Manag. 2012 Sep-Oct;17(5):229-35. doi: 10.1097/NCM.0b013e3182529c05.
Studiare le date dei record
Studia le date principali
Inizio studio
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- Pro00041252
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
Prove cliniche su Dolore
-
NCT06872944CompletatoSCOPO PAIN (VAS) a 24 ore dopo l'intervento
-
NCT03901560CompletatoDolore addominale funzionale | Crisi falciforme | Pazienti seguiti dal Pain Team
-
NCT07018791ReclutamentoDisturbi temporomandibolari (TMD) | Dolore dell'ATM | Arteterapia | TMJ - orale & amp; chirurgia maxillofaciale | Wilkes 1 e 2 | TMD Art Pain Study
Prove cliniche su Dilaudid
-
NCT01442818CompletatoDolore post operatorio
-
NCT00398957Completato
-
NCT02295124Completato
-
NCT00853554Completato
-
NCT04234191Reclutamento
-
NCT03052816CompletatoDolore, Postoperatorio | Prolasso degli organi pelvici
-
NCT03757559Completato