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Intravenous Lidocaine Infusion in the Management of Post-operative Pain in Colorectal Patients

7 marzo 2016 aggiornato da: 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.

Panoramica dello studio

Stato

Ritirato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

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.

Tipo di studio

Interventistico

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 45229
        • Cincinnati Children's Hospital Medical Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 1 anno a 15 anni (Bambino)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Triplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: 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
Droga: Lidocaine
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.
Comparatore placebo: 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.
Droga: Lidocaine
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.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Length of stay in hospital following abdominal surgery
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Postoperative pain scores
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Children's Hospital Medical Center, Cincinnati

Investigatori

  • Investigatore principale: Smokey J Clay, MD, Children's Hospital Medical Center, Cincinnati

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 gennaio 2015

Completamento primario (Anticipato)

1 marzo 2018

Completamento dello studio (Anticipato)

1 aprile 2018

Date di iscrizione allo studio

Primo inviato

8 aprile 2013

Primo inviato che soddisfa i criteri di controllo qualità

17 aprile 2013

Primo Inserito (Stima)

22 aprile 2013

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

8 marzo 2016

Ultimo aggiornamento inviato che soddisfa i criteri QC

7 marzo 2016

Ultimo verificato

1 marzo 2016

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • CCHMC 2012-0674

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 .

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