Neurostimulation for the Treatment of Post-Operative Ileus
調査の概要
詳細な説明
The purpose of this study is to investigate the effects of neurostimulation in the epidural space in the spine on the activity of the enteric nervous system (ENS).
ElectroCore has successfully studied POI in an animal model and believes that temporary neurostimulation of the spine may be useful in re-starting the ENS in humans, resulting in the resumption of coherent GI motility in the gut and normal bowel function in a shorter period of time than currently occurs. Electrical pulses will be used to modulate the signals that may be preventing a return to normal GI activity. This device and procedure used in this study are similar to the system and procedure used to implant the temporary trial stimulator used evaluate the effectiveness of spine pain stimulation prior to implantation of the permanent device.
研究の種類
段階
- 適用できない
連絡先と場所
研究場所
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Illinois
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Chicago、Illinois、アメリカ、60611
- Northwestern
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Maryland
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Baltimore、Maryland、アメリカ、21205
- Johns Hopkins Medical Center
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Pennsylvania
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Philadelphia、Pennsylvania、アメリカ、19106
- Pennsylvania Hospital
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Male or Female, Age >18 years, < 65 years
- Partial small or large bowel open resection with primary anastomosis
- 120 hours post-operative with no signs of functional bowel activity
- Able to give Informed Consent
By Post-Op Day 5, patient care has involved at least 3 of the following conservative therapies to minimize long term POI:
i. post-operative, patient controlled opioid analgesia ii. removal of intra-operative nasogastric tube at time of surgery or on post-operative day 1 iii. advancement of liquid diet iv. advancement of solid food v. ambulation vi. use of chewing gum
Exclusion Criteria:
- Pregnant
- Undergoing surgery for repair of penetrating trauma injury, gangrene or ischemic bowel
- Evidence of anastomotic leak, abdominal infection, sepsis, bowel perforation, mechanical small bowel obstruction or metabolic derangement (e.g., low potassium/magnesium)
- Presence of existing implanted or external stimulator for pain or other indications (including pacemaker)
- Operative blood lost of > 500 cc
- Significant scarring of the skin along the lower thoracic/lumbar spine or deformation of thoracic spinal canal from congenital, developmental or traumatic causes, or previous extensive spinal thoracic surgery other than diskectomy
- Received a lumbar or thoracic epidural block placed immediately prior to surgery
- Body Mass Index > 35
- Unstable cardiac status
- Severe hypertension
- American Society of Anesthesiologists (ASA) Score greater than/equal to 3
- On anti-coagulation therapy (other than aspirin) or has an underlying bleeding disorder
- Active or suspected pelvic infection
- Unable to communicate perception of the stimulation
- Significant surgical complications where in the view of the physician, participation in the study could further complicate subject care (i.e. infection at surgical site, deep venous thrombosis, respiratory complications, etc)
- Treatment with Entereg (alvimopam) during post-operative period
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし：2
Subject will be observed until recovery of normal GI function
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実験的：1
Spinal neurostimulation
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An electrical neurostimulation signal will be applied to the spine
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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To validate the design of ElectroCore Resolution Motility System™ , to safely place a stimulation electrode in the epidural space of the spine in a post-operative subject, and to evaluate the subject's ability to tolerate stimulation for up to 48 hours
時間枠：30 days
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30 days
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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To confirm that the electrical signal being delivered via this electrode shows evidence of effectiveness in improving the functional motility in subjects experiencing post-operative paralytic ileus.
時間枠：48 hours
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48 hours
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Michael Erdeck, MD、Johns Hopkins Medical Center
- 主任研究者：David Walega, MD、Northwestern University Medical Center
- 主任研究者：Robert Frye, MD、Pennsylvania Hospital
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- IL - 01
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