- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01534416
Effect of Paracervical Block on Post Operative Pain in Laparoscopic Gynecologic Surgery
Use of Paracervical Block in Laparoscopic Gynecologic Surgery: A Randomized Controlled Trial
연구 개요
상세 설명
A variety of traditionally open surgical procedures have recently become minimally invasive through the use of laparoscopic technology. Gynecologic surgeries are no exception. However, some gynecologic laparoscopic procedures are associated with significant post-operative pain, necessitating prolonged hospitalization, use of post-operative opioids, and in some cases, the development of chronic post-operative pain. Prolonged hospitalization and use of opioids pose important patient safety concerns, such as increased risk of hospital borne illnesses and medication errors; in addition, opioids may cause respiratory depression and addiction. Given the rising cost of health care there is also an economic incentive to eliminate the need for hospital admission due to post-operative pain.
Preemptive analgesia involves nerve blockade or administration of pain medication systemically prior to incision to reduce post-procedure pain. Paracervical blockade is a form of preemptive analgesia. Paracervical blocks have been demonstrated to be safe and effective for obstetrical procedures in reducing post-operative pain since the 1970s. Recently they have also been shown to be efficacious for reducing post-operative pain in vaginal hysterectomy (Long et al, Int Urogynecol J (2009) 20:5-10).
For the present investigation, we intend to study the effectiveness of paracervical blockade for laparoscopic and robotic-assisted laparoscopic gynecological surgery. We hypothesize that paracervical blockade prior to surgical incision will lessen levels of post-operative pain, reduce use of opioids, and decrease the number of patients requiring hospitalization for pain control. We also hypothesize that the effects may be longer lasting than the immediate post-operative period and may decrease the amount of time to return to normal activity after surgery.
Using anecdotal evidence from the primary investigator, Dr. Ascher-Walsh the rate of hospitalization for laparoscopic hysterectomy (laparoscopic-assisted vaginal hysterectomy, total laparoscopic hysterectomy, laparoscopic assisted supracervical hysterectomy) is approximately 67%. In this study, we wish to decrease hospitalization with the paracervical block by 50%, thus obtaining an overall post-operative hospitalization rate of 33%. For robotic-assisted laparoscopic myomectomy, the rate of hospitalization is 50%. We wish to decrease this by 50% as well. Overall we are aiming to achieve a rate of 30% for post-operative hospitalization for pain control for laparoscopic hysterectomies and robotic myomectomies combined.
연구 유형
등록 (실제)
단계
- 해당 없음
연락처 및 위치
연구 장소
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New York
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New York, New York, 미국, 10029
- Icahn School of Medicine at Mount Sinai
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Female
- Age 18 or older
- Scheduled for robotic-assisted laparoscopic myomectomy or laparoscopic hysterectomy, including total and supracervical hysterectomy, laparoscopic-assisted vaginal hysterectomy
- Surgery being performed for benign disease
Exclusion Criteria:
- Male
- Women under 18 years old
- Pregnancy
- Suspected or known malignant disease
- Immunocompromised
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 네 배로
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
실험적: Bupivacaine
Subjects receive paracervical block with bupivacaine-epinephrine
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Subjects are injected paracervically with 10 ml of 0.5% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
다른 이름들:
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위약 비교기: Saline
Subjects receive paracervical injection of normal saline
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Subjects are injected paracervically with 10 ml of normal saline prior to surgical incision.
다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Number of Participants With Hospital Admission for Postoperative Pain Control
기간: Four hours after conclusion of surgery
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Unplanned hospital admissions and the hospital admissions at the request of the patients for pain management
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Four hours after conclusion of surgery
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Postoperative Pain Score
기간: 1and 2 hour postoperatively
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Postoperative pain levels assessed using the visual analogue pain scale.
This scale pairs faces with numbers 1-10, with 1 being no pain and 10 being extreme pain.
In the PACU pain assessed using this scale by the nursing staff.
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1and 2 hour postoperatively
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Postoperative Pain Score
기간: 1, 2, 4 hour postoperatively, Day 1 post operatively, Day 2 postoperative
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Postoperative pain levels assessed using the visual analogue pain scale.
This scale pairs faces with numbers 1-10, with 1 being no pain and 10 being extreme pain.
In the PACU pain assessed using this scale by the nursing staff.
On postoperative days 1 and 2 the subjects self-reported their pain level.
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1, 2, 4 hour postoperatively, Day 1 post operatively, Day 2 postoperative
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Postoperative Day Pain Medication Use
기간: Postoperative days 0-10
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Numbers of Patients Using Pain Medication on Postoperative Days 1-10.
The subjects recorded at home the type and amount of pain medication they use for 10 days postoperatively.
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Postoperative days 0-10
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공동 작업자 및 조사자
수사관
- 수석 연구원: Charles Ascher-Walsh, MD, Icahn School of Medicine at Mount Sinai
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
Bupivacaine에 대한 임상 시험
-
InnocollPremier Research Group plc모병
-
University of Texas Southwestern Medical Center완전한
-
Pacira Pharmaceuticals, Inc완전한
-
Good Samaritan Regional Medical Center, Oregon완전한