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

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.

Studie Overzicht

Toestand

Ingetrokken

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Fase

  • Fase 2
  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Ohio
      • Cincinnati, Ohio, Verenigde Staten, 45229
        • Cincinnati Children's Hospital Medical Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

1 jaar tot 15 jaar (Kind)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verdrievoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: 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
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.
Placebo-vergelijker: 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.
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Length of stay in hospital following abdominal surgery
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Postoperative pain scores
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

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

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 januari 2015

Primaire voltooiing (Verwacht)

1 maart 2018

Studie voltooiing (Verwacht)

1 april 2018

Studieregistratiedata

Eerst ingediend

8 april 2013

Eerst ingediend dat voldeed aan de QC-criteria

17 april 2013

Eerst geplaatst (Schatting)

22 april 2013

Updates van studierecords

Laatste update geplaatst (Schatting)

8 maart 2016

Laatste update ingediend die voldeed aan QC-criteria

7 maart 2016

Laatst geverifieerd

1 maart 2016

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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