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Does Trendelenburg Positioning During Pulmonary Recruitment Breaths Affect Post-laparoscopy Shoulder Pain
Trendelenburg Positioning During Pulmonary Recruitment Breaths: A Randomized Controlled Trial
The goal of this clinical trial is to evaluate whether different positioning in the operating room during removal of laparoscopic surgical gas differs in post-surgery shoulder pain. An additional goal of this study is to evaluate whether positions change other post-surgery metrics such as bloating, time to passing gas, nausea and vomiting, and time to oral intake.
Researchers will compare Trendelenburg positioning where your head is tilted down to supine (level or flat) positioning during removal of surgical gas.
Participants will be asked to complete brief surveys at 24 and 72-hours post-surgery.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Debbie Shim
- Telefoonnummer: 502-561-7260
- E-mail: deborah.shim@louisville.edu
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Robot-assisted laparoscopic surgery for benign gynecologic indication
- Surgery is booked for 60 minutes or longer
- Reliable working phone number or email
Exclusion Criteria:
- Patients with baseline opioid use
- Patients with existing shoulder or neck pain
- Active malignancy-related pain or surgery for malignant indication
- Concomitant upper abdominal or thoracic surgery
- Pre-existing emphysema, chronic obstructive pulmonary disease, or pneumothorax
- Non-English speaking
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: PRM Trendelenburg
PRM in Trendelenburg position (to 30 degrees or greatest degree patient can tolerate) with removal of tops of laparoscopic trocars
|
Active recruitment breaths delivered to patient by anesthesia provider as opposed to passive evacuation of pneumoperitoneum
Andere namen:
Trendelenburg position as opposed to neutral (supine) position
|
|
Actieve vergelijker: PRM Supine
PRM in neutral position with removal of tops of laparoscopic trocars
|
Active recruitment breaths delivered to patient by anesthesia provider as opposed to passive evacuation of pneumoperitoneum
Andere namen:
|
|
Geen tussenkomst: Passive Supine
control group with passive evacuation of pneumoperitoneum: insufflation evacuation by removal of tops of laparoscopic trocars in neutral (supine) position
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Post-laparoscopy shoulder pain, 24 hour VAS
Tijdsspanne: 24 hours post-operatively
|
Post-laparoscopy shoulder pain assessed on a visual analog scale zero to ten with zero representing no pain and ten representing the worst pain of their life.
|
24 hours post-operatively
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Post-laparoscopy shoulder pain, 72 hour VAS
Tijdsspanne: 72-hours post-operatively
|
Post-laparoscopy shoulder pain assessed on a visual analog scale zero to ten with zero representing no pain and ten representing the worst pain of their life.
|
72-hours post-operatively
|
|
Pain Interference, 24 hour
Tijdsspanne: 24 hours post-operatively
|
Pain interference assessed by PROMIS Pain Interference Short Form 8a questionnaire.
A raw score ranges from 8 (least problems with pain hindering activities) to 40 (most problems with pain hindering activities).
|
24 hours post-operatively
|
|
Pain Interference, 72 hour
Tijdsspanne: 72 hours post-operatively
|
Pain interference assessed by PROMIS Pain Interference Short Form 8a questionnaire.
A raw score ranges from 8 (least problems with pain hindering activities) to 40 (most problems with pain hindering activities).
|
72 hours post-operatively
|
|
Total opioid use, 24 hr
Tijdsspanne: 24-hours postoperatively
|
total opioid use measured by MME
|
24-hours postoperatively
|
|
Total opioid use, 72 hr
Tijdsspanne: 72-hours postoperatively
|
total opioid use at 72-hr postoperatively measured by total MME
|
72-hours postoperatively
|
|
Time to flatus
Tijdsspanne: up to 72-hours postoperatively
|
up to 72-hours postoperatively
|
|
|
Nausea and Vomiting, 24 hour
Tijdsspanne: 24 hours post-operatively
|
Rhodes Index of Nausea Vomiting Retching is an 8-item questionnaire with scores ranging from 0 (no symptoms) to 32 (most severe symptoms).
|
24 hours post-operatively
|
|
Nausea and Vomiting, 72 hour
Tijdsspanne: 72 hours post-operatively
|
Rhodes Index of Nausea Vomiting Retching is an 8-item questionnaire with scores ranging from 0 (no symptoms) to 32 (most severe symptoms).
|
72 hours post-operatively
|
|
Gas & Bloating, 24 hour
Tijdsspanne: 24 hours post-operatively
|
Bloating measured by PROMIS Gas and Bloating 13a questionnaire.
The raw summed score ranges from 3 (no symptoms) to 36 (worst reported symptoms).
|
24 hours post-operatively
|
|
Gas & Bloating, 72 hour
Tijdsspanne: 72 hours post-operatively
|
Bloating measured by PROMIS Gas and Bloating 13a questionnaire.
The raw summed score ranges from 3 (no symptoms) to 36 (worst reported symptoms).
|
72 hours post-operatively
|
Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- Phelps P, Cakmakkaya OS, Apfel CC, Radke OC. A simple clinical maneuver to reduce laparoscopy-induced shoulder pain: a randomized controlled trial. Obstet Gynecol. 2008 May;111(5):1155-60. doi: 10.1097/AOG.0b013e31816e34b4.
- Berberoglu M, Dilek ON, Ercan F, Kati I, Ozmen M. The effect of CO2 insufflation rate on the postlaparoscopic shoulder pain. J Laparoendosc Adv Surg Tech A. 1998 Oct;8(5):273-7. doi: 10.1089/lap.1998.8.273.
- Ryu K, Choi W, Shim J, Song T. The impact of a pulmonary recruitment maneuver to reduce post-laparoscopic shoulder pain: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2017 Jan;208:55-60. doi: 10.1016/j.ejogrb.2016.11.014. Epub 2016 Nov 16.
- Kiyak H, Yilmaz G, Ay N. Semi-Fowler positioning in addition to the pulmonary recruitment manoeuvre reduces shoulder pain following gynaecologic laparoscopic surgery. Wideochir Inne Tech Maloinwazyjne. 2019 Dec;14(4):567-574. doi: 10.5114/wiitm.2019.84384. Epub 2019 Apr 11.
Studie record data
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Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pijn
- Neurologische manifestaties
- Postoperatieve complicaties
- Pathologische processen
- Ziekten van het spijsverteringsstelsel
- Peritoneale ziekten
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Pijn, postoperatief
- Pneumoperitoneum
- Musculoskeletale fysiologische fenomenen
- Musculoskeletale en neurale fysiologische fenomenen
- Houding
- Head-down tilt
Andere studie-ID-nummers
- 25.0897
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
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Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
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