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

7. mars 2016 oppdatert av: 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.

Studieoversikt

Status

Tilbaketrukket

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Intervensjonell

Fase

  • Fase 2
  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Ohio
      • Cincinnati, Ohio, Forente stater, 45229
        • Cincinnati Children's Hospital Medical Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

1 år til 15 år (Barn)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Trippel

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: 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
Legemiddel: 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.
Placebo komparator: 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.
Legemiddel: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Length of stay in hospital following abdominal surgery
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Postoperative pain scores
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Children's Hospital Medical Center, Cincinnati

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2015

Primær fullføring (Forventet)

1. mars 2018

Studiet fullført (Forventet)

1. april 2018

Datoer for studieregistrering

Først innsendt

8. april 2013

Først innsendt som oppfylte QC-kriteriene

17. april 2013

Først lagt ut (Anslag)

22. april 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

8. mars 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

7. mars 2016

Sist bekreftet

1. mars 2016

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CCHMC 2012-0674

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