- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT02248493
Intravenous Paracetamol for Postoperative Pain (IVPARACET)
The Effect of Intravenous Paracetamol in Combination With NSAIDs for Postoperative Pain in Children
The purpose of this study is to define if intravenous paracetamol may improve analgesia and outcome in pediatric surgical patients treated with non-steroidal anti-inflammatory drugs (NSAIDs) postoperatively.
Hypothesis: intravenous paracetamol in a dose 60 mg/kg/24 h IV, given in addition to IV ketoprofen (4,5 mg/kg/24h), improves analgesia and physical recovery in children and adolescents following surgery.
Studieoversikt
Status
Detaljert beskrivelse
Patients aged 1-18 years undergoing general, plastic or orthopedic surgery with expected moderate to severe pain at least for 24 hours postoperatively, who meet inclusion criteria and does not meet exclusion criteria, are enrolled. At the end of surgical procedure, at skin closure, all patients are given 1,5 mg/kg intravenous ketoprofen and repeated every 8 hours up till 4,5 mg/kg/24 h. Patients in paracetamol group are additionally given the first dose of IV paracetamol 20 mg/kg and repeated 6 and 20 hours postoperatively up till 60 mg/kg/24 h. Patients in the placebo group are given 0.9% sodium chloride 2 ml/kg IV and repeated 6 and 20 hours postoperatively.
After surgery optional rescue analgesia is given on patient request: either tramadol in a dose of 2 mg/kg (up till 4 mg/kg/24h), either patient-controlled analgesia (PCA) with morphine, as indicated according to the standard of care. Patients are evaluated up till 24 hours postoperatively. After that patients are followed up as long as indicated per standard of care.
Studietype
Registrering (Faktiske)
Fase
- Fase 4
Kontakter og plasseringer
Studiesteder
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Kaunas, Litauen, 50009
- Lithuanian University of Health Sciences Kaunas Clinics
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Patients 1-18 years of age, undergoing general, plastic or orthopedic surgery with expected median to severe pain postoperatively.
- physical status of the patient corresponding to American Society of Anesthesiologists (ASA) class 1 or 2
- Signed written informed consent by parents/official caregivers.
Exclusion Criteria:
- Allergy to paracetamol, ketoprofen, tramadol, morphine or any NSAID
- oncologic disease
- central nervous system disease
- renal dysfunction
- hepatic dysfunction
- bronchial asthma
- ulcer(s) in gastrointestinal system
- hemorrhagic diathesis
- chronic use of NSAIDs
- chronic use of opioids
- chronic use of anticoagulants
- female patient is known to be pregnant
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Trippel
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: paracetamol and ketoprofen
paracetamol 20 mg/kg (1% 2 ml/kg) IV at the end of surgery 6 and 20 hours thereafter. ketoprofen 1.5 mg/kg IV at the end of surgery 8 and 16 hours thereafter. tramadol 2 mg/kg IV on patient request up til 4 mg/kg or PCA morphine during 24 hours postoperatively. |
Andre navn:
Andre navn:
Administered on request as rescue medication in a dose 2 mg/kg IV up till 2 doses.
No other opioid is given to these patients.
Andre navn:
administered in patients receiving IV PCA with morphine postoperatively.
No other opioid is given to these patients.
|
|
Placebo komparator: placebo and ketoprofen
0.9% sodium chloride (2 ml/kg) IV at the end of surgery 6 and 20 hours thereafter. ketoprofen 1.5 mg/kg IV at the end of surgery 8 and 16 hours thereafter. tramadol 2 mg/kg IV on patient request up til 4 mg/kg or PCA morphine during 24 hours postoperatively. |
Andre navn:
Administered on request as rescue medication in a dose 2 mg/kg IV up till 2 doses.
No other opioid is given to these patients.
Andre navn:
administered in patients receiving IV PCA with morphine postoperatively.
No other opioid is given to these patients.
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
change in postoperative intravenous opioid dose
Tidsramme: 24 hours postoperatively
|
24 hours postoperatively
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
change in pain level (analgesia) assessed by 10 point pain scales
Tidsramme: 1 hour postoperatively
|
1 hour postoperatively
|
|
change in pain level (analgesia) assessed by 10 point pain scales
Tidsramme: 24 hours postoperatively
|
24 hours postoperatively
|
Andre resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
time until the first oral intake after surgery
Tidsramme: 24 hours postoperatively
|
24 hours postoperatively
|
|
time until the first urination after surgery
Tidsramme: 24 hours postoperatively
|
24 hours postoperatively
|
|
time until ambulation after surgery
Tidsramme: 24 hours postoperatively
|
24 hours postoperatively
|
Samarbeidspartnere og etterforskere
Etterforskere
- Hovedetterforsker: Danguole C Rugyte, MD. PhD, Lithuanian University of Health Sciences
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010 Apr 1;110(4):1170-9. doi: 10.1213/ANE.0b013e3181cf9281. Epub 2010 Feb 8.
- Wong I, St John-Green C, Walker SM. Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Paediatr Anaesth. 2013 Jun;23(6):475-95. doi: 10.1111/pan.12163. Epub 2013 Apr 9.
- Hiller A, Silvanto M, Savolainen S, Tarkkila P. Propacetamol and diclofenac alone and in combination for analgesia after elective tonsillectomy. Acta Anaesthesiol Scand. 2004 Oct;48(9):1185-9. doi: 10.1111/j.1399-6576.2004.00473.x.
- Rugyte D, Kokki H. Intravenous ketoprofen as an adjunct to patient-controlled analgesia morphine in adolescents with thoracic surgery: a placebo controlled double-blinded study. Eur J Pain. 2007 Aug;11(6):694-9. doi: 10.1016/j.ejpain.2006.11.001. Epub 2006 Dec 20.
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Patologiske prosesser
- Postoperative komplikasjoner
- Smerte
- Nevrologiske manifestasjoner
- Smerter, postoperativt
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Sentralnervesystemdepressiva
- Agenter fra det perifere nervesystemet
- Enzymhemmere
- Analgetika
- Sensoriske systemagenter
- Anti-inflammatoriske midler, ikke-steroide
- Analgetika, ikke-narkotisk
- Anti-inflammatoriske midler
- Antirevmatiske midler
- Syklooksygenase-hemmere
- Antipyretika
- Analgetika, opioid
- Narkotika
- Paracetamol
- Farmasøytiske løsninger
- Morfin
- Tramadol
- Ketoprofen
Andre studie-ID-numre
- BEC-MF-10
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