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Paravertebral Catheters for Pancreatic Surgery

30. august 2017 oppdatert av: University of Minnesota

Ultrasound Guided Bilateral Paravertebral Catheters Versus Thoracic Epidural Analgesia for Post- Operative Pain Control in Open Pancreatic Surgery: A Prospective Outcomes Study

Design: Level I randomized prospective outcomes study comparing two groups of patients. One group will receive bupivacaine and dilaudid thoracic epidural analgesia (PCA) post-operatively. The other will receive bilateral ultrasound guided paravertebral blocks with indwelling paravertebral catheters with an infusion of 0.2% ropivicaine post-operatively and a PCA.

Sample Size: 50 patients Study Duration: Approximately 12 months Population:. Patients presenting to the University of Minnesota Medical Center for elective open pancreatic surgery.

Primary Objective: To determine if bilateral paravertebral catheters in patients with open pancreatic procedures result in decreased pain compared to patients treated with thoracic epidural for post-operative pain.

Secondary Objectives:

  1. To determine whether the use of bilateral paravertebral catheters impacts the length of ICU and hospital stay for patients, compared to a thoracic epidurals in patients undergoing elective open pancreatic surgery.
  2. To determine whether the use of ultrasound guided bilateral paravertebral catheters leads to lower risk of complications, compared to use of a thoracic epidural in patients undergoing open pancreatic surgery.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Design: Level I randomized prospective outcomes study comparing two groups of patients. One group will receive buipvacanine and dilaudid thoracic epidural analgesia (PCA) post-operatively. The other will receive bilateral ultrasound guided paravertebral blocks with indwelling paravertebral catheters with an infusion of 0.2% ropivicaine post-operatively and a PCA.

Sample Size: 50 patients Study Duration: Approximately 12 months Population:. Patients presenting to the University of Minnesota Medical Center for elective open pancreatic surgery.

Primary Objective: To determine if bilateral paravertebral catheters in patients with open pancreatic procedures result in decreased total maximal pain scores compared to patients treated with thoracic epidural for post-operative pain.

Secondary Objectives:

  1. To determine whether the use of bilateral paravertebral catheters impacts the length of ICU and hospital stay for patients, compared to a thoracic epidurals in patients undergoing elective open pancreatic surgery.
  2. To determine whether the use of ultrasound guided bilateral paravertebral catheters leads to lower risk of complications, compared to use of a thoracic epidural in patients undergoing open pancreatic surgery.

2. Synopsis and Medical Application:

Specific Aims:

Primary Hypothesis: Paravertebral catheters will result in improved pain control relative to thoracic epidural for post-operative pain from open pancreatic surgery.

Secondary Hypothesis: Paravertebral catheters will result in fewer hospital days and improved subjective respiratory function compared to patients in the thoracic epidural group.

Studietype

Intervensjonell

Registrering (Faktiske)

50

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiesteder

  • Forente stater
    • Minnesota
      • Minneapolis, Minnesota, Forente stater, 55455
        • University of Minnesota

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

18 år til 85 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • • All patients undergoing open pancreatic surgery.

Exclusion Criteria:

  • • Previous difficult airway or multiple previous intubations

    • History of myasthenic syndrome
    • Systemic infection
    • Pre-existing sensory deficit
    • PT >14 or PTT >40 sec
    • Platelet count less than 50,000
    • Creatinine > 1.5
    • Allergy to local anesthetics
    • Patients who remain intubated for one week after surgery or who are unable to provide information as to their feelings of pain post-operatively for the first week post-operatively
    • Use of a spinal or epidural anesthetic for surgery
    • Daily use of opioid for more than a week or chronic pain syndrome
    • Lack of patient cooperation

    • Contraindication to regional anesthesia

      • Infection at injection site
      • Inability to guarantee sterile equipment or sterile conditions for the block
      • Patient refusal
      • Risk of local anesthetic toxicity
      • Coagulopathy or bleeding disorder
      • Severe respiratory disease (where the patient depends on intercostal muscle function for ventilation);
      • Ipsilateral diaphragmatic paresis;

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: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Standard of Care
Epidural placed for postoperative pain control
Fremgangsmåte: Epidural
A mid thoracic epidural is placed preoperatively and a local anesthetic and opioid infusion is run postoperatively
Eksperimentell: Experimental Intervention
Bilateral paravertebral catheters placed for postoperative pain control
Fremgangsmåte: Paravertebral catheters
Bilateral paravertebral catheters are placed and a local anesthetic infusion via an elastomeric pump is run postoperatively

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
total Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 1 through postoperative day 5
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 1 through postoperative day 5

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 1
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 1
Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 2
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 2
Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 3
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 3
Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 4
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 4
Maximal Pain scored via NRS 0-10 scale
Tidsramme: on postoperative day 5
maximal pain scored via NRS 0-10 scale assessed by independent assessor
on postoperative day 5
Nausea/vomiting
Tidsramme: the first five days postoperatively
the presence of nausea and or vomiting endorsed by the patient as assessed by an independent assessor
the first five days postoperatively
Length of stay
Tidsramme: when the patient meets discharge criteria or is discharged home, expected length of stay 10 days
up through the time the patient is discharged , expected length of stay 10 days.
when the patient meets discharge criteria or is discharged home, expected length of stay 10 days

Samarbeidspartnere og etterforskere

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Sponsor

University of Minnesota

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. august 2012

Primær fullføring (Faktiske)

1. desember 2015

Studiet fullført (Faktiske)

1. juni 2016

Datoer for studieregistrering

Først innsendt

3. februar 2015

Først innsendt som oppfylte QC-kriteriene

13. februar 2015

Først lagt ut (Anslag)

16. februar 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

31. august 2017

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. august 2017

Sist bekreftet

1. august 2017

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 1203M11482

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