- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07558226
Multimodal Anesthesia in Robotic Laparoscopic Nephrectomy (MANTRA)
Efficacy of Multimodal Anesthesia in Robotic Laparoscopic Nephrectomy: Impact on Recovery and Early Hospital Discharge.
Przegląd badań
Status
Interwencja / Leczenie
Szczegółowy opis
Prospective, randomized, controlled clinical trial to evaluate whether multimodal anesthesia allows for early hospital discharge (reduce 24-hour admission) compared to conventional anesthesia in oncological robotic nephrectomies; both according to usual practice. The effect of no specific drug will be evaluated, but rather the anesthetic approach pologies of surgical patients. It will be enrolled 80 patients. Patients will be randomized 1:1 using a computer-generated sequence into: Group A: multimodal anesthesia vs Group B: conventional anesthesia.
Main objective is to demonstrate the superiority of multimodal anesthesia over conventional anesthesia in patients undergoing robotic laparoscopic nephrectomy within a short-stay surgical program, in terms of reducing hospital admission time and earlier discharge. To demonstrate that multimodal anesthesia allows a reduction in hospital admission time allowing for early discharge.
Estimated duration of the study is 18 months. This involves collecting data from preoperative to 30 days post-surgery from patients undergoing oncological robotic nephrectomy.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: DIANA VERNETTA, MD
- Numer telefonu: 0034934169700
- E-mail: dvernetta@fundacio-puigvert.es
Lokalizacje studiów
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BARCELONA
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Barcelona, BARCELONA, Hiszpania, 08025
- Rekrutacyjny
- Fundacio Puigvert
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Kontakt:
- DIANA VERNETTA, MD
- Numer telefonu: 0034934169700
- E-mail: dvernetta@fundacio-puigvert.es
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Kontakt:
- Silvia Mateu, MD
- Numer telefonu: 0034 934169700
- E-mail: smateu@fundacio-puigvert.es
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Główny śledczy:
- DIANA VERNETTA, MD
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Patients ≥18 years.
- Indication for elective oncological robotic partial or radical nephrectomy.
- ASA classification I-III.
- Candidates for short-stay surgery according to institutional protocol.
- Signed informed consent.
Exclusion Criteria:
- Chronic opioid use. Defined as continuous opioid use during the 3 months prior to surgery
- Uncontrolled chronic pain. Defined as chronic pain not adequately controlled with usual treatment during the 3 months prior to surgery.
- Contraindications to NSAIDs, regional anesthesia, or drugs of the multimodal protocol.
- Advanced renal failure (GFR <30 ml/min) at the preanesthetic visit.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie podtrzymujące
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Potroić
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Aktywny komparator: Multimodal anesthesia
Multimodal anesthesia Balanced general anesthesia. Standardized multimodal analgesia: Paracetamol iv NSAID or COX-2 (if not contraindicated) Magnesium sulfate iv Lidocaine iv Ketamine iv Methadone iv at the beginning surgical incision at low doses TAP block with local anesthetic: Bupivacaine 0.25% 10ml Surgical wound infiltration with local anesthetic: bupivacaine 0.25% 2ml per to knock |
Administration of multimodal anesthesia in patients randomized to this arm and undergoing oncological robotic nephrectomies according to usual practice. Premedication: Midazolam: 1-2mg Ondansetron: 4-8mg IV Dexamethasone: 4-8mg IV +/-Scopolamine (patients high risk PONV) iv Magnesi Sulfate: 30-50mg/Kg iv Induction: Fentanyl: 1mcg/kg iv Propofol: 1-2mg/Kg iv Rocuroni: 0.3mg/kg iv Lidocaine: 1.1.5mg/Kg iv bolus Ketamine: 0.25-0.5mg/Kg Methadone: 0.5-0.1mg/kg IV at the beginning of the surgical incision (single dose). Maintenance: Propofol/sevorane Rocuroni: 0.3mg/kg/h iv Lidocaine: 1-2 mg/Kg/h Ketamine: 0.1-0.2 mg/kg/h Postoperative: Paracetamol: 1g/8h IV Metamizole: 1g/8h iv Rescue opioids if VAS>4: Adolonta or Morphine |
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Aktywny komparator: Conventional anesthesia
Balanced general anesthesia. Standardized conventional analgesia: Paracetamol IV NSAID or COX-2 (if not contraindicated) Analgesia based mainly on systemic opioids. Absence of protocolized regional blocking. |
Administration of conventional anesthesia in patients randomized to this arm and undergoing oncological robotic nephrectomies according to usual practice. Premedication: Midazolam: 1-2mg Ondansetron: 4-8 mg IV Dexamethasone: 4-8 mg IV +/-Scopolamine (patients high risk PONV) iv Induction: Fentanyl: 1mcg/kg iv Propofol: 1-2mg/kg iv Rocuroni: 0.3mg/kg iv Maintenance: Propofol/sevorane Rocuroni: 0.3mg/kg/h iv Remifentanil: 0.05-0.2 mcg/Kg/h Methadone: 1-1.5mg/kg IV at the end of surgery Postoperative: Paracetamol: 1g/8h IV Metamizole: 1g/8h iv Rescue opioids if VAS>4: Adolonta or Morphine. |
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change hospital admission time and earlier discharge
Ramy czasowe: From enrollment to the end of follow up 30 days
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Changes over time in the hospital stay, expressed in hours, will be measured and reported.
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From enrollment to the end of follow up 30 days
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Post surgery pain
Ramy czasowe: Post surgery time 6, 24 and 48 hours.
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Postoperative pain will be assessed using the VAS scale (Visual Analogue Scale) at 6, 24 and 48 hours.
The results will be recorded on a scale of 0 (minimal pain) to 10 (maximum pain).
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Post surgery time 6, 24 and 48 hours.
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Cumulative consumption of opioids
Ramy czasowe: From enrollment to the end of follow up 30 days
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Compare the cumulative consumption of opioids (morphine equivalents).
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From enrollment to the end of follow up 30 days
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Nausea and vomiting
Ramy czasowe: From enrollment to the end of follow up 30 days
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Compare the incidence of postoperative nausea and vomiting (PONV).
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From enrollment to the end of follow up 30 days
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Early ambulation
Ramy czasowe: From end of surgery to ambulation
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Compare the time in hours from end of surgery to early ambulation during hospitalization.
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From end of surgery to ambulation
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Oral tolerance
Ramy czasowe: From end of surgery to oral tolerance
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Compare the time in hours from end of surgery to oral tolerance during hospitalization.
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From end of surgery to oral tolerance
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Hospital stay
Ramy czasowe: From enrrolment to end of hospital stay
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Compare the time of hospital stay in hours from hospitalization to discharged.
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From enrrolment to end of hospital stay
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Duration of surgery
Ramy czasowe: From start surgery to end surgery
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Compare the duration of surgery in hours
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From start surgery to end surgery
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Perioperative complications
Ramy czasowe: From enrollment to the end of follow up 30 days
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Compare perioperative complications according to the Clavien-Dindo classification.
It grades complications from I (menor) to V (major), with suffix 'd' for permanent disability.
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From enrollment to the end of follow up 30 days
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Readmission or unscheduled consultations
Ramy czasowe: From enrollment to the end of follow up 30 days
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Compare the rate of readmission or unscheduled consultations at 30 days.
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From enrollment to the end of follow up 30 days
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Postoperative recovery
Ramy czasowe: From enrollment to the end of follow up 30 days
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Assess the quality of postoperative recovery using the QoR-15 questionnaire (Quality of Recovery-15).
It consists of 15 items that assess pain, physical comfort, physical independence and emotional state, with a total score ranging from 0 to 150 (the higher the score, the better the recovery)
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From enrollment to the end of follow up 30 days
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Surgical procedure satisfaction
Ramy czasowe: From enrollment to the end of follow up 30 days
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Compare the level of general satisfaction with the surgical procedure using a satisfaction questionnaire based on the Likert scale: Very dissatisfied, Dissatisfied, Neutral, Satisfied, Very satisfied.
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From enrollment to the end of follow up 30 days
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Predictive factors for better response to multimodal anesthesia
Ramy czasowe: From enrollment to the end of follow up 30 days
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Determine predictive factors for better response to multimodal anesthesia (e. g.: age report in years, sex (male or female), the ASA (American Society of Anesthesiologists) classification (I-VI), weight and height will be combined to report BMI in kg/m^2, pathological history, nephrectomy, bleeding, perioperative complications).
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From enrollment to the end of follow up 30 days
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Współpracownicy i badacze
Sponsor
Śledczy
- Główny śledczy: DIANA VERNETTA, MD, FUNDACIO PUIGVERT IUNA
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Inne numery identyfikacyjne badania
- FP2026/01
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
The investigators and the sponsor will preserve the confidentiality of all patients participating in the clinical trial, in accordance with GCP, and the patient's identity will be kept confidential throughout the trial. Complete affiliation data and written consent will be kept in the investigator's file.
The personal data of the participants will be treated in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on Data Protection (GDPR), and the corresponding Organic Law 3/2018, of 5 December, on the protection of personal data and the guarantee of digital rights. The data collected are only those data strictly necessary for the purposes of this research and will be used exclusively for this purpose.
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- CSR
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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