- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT07571252
Impact of Preemptive Analgesia on Postoperative Pain in Orthognathic Surgery
Impact of Preemptive Analgesia on Postoperative Pain in Patients Undergoing Orthognathic Surgery: A Randomized Controlled Trial.
This randomized controlled clinical trial evaluates the effect of preemptive analgesia on postoperative pain outcomes in adult patients undergoing orthognathic surgery. Participants scheduled for bilateral sagittal split osteotomy and Le Fort I osteotomy under general anesthesia will be randomized to one of three groups: intravenous acetaminophen, intravenous ibuprofen, or a control group receiving standard postoperative analgesia without preoperative medication.
The study aims to determine whether the administration of pre-surgical analgesics reduces postoperative pain intensity and analgesic requirements during the early postoperative period. Pain will be assessed using a standardized pain scale at multiple time points following surgery, and secondary outcomes will include postoperative analgesic consumption and patient satisfaction with pain control.
This investigation seeks to contribute evidence supporting multimodal analgesic strategies and improved postoperative pain management in patients undergoing orthognathic surgery.
Обзор исследования
Статус
Вмешательство/лечение
Подробное описание
Effective management of postoperative pain remains an important component of perioperative care in patients undergoing orthognathic surgery. Procedures such as bilateral sagittal split osteotomy and Le Fort I osteotomy are associated with significant postoperative discomfort due to extensive manipulation of osseous and soft tissue structures. Preemptive analgesia, defined as the administration of analgesic medication prior to surgical injury, has been proposed as a strategy to attenuate central sensitization and reduce postoperative pain intensity.
This study is designed as a participant-blinded, randomized controlled clinical trial conducted in the operating room at the Administration of Medical Services in Puerto Rico (ASEM). Adult patients between 21 and 65 years of age with American Society of Anesthesiologists (ASA) physical status I or II who are scheduled to undergo orthognathic surgery will be invited to participate following informed consent. A total of 72 participants will be enrolled and randomly assigned in a 1:1:1 ratio to one of three groups: intravenous acetaminophen, intravenous ibuprofen, or a control group receiving no preoperative analgesic intervention.
Participants in the intervention groups will receive either acetaminophen 1 g intravenously or ibuprofen 600 mg intravenously approximately 30 minutes before surgical incision, with a second dose administered near the end of the procedure according to the medication half-life. The control group will receive no pre-surgical analgesic administration and will follow the institution's standard postoperative pain management protocol.
Postoperative pain intensity will be measured using a validated pain scale at predetermined intervals during the postoperative period. Additional outcomes include postoperative analgesic requirements and patient satisfaction with pain control. By comparing two commonly used intravenous analgesic medications with standard care, this study aims to evaluate the effectiveness of preemptive analgesic strategies in improving postoperative pain outcomes and reducing analgesic consumption following orthognathic surgery.
Тип исследования
Регистрация (Оцененный)
Фаза
- Фаза 4
Контакты и местонахождение
Контакты исследования
- Имя: Dennys Rivera Pérez, MD
- Номер телефона: 1920-1921 7877582525
- Электронная почта: dennys.rivera@upr.edu
Учебное резервное копирование контактов
- Имя: Alvara J Horta Caicedo, DMD
- Номер телефона: 1-678-394-7721
- Электронная почта: alvaro.horta@upr.edu
Места учебы
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San Juan, Пуэрто-Рико, 00936
- Рекрутинг
- Administración de Servicios Médicos (ASEM)
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Контакт:
- Dennys Rivera Pérez, MD
- Номер телефона: 1920-1921 7877582525
- Электронная почта: dennys.rivera@upr.edu
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Контакт:
- Alvara J Horta Caicedo, DMD
- Номер телефона: 1-678-394-7721
- Электронная почта: alvaro.horta@upr.edu
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
- Взрослый
- Пожилой взрослый
Принимает здоровых добровольцев
Описание
Inclusion Criteria:
- Adults aged 21 to 65 years.
- American Society of Anesthesiologists (ASA) physical status I or II.
- Scheduled to undergo orthognathic surgery including bilateral sagittal split osteotomy and Le Fort I osteotomy under general anesthesia.
- Ability to understand the study procedures and provide written informed consent.
Exclusion Criteria:
- Pregnancy or breastfeeding.
- Known allergy or intolerance to acetaminophen, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs).
- Renal dysfunction, defined as estimated glomerular filtration rate <60 mL/min/1.73 m².
- Hepatic dysfunction, defined as liver enzyme levels greater than twice the upper limit of normal.
- History of bleeding disorders or coagulopathy.
- Active or recent peptic ulcer disease.
- Current use of recreational drugs, including cannabis, that in the judgment of the investigators could interfere with anesthesia management, postoperative pain assessment, or study outcomes.
- Any medical condition that, in the judgment of the investigators, would make participation unsafe or interfere with study participation.
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Тройной
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
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Экспериментальный: Intravenous Acetaminophen
Participants randomized to this arm will receive acetaminophen 1 g administered intravenously approximately 30 minutes prior to surgical incision during orthognathic surgery under general anesthesia.
A second dose will be administered near the end of the surgical procedure according to the medication half-life.
Postoperative pain outcomes will be compared with the other study groups.
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Acetaminophen 1 g administered intravenously approximately 30 minutes prior to surgical incision during orthognathic surgery under general anesthesia.
A second dose will be administered near the end of the surgical procedure according to the medication half-life.
Другие имена:
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Экспериментальный: Intravenous Ibuprofen
Participants randomized to this arm will receive ibuprofen 600 mg administered intravenously approximately 30 minutes prior to surgical incision during orthognathic surgery under general anesthesia.
A second dose will be administered near the end of the procedure according to the medication half-life.
Postoperative pain outcomes will be compared with the other study groups.
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Ibuprofen 600 mg administered intravenously approximately 30 minutes prior to surgical incision during orthognathic surgery under general anesthesia.
A second dose will be administered near the end of the surgical procedure according to the medication half-life.
Другие имена:
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Без вмешательства: Standard Care Control
Participants randomized to this arm will not receive preoperative analgesic medication.
Postoperative pain management will follow the institution's standard care protocol after completion of the surgical procedure.
Outcomes will be compared with participants receiving preemptive intravenous analgesic interventions.
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Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Postoperative Pain Intensity
Временное ограничение: 1 hour, 4 hours, and 24 hours after surgery
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Postoperative pain intensity measured using a validated pain scale (Visual Analog Scale, 0-10) in patients undergoing orthognathic surgery.
Pain scores will be recorded and compared between the acetaminophen, ibuprofen, and control groups.
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1 hour, 4 hours, and 24 hours after surgery
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Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Postoperative Analgesic Consumption
Временное ограничение: Within 24 hours after surgery
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Total amount of rescue analgesic medications administered during the postoperative period will be recorded and compared between study groups.
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Within 24 hours after surgery
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Patient Satisfaction with Pain Management
Временное ограничение: 24 hours after surgery
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Patient satisfaction with postoperative pain control measured using the Spanish version of the Pain Treatment Satisfaction Scale (PTSS).
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24 hours after surgery
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Соавторы и исследователи
Спонсор
Публикации и полезные ссылки
Общие публикации
- Cillo JE Jr, Dattilo DJ. Pre-emptive analgesia with pregabalin and celecoxib decreases postsurgical pain following maxillomandibular advancement surgery: a randomized controlled clinical trial. J Oral Maxillofac Surg. 2014 Oct;72(10):1909-14. doi: 10.1016/j.joms.2014.05.014. Epub 2014 May 27.
- Alyahya A, Aldubayan A, Swennen GRJ, Al-Moraissi E. Effectiveness of different protocols to reduce postoperative pain following orthognathic surgery: A systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2022 Sep;60(7):e1-e10. doi: 10.1016/j.bjoms.2022.03.013. Epub 2022 Apr 23.
- Xuan C, Yan W, Wang D, Li C, Ma H, Mueller A, Chin V, Houle TT, Wang J. Efficacy of preemptive analgesia treatments for the management of postoperative pain: a network meta-analysis. Br J Anaesth. 2022 Dec;129(6):946-958. doi: 10.1016/j.bja.2022.08.038. Epub 2022 Oct 26.
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Первичное завершение (Оцененный)
Завершение исследования (Оцененный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Боль
- Неврологические проявления
- Послеоперационные осложнения
- Патологические процессы
- Патологические состояния, признаки и симптомы
- Признаки и симптомы
- Боль, Послеоперационный
- Органические химические вещества
- Карбоновые кислоты
- Анилиды
- Амиды
- Анилиновые соединения
- Амины
- Ацетанилиды
- Кислоты, карбоциклический
- Фенилпропионаты
- Ацетаминофен
- Ибупрофен
Другие идентификационные номера исследования
- 2603555595
Планирование данных отдельных участников (IPD)
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Описание плана IPD
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
продукт, произведенный в США и экспортированный из США.
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .