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Postoperative Oral Methadone After Major Spine Surgery; Safety, Feasibility and Efficacy in Prevention of Progression to Chronic Opioid Usage at 3 Months

Phase 2
Withdrawn
Conditions
Spine Surgery
Interventions
Drug: Postoperative placebo
Drug: Rescue Analgesia
Registration Number
NCT05693675
Lead Sponsor
The University of Texas Health Science Center, Houston
Brief Summary

The purpose of this study is to evaluate the feasibility and safety of a clinical protocol based on the administration of intraoperative intravenous methadone followed by a short regimen of oral/IV (if the patient is not able to take oral) methadone following spine surgery and to evaluate if methadone decreases persistent opioid usage at 3 months in comparison to placebo.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Adults undergoing multilevel complex lumbar and/or thoracic spine fusion surgery, including revision surgeries
Exclusion Criteria
  • BMI greater than 40

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Postoperative methadonePostoperative methadone-
Postoperative methadoneRescue Analgesia-
Postoperative placeboPostoperative placebo-
Postoperative placeboRescue Analgesia-
Primary Outcome Measures
NameTimeMethod
Feasibility of study design as assessed by the number of participants for which scheduled postoperative methadone versus placebo were able to be administered according to the scheme describedDay of discharge (about 6 days after surgery)
Feasibility of study design as assessed by number of participants for which safety was able to be assessed (EKGs)postop days 1 and 5
Feasibility of study design as assessed by the number of participants for which safety was able to be assessed (respiratory events)Day of discharge (about 6 days after surgery)

ability to evaluate adverse respiratory events

Feasibility of study design as assessed by the number of participants for which postop opioid usage could be surveyed at 3 months3 months after surgery
Secondary Outcome Measures
NameTimeMethod
Safety as assessed by the number of participants with dizzinessby fifth day of hospital stay
Safety as assessed by the number of patients developing clinically significant corrected QT interval(QTc )prolongationby fifth day of hospital stay

QTc interval \>500ms or \>25% increase from baseline; number of patients developing arrhythmias needed treatment

Safety as assessed by the number of participants with occurrence of nauseaby fifth day of hospital stay
Number of participants for which opioid usage was able to be collectedDay of discharge (about 6 days after surgery)
Safety as assessed by the number of participants with hallucinationsby fifth day of hospital stay
Safety as assessed by the number of participants with Antiemetic useby fifth day of hospital stay
Safety as assessed by the number of participants with occurrence of vomitingby fifth day of hospital stay
Safety as assessed by the number of patients developing respiratory depressionby fifth day of hospital stay

Saturation of Oxygen(SPO2) less than 85%, Respiratory rate \<5 for longer than 3 minutes, ( Khanna et) increased oxygen requirement related to opioid-induced respiratory depression, naloxone use. The SPO2 will be monitored continuously per usual care in post anesthesia care unit (PACU) and every 4 hours in the ward.

Safety as assessed by the number of subjects with persistent opioid use3 months after surgery

This is scored from 0(less than once a week) to 4(constantly, a higher number indicating more opioid use)

Safety as assessed by the number of participants with occurrence of Ileus or constipationby fifth day of hospital stay

Trial Locations

Locations (1)

The University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

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