MedPath

Conditioned Open Label Placebo for Postoperative Pain Management

Not Applicable
Recruiting
Conditions
Pain, Postoperative
Interventions
Behavioral: Placebo
Registration Number
NCT06107595
Lead Sponsor
Centre de Médecine Intégrative et Complémentaire (CEMIC)
Brief Summary

The primary objective is to evaluate the efficacy of two Conditioned Open Label Placebos (COLP): COLP pill and COLP odor to reduce opioid intake for postoperative (thoracic and spinal surgery) pain management compared to the opioid only usual treatment (TAU).

Detailed Description

Patients, eligible for an elective thoracic or spinal surgery, will be randomized into either standard of care, COLP_pill or COLP_odor. Patients in COLP groups will be asked to pair each opioid intake with an open label placebo intake (either a pill or an inhalation) for postoperative (POD) day 0 to 17. From POD 2, patients in the intervention arms will be additionally asked to take OLP alone 3 times a day. Patients will have unrestricted access to pain killers. Patients will daily assess opioid intake, pain intensity, side effects, mobility and sense of agency using a e-dairy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
222
Inclusion Criteria
  • Spinal or thoracic elective surgery for the indications mentioned above
  • Able to give informed consent
  • Interested in trying COLP as complementary pain management therapy
  • Able to fill a e-diary at home
Exclusion Criteria
  • Cognitive impairment (MOCA score <26)
  • Inability to engage in the intervention of the study e.g. inability to communicate in French without a translator, severe hearing impairment without any hearing aid available at the time of intervention, anosmia or intolerance to eugenol.
  • Acute psychiatric (e.g. psychotic or suicidal ideation) or somatic (e.g. unstable cardio-respiratory condition) co-morbidity preventing full engagement during intervention
  • Opioid use disorder (toxicomania) or contraindication to pain management using opioids (allergy, refusal, ...)
  • Intolerance to placebo ingredients

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Efficacy of conditioned open label placebo pillPlaceboOn postoperative day 0, participant will self-administer one OLP with all opioid analgesics (whether administered intravenously or orally). This pairing will be done from postoperative day 0 to postoperative day 17. Starting on postoperative day 2, participants take 3 scheduled placebo doses (pills or inhalation) every day, at 3 convenient times. In parallel, the OLP pairing to standard and rescue doses of opioids will continue. The patients are told to continue taking both scheduled standalone COLP and paired COLP (if needed) until postoperative day 17.
Standard of carePlaceboUsual postoperative pain management, relying mainly on opioids
Efficacy of conditioned open label placebo odorPlacebo1 drops of clove oil (i.e. eugenol) will be disposed on a cotton and inserted into a stick. The patients will be asked to actively smell them by sniffing using a stick of inhalation. On postoperative day 0, participant will self-administer one OLP with all opioid analgesics (whether administered intravenously or orally). This pairing will be done from postoperative day 0 to postoperative day 17. On postoperative day 2, participants take 3 scheduled placebo doses (pills or inhalation) every day, at 3 convenient times. In parallel, the OLP pairing to standard and rescue doses of opioids will continue. The patients are told to continue taking both scheduled standalone COLP and paired COLP (if needed) until postoperative day 17
Primary Outcome Measures
NameTimeMethod
Opioids consumption17 days

Cumulative opioids intake as postoperative consumption (in MgMeq)

Secondary Outcome Measures
NameTimeMethod
Time to Opioid withdrawal (in days)until the 6 months follow-up

Time to Opioid withdrawal calculated for COLP compared to treatment as usual

Postoperative pain intensity17 days

Daily Visual Analog Score from the e-diary (score from 0 to 10, 10=worst pain)

Satisfaction with postoperative management17 days

Daily Visual Analog Score from the e-diary (score from 0 to 10, 10=highest satisfaction)

Mobility17 days

Daily Visual Analog Score from the e-diary (score from 0 to 10, 10=best ability to move)

Sense of agency17 days

Daily Visual Analog Score from the e-diary (score from 0 to 10, 10=best sense of agency)

Side effects intensity17 days

Daily Visual Analog Score from the e-diary (score from 0 to 10, 10=worst intensity)

Trial Locations

Locations (1)

Centre de Médecine Intégrative et Complémentaire, Service d'anesthésiologie, CHUV,

🇨🇭

Lausanne, Vaud, Switzerland

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