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Pharmacodynamic Differences Between Branded and Unbranded Remifentanil Molecules

Phase 4
Completed
Conditions
Pain
Interventions
Registration Number
NCT02048293
Lead Sponsor
Fundación Universitaria de Ciencias de la Salud
Brief Summary

Unbranded drug molecules are produced after the patent of a given drug has expired. Unbranded molecules of Remifentanil have been marketed in Colombia, and several reports by anesthesiologist indicate that there are differences in the physiologic response of patients to these molecules. The investigators hypothesized that unbranded molecules of remifentanil require higher doses to obtain desired physiological responses as compared to the branded molecule.

Detailed Description

Introduction. Several remifentanil products are commercialized in Colombia while these have never been compared in a clinical setting.

Objective. The aim of this study was to investigate the pharmacodynamic profile of the innovative molecule of remifentanil (group O = Ultiva®) and two unbranded molecules (group A = Remifentanil Laboratorios Chalver de Colombia S.A. and group B = Fada Remifentanilo) registered in Colombia.

Methods. The investigators carried out a double-blind, randomized, controlled trial. The branded molecule of remifentanil (group O, n=29) was compared against the two unbranded molecules (group A, n=29; group B, n=32) during anesthetic induction and tracheal intubation in adult patients American Society of Anesthesiology Physical Status Classification = I without predictors for difficult airway. The target controlled infusion (TCI) doses evaluated were 6, 8 and 10 ng/ml with the Minto model. Induction was complemented with propofol 5 mg/ml (TCI) with the Schneider model and rocuronium 0.6 mg/kg. The primary outcome was defined as the difference in mean arterial pressure and heart rate pre-intubation (TCI equilibrium) and post-intubation (maximum measurement within 5 minutes).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Patients requiring orotracheal intubation
  • 18-50 years old
  • Body mass index <31 kg/m2
  • Written informed consent
Exclusion Criteria
  • Pregnancy
  • Risk of difficult airway
  • History of opioid use

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group OFada RemifentaniloRemifentanyl innovative molecule = Ultiva®
Group ORemifentanyl, Ultiva®Remifentanyl innovative molecule = Ultiva®
Group ARemifentanil Laboratorios Chalver de Colombia S.A.Remifentanyl comparator A = Remifentanil Laboratorios Chalver de Colombia S.A.
Group BRemifentanyl, Ultiva®Remifentanyl comparator B = Fada Remifentanilo
Group BRemifentanil Laboratorios Chalver de Colombia S.A.Remifentanyl comparator B = Fada Remifentanilo
Group AFada RemifentaniloRemifentanyl comparator A = Remifentanil Laboratorios Chalver de Colombia S.A.
Primary Outcome Measures
NameTimeMethod
Composite outcome of heart rate or mean arterial pressure difference before and after tracheal intubationAverage of 5 minutes

Heart rate measured with EKG. Mean arterial pressure measured with automatic blood pressure cuff.

Secondary Outcome Measures
NameTimeMethod
Cooper intubation condition scoreMeasured during tracheal intubation, average of 30 seconds

Jaw relaxation: 0 poor, 1 minimum, 2 moderate, 3 good. Vocal cords: 0 closed, 1 closing, 2 moving, 3 open. Intubation response: 0 severe cough, 1 mild cough, 2 mild diaphragmatic movement, 3 no response.

Cooper score: Jaw relaxation + Vocal cords + Intubation response

Trial Locations

Locations (1)

Fundación Universitaria de Ciencias de la Salud, Hospital de San Jose

🇨🇴

Bogota, Cundinamarca, Colombia

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