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NK Activity Modulation Induced by Intravenous Lidocaine During Colorectal Laparoscopic Surgery

Phase 4
Conditions
Colorectal Cancer
Interventions
Drug: Normal saline infusion
Registration Number
NCT01841294
Lead Sponsor
Maisonneuve-Rosemont Hospital
Brief Summary

Surgical resection is the best treatment option for colorectal cancer. Despite this radical approach, recurrences within five years are still common. Several authors have proposed that the immunosuppressive state surrounding the perioperative period was a key element of cancer cells spread.

A particular subtype of T lymphocytes, the Natural Killer cells (NKs), is the main actor of the innate immune system. Several factors of the perioperative period can reduce activity of NKs such as stress, pain, opioids and general anaesthetics.

Lidocaine is a local anaesthetic that has been widely used intravenously for abdominal surgeries. Intravenous lidocaine has been shown to reduce pain scores, morphine consumption, ileus time and length of stay in major colorectal surgeries. It reduced markers of systemic inflammation as well.

The authors hypothesize that the use of intravenous lidocaine during laparoscopic surgeries for colorectal cancer resection will preserve NKs activity.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Patients admitted for resection of colorectal cancer under laparoscopic surgery
  • American Society of Anesthesiologists class I-III.
  • The subject is able to understand the study objectives, the experimental protocol and procedures, and is capable of providing an informed consent.
Exclusion Criteria
  • Subjects allergic to any of the study drugs.
  • BMI > 35 kg/m2.
  • Severe renal or hepatic failure.
  • Pregnancy.
  • Emergent procedure.
  • Heart failure NYHA > III.
  • Systolic blood pressure < 90 mmHg.
  • Advanced heart block (unless patient has a pacemaker).
  • Unstable angina and/or myocardial infarction within past 6 weeks.
  • FEV1 ≤ 0.8 L.
  • Oxygen-dependent patient.
  • Electrocardiographic abnormalities
  • Treatment with immunosupressive drugs, corticosteroids, NSAIDS, antiarythmic
  • Morphine intolerance or allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboNormal saline infusionInfusion of normal saline form the induction of anaesthesia untill one hour after PACU admission
Intravenous LidocaineIntravenous LidocainePatients undergoing laparoscopic surgery for resection of colorectal cancer will benefit of an infusion of intravenous lidocaine from the induction of anesthesia untill one hour after PACU admission
Primary Outcome Measures
NameTimeMethod
Dosage of NKs activity after surgerycompare the activity of NK cells on day 1 and day 3 after surgery

Dosage of NKs activity after surgery

Secondary Outcome Measures
NameTimeMethod
Pain scorespain scores from the PACU to the 3rd day after surgery

From the PACU to the 3rd day after surgery

Morphine consumptionFrom the PACU to the 3rd day after surgery

Morphine consumption from the PACU to the 3rd day after surgery

Ileus timeDay 1 and Day 3 after surgery

time to get flattus after surgery

Surgical complicationsWithin 3 days after surgery

Infections, leakage, abcess

Fentanyl doseOperative time

Cumulative dose of fentanyl needed for the surgery

Nausea and vomitingFrom the PACU to the 3rd day after surgery

Nausea and vomiting from the PACU to the 3rd day after surgery

Major adverses eventsStart of the surgery untill one hour after PACU ad;ission

Hypotension, heart rythm blocks, tachycarida, bradycardia

Trial Locations

Locations (1)

Hôpital Maisonneuve Rosemont

🇨🇦

Montreal, Quebec, Canada

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