MedPath

Intrathecal Morphine for Postoperative Analgesia in Major Laparoscopic Abdominal Surgery, a IMPACT-Scope Trial

Phase 4
Not yet recruiting
Conditions
Patients Undergoing Major Laparoscopic Abdominal Surgery
Interventions
Drug: ITM + Usual Care
Drug: Sham ITM + Usual Care
Registration Number
NCT06666985
Lead Sponsor
First Affiliated Hospital, Sun Yat-Sen University
Brief Summary

The goal of this clinical trial is to learn the clinical and cost effectiveness of intrathecal morphine (ITM) in addition to usual care as a postoperative pain relief strategy following major laparoscopic abdominal surgery compared with current usual care. The main questions it aims to answer are:

An enhanced analgesic technique, consisting of ITM in addition to usual care , improves the postoperative quality of recovery at day 1 after surgery by at least 6 points on the 15-item quality of recovery questionnaire (QoR-15) compared to usual care alone, in patients undergoing major laparoscopic abdominal surgery?

Researchers will compare ITM + Usual care to Sham ITM + Usual Care (The sham ITM mimics the ITM procedure, but the dura is not breached) to see if ITM works to postoperative pain relief.

Participants will:

Receive ITM + Usual care or Sham ITM + Usual care on surgery day Have interview with outcome assessors and complete the CRFs on the day of surgery, postoperative day 1, day 2, day 3 and up to postoperative day 30

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
700
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ITM + Usual CareITM + Usual Care-
Sham ITM + Usual CareSham ITM + Usual Care-
Primary Outcome Measures
NameTimeMethod
Quality of recoveryPostoperative day 1

Quality of recovery is measured using the 15-item Quality of Recovery Questionnaire (QoR-15)

Secondary Outcome Measures
NameTimeMethod
Quality of recoveryPostoperative day 2 , Postoperative day 3 (or at discharge, if earlier)

Quality of recovery is measured using the 15-item Quality of Recovery Questionnaire (QoR-15)

Quality of lifePostoperative day 1, Postoperative day 2, Postoperative day 3 (or at discharge, if earlier) and Postoperative day 30

Quality of life is measured using the European Quality of life-5 Dimensions-5 Level (EQ-5D-5L)

Pain scores in the post-anaesthesia recovery unitDay of surgery

Pain scores is measured using a numeric rating scale (NRS 0-10)

Worst pain scorePostoperative day 1, Postoperative day 2, and Postoperative day 3 (or at discharge, if earlier)

Worst pain score is measured using a numeric rating scale (NRS 0-10)

Anaesthesia-related discomfort (nausea and/or vomiting, drowsiness, shivering, pruritus)Postoperative day 1, Postoperative day 2, Postoperative day 3 (or at discharge, if earlier)

Anaesthesia-related discomfort is measured using a bespoke questionnaire

Patient satisfactionPostoperative day 1, Postoperative day 2, Postoperative day 3 (or at discharge, if earlier)

Patient satisfaction is measured using a bespoke questionnaire

Time in minutes to tracheal extubation from the end of anaesthesiaFrom end of anesthesia to tracheal extubation on day of surgery or from end of anesthesia to discharge day (for ICU patients) up to 48 hours
Number of pain management visitsPostoperative day 1, Postoperative day 2, Postoperative day 3(or at discharge, if earlier), day of discharge and Postoperative day 30
Postoperative pulmonary complicationsPostoperative day 1, Postoperative day 2 and Postoperative day 3 (or at discharge, if earlier)

Postoperative pulmonary complications is measured according to the Standardized Endpoints for Perioperative Medicine and the Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAQ) definition

Respiratory depressionDay of surgery, Postoperative day 1, Postoperative day 2, Postoperative day 3 (or at discharge, if earlier)

Respiratory depression is defined as respiratory rate less than 8 breaths per minute AND need for medical intervention

Total opioid consumptionDuring operation and up to Postoperative day 30

Total opioid consumption is transformed into oral morphine equivalent daily dose

Postoperative mobilisationPostoperative day 1,Postoperative day 2, Postoperative day 3 (or at discharge, if earlier)

Postoperative mobilisation is ability to transfer from bed to chair, with or without assistance

Doses of antiemetics administered postoperatively (number of administration)Day of Surgery, Postoperative day 1, Postoperative day 2, Postoperative day 3 (or at discharge, if earlier)
Length of Hospital Stay1 Day after surgery

Length of Hospital Stay (in days) is number of days from starting day of surgery to the day of discharge, calculated as discharge date - surgery date + 1 day

Days at Home and well After Surgery (DAH-30)Postoperative day 30
MortalityPostoperative day 30
© Copyright 2025. All Rights Reserved by MedPath