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Xenon Combined With Intraoperative Thoracic Epidural Analgesia

Phase 2
Completed
Conditions
Colorectal Cancer
Interventions
Registration Number
NCT01696630
Lead Sponsor
Centre Leon Berard
Brief Summary

This is a monocentric study in 2 steps: A safety part to assess the feasibility of using Xenon in association with a thoracic epidural analgesia (TEA) with a sequential recruitment of 3, 6 or 9 patients according to predefined safety rules. The second part will randomly allocated patients (1:1) to receive TEA+Xenon or TEA+Desflurane. 28 patients will be enrolled and followed over 45 days.

Detailed Description

The first step is divided into 3 parts. 9 patients will be sequentially enrolled (3 patients in each part). The patients will be followed during 45 days and the following rules will be used to assess the safety:

First part: if no toxicity: initiation of the randomised part. If 1/3 toxicity: start of the second part. If 2 or 3/3 toxicity: end of the study.

Second part: same rules and possible start of the third part. Third part: if no toxicity: initiation of the randomised part. If 1 or more toxicity: end of the study.

The safety will be assessed after each part by an independent data safety monitoring board.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
31
Inclusion Criteria
  • Older than 18 years old
  • Planned surgery for oncologic colic and/or rectal surgery
  • ASA score I or II
  • Indication of complementary thoracic epidural analgesia
  • Agree to use an effective form of contraception
  • Patients who can understand, read and write French language
  • Covered by a medical insurance
  • Patients who have dated/signed an inform consent
Exclusion Criteria
  • Unstable angina within the 30 last days
  • Myocardial infarction within 28 days prior to surgery
  • Uncontrolled arterial high blood pressure
  • Severe cardiac insufficiency
  • Severe chronic obstructive pneumopathy
  • Patient who requires FiO2 > 40%
  • Patient already enrolled in a clinical study which may interfere with the present study
  • Known hypersensitivity to one of the study drugs
  • History or familial history of malignant hyperthermia
  • Documented high intracranial pressure
  • Eclampsia or pre-eclampsia
  • Pregnant or breastfeeding woman
  • Liver injury (icterus) and/or unexplained fever and/or eosinophilia after halogen exposure
  • Failure in epidural anesthesia installation
  • Patient refusal
  • Patient who can't be compliant to the present protocol

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DesfluraneDesfluraneDesflurane 6.5% (+/-0.5%) in association with a thoracic epidural analgesia in maintenance phase
XenonXenonXenon 60% (+/-5%) in association with a thoracic epidural analgesia in maintenance phase
Primary Outcome Measures
NameTimeMethod
Variation of intraoperative Mean Arterial Pressure (MAP)Maintenance phase

Variation between the Mean Arterial Pressure (MAP) at induction and the mean of intraoperative MAP values in each patient and comparaison between arms.

Secondary Outcome Measures
NameTimeMethod
Measure of hemodynamic parameters (Systolic Ejection Volume, Heart rate, DeltaPP)Throughout the maintenance of anesthesia, an expected average of 6 hours

monitoring device (automatic recorder)

Delay from the surgery to the discharge datefrom the surgery to the hospital discharge date

Delay from the date of surgery to the date of hospital discharge (days)

Delay between the end of surgery and Post Anesthesia Care Unit's exit (min)from the end of surgery up to Post Anesthesia Care Unit's exit

Delay between the end of surgery and Post Anesthesia Care Unit's exit (min)

Total dose requirement of Vasopressive and hypotensive agentsThroughout the maintenance of anesthesia, an expected average of 6 hours
Volume of each product infusedThroughout the maintenance of anesthesia, an expected average of 6 hours
Total dose of morphineThroughout the maintenance of anesthesia, an expected average of 6 hours

Total dose of morphine required to maintain BIS between 40 and 60 (in mg/kg)

Quality of awaking5 minutes after eyes opening

Modified Aldrete score and Recovery Index

Delay to oral feeding recoveryFrom surgery to oral feeding reintroduction

Time from the date of surgery to the date of first subsequent oral food intake

Post-operative Adverse Events45 days after surgery

Post-operative Adverse Events (according to the NCI-CTC version 4.03)

post-operative painAt entrance and exit of post operative room and 24 hours after the end of anesthesia

Score to Visual Analog Scale

Delay to intestinal transit recoveryTime to postoperative stools

Time from the date of surgery to the date of first postoperative stools

Trial Locations

Locations (1)

Centre Léon Bérard

🇫🇷

LYON Cedex 08, France

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