MedPath

Postoperative Pain Management on Uvulopalatopharyngoplasty Patients

Phase 4
Not yet recruiting
Conditions
Obstructive Sleep Apnea-hypopnea Syndrome
Pain, Postoperative
Pain, Acute
Interventions
Other: Routine practice
Registration Number
NCT05825495
Lead Sponsor
Li-Jen Hsin
Brief Summary

This is a randomized controlled study, aimed to investigate the effects of dinalbuphine sebacate (DS) on patients having uvulopalatopharyngoplasty (UPPP). DS is a prodrug of nalbuphine, a mixed agonist-antagonist opioid. The mean absorption time for the complete release of DS into systemic circulation is approximately 145 h, which could theoretically provide extended analgesic effects for up to 6 days. Patients diagnosed with obstructive sleep apnea are generally associated with higher risks towards opioid side effects, especially respiratory depression. Post-UPPP pain managing should be cautiously arranged and executed. We hypothesize that the combination of our routine practice and DS will improve the outcomes after Uppp.

Detailed Description

Within 4 weeks before uvulopalatopharyngoplasty, patients are invited for this study. After written informed consent gained, the eligibilities are checked. Eligible patients are arrogated into experimental or control group randomly prior to surgery. Experimental group receives the DS administration at least 12 hours before surgery. During peri-operative period, pain management are conducted following our routine practice. Pain intensity, consumption of analgesics, adverse events, swallow function and life quality are all assessed and recorded within 14 days after surgery.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
78
Inclusion Criteria
  • aged between 20 and 65.
  • diagnosed with obstructive sleep apnea.
  • arranged to undergo uvulopalatopharyngoplasty.
  • classified as ASA I, II, or III.
Exclusion Criteria
  • can not comply with study protocol.
  • BMI > 34 kg/m2.
  • history of chronic pain.
  • history of narcotics or alcohol abuse.
  • allergic to NSAID.
  • diagnosed as diabetes mellitus with poor glycemic control.
  • diagnosed with severe cardiovascular or respiratory diseases.
  • judged as an unsuitable subject by investigators.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental groupDinalbuphine sebacateSubjects will intragluteally injected with a dose of 150 mg dinalbuphine sebacate at least 12 hours before surgery. During intra- and post-operative period, the pain management will execute following our routine practice.
Experimental groupRoutine practiceSubjects will intragluteally injected with a dose of 150 mg dinalbuphine sebacate at least 12 hours before surgery. During intra- and post-operative period, the pain management will execute following our routine practice.
Control groupRoutine practiceThe pain management will peri-operatively execute following our routine practice without dinalbuphine sebacate administration.
Primary Outcome Measures
NameTimeMethod
Pain intensitywithin 3 days after surgery

Pain intensity will be assessed via numeric rating scale, 0 means no pain and 10 means the worst pain imaged.

Secondary Outcome Measures
NameTimeMethod
Consumption of analgesicswithin 14 days after surgery

Consumption of analgesics will be summarized by drug categories, routes and the individual days administrated.

Incidence of adverse eventswithin 14 days after surgery

Percentage and number of patients suffering from adverse events will be summarized by the individual days.

MD Anderson Dysphagia Inventory1 day, 3 days, 7 days and 14 days after surgery

The MDADI is the first validated and reliable self-administered questionnaire designed specifically for evaluating the impact of dysphagia on the QOL of patients with head and neck cancer. There are 20 questions in the questionnaire. Each question has five levels, including strongly disagree, disagree, no opinion, agree, strongly agree.

Percentage of patients consuming analgesicswithin 3 days after surgery

Percentage and number of patients consuming analgesics will be summarized by drug categories, route and the individual days administrated.

EAT-10 (Eating Assessment Tool)1 day, 3 days, 7 days and 14 days after surgery

EAT-10 is a dysphagia assessment that helps to measure swallowing difficulties. There are 10 questions in the questionnaire. Each question has 5 levels, 0 means no problem and 4 means severe problem.

Pain intensitywithin 14 days after surgery

Pain intensity will be assessed via numeric rating scale, 0 means no pain and 10 means the worst pain imaged.

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