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Effect of Lidocaine on Postoperative Pain and Long-term Survival in Elderly Patients Undergoing Colorectal Surgery

Not Applicable
Recruiting
Conditions
Colorectal Cancer
Interventions
Drug: Placebo
Registration Number
NCT06405776
Lead Sponsor
West China Hospital
Brief Summary

This study is a further observation and follow-up of the patients enrolled in the registration number NCT05920980 to further evaluate the effect of long-term infusion of lidocaine on postoperative chronic pain, long-term quality of life and survival rate in patients undergoing colorectal cancer surgery.

Detailed Description

This study is a further observation and follow-up of the patients enrolled in the registration number NCT05920980 to further evaluate the effect of long-term infusion of lidocaine on postoperative chronic pain, long-term quality of life and survival rate in patients undergoing colorectal cancer surgery. Patients who meet the enrollment criteria will be randomized 1:1 to the lidocaine group or placebo group. In the lidocaine group, lidocaine 1.5mg/kg/h was continuously infused (using ideal body weight) during the whole procedure. Postoperative analgesia pump with lidocaine (lidocaine 50mg/kg, sufentanil 2ug/kg, glassetron 12mg) diluted to 200ml with saline until 72h after surgery. In the placebo group, the same volume of normal saline will be administered during anesthesia. The postoperative PCIA device will contain sufentanil 2μg/kg, granisetron 12mg diluted to 200mL in 0.9% normal saline solution with a total volume of 200mL.Follow-up after discharge includes chronic pain, the impact of chronic pain on quality of life, the relapse-free survival and overall survival from postoperative 3 months to 5 years.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
276
Inclusion Criteria
  1. Participants were at least 60 years old;
  2. American Society of Anesthesiologists (ASA) physical status I to III;
  3. Body-mass index of 18-30 kg/m2;
  4. Scheduled for elective colorectal surgery.
Exclusion Criteria
  1. Metastases occurring in other distant organs;
  2. Severe hepatic insufficiency (aspartate aminotransferase or alaninetransaminase or bilirubin >2.5 times the upper limit of normal);
  3. Renal impairment (creatinine clearance <60 mL/min);
  4. Cardiac rhythm disorders or systolic heart failure (second-and thirddegree heart block, ejection fraction <50%);
  5. Allergies to any of the trial drugs; chronic opioid use;
  6. Inability to comprehend numeric rating scale.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo groupPlaceboIn the placebo group, the same volume of normal saline will be administered during anesthesia. The postoperative PCIA device will contain sufentanil 2μg/kg, granisetron 12mg diluted to 200 mL in 0.9% normal saline solution with a total volume of 200 mL.
Lidocaine grouplidocainePatients in the lidocaine group, lidocaine 1.5mg/kg/h is continuously infused (using ideal body weight) during the whole procedure, postoperative analgesia pump with lidocaine (lidocaine 50mg/kg, sufentanil 2ug/kg, glassetron 12mg) diluted to 200ml with saline until 72h after surgery.
Primary Outcome Measures
NameTimeMethod
The incidence of chronic pain at 3 months postoperatively3 months postoperatively

Chronic pain is defined as pain that lasts or recurs for longer than 3 months. For chronic postsurgical pain(CPSP), it mainly refers to the pain that persists past normal healing time. Pain scoring is performed at 3 months using the Numerical Rating Scale(NRS), with 11 digits ranging from 0 to 10 indicating the degree of pain,0 indicating no pain, and 10 indicating severe pain. Subjects choose a number to indicate the degree of pain based on their personal pain experience.

Secondary Outcome Measures
NameTimeMethod
Disability-free surviva survival6 months, 1 year, 3 years, 5 years postoperatively

Patient self-assessment is carried out by using the World Health Organization(WHO) Disability Scale, with a minimum score of 12 points and a maximum score of 60 points. The lower the score, the higher the quality of life.

The prevalence of neuropathic pain3 months, 6 months, 1 year, 3 years, 5 years postoperatively

The ID Pain scale is used as a validated assessment of neuropathic pain. ID pain questionnaire consists of six items. Pain higher scores suggest a neuropathic component to the pain.

Overall survival after surgery6 months, 1 year, 3 years, 5 years postoperatively

Overall survival is defined as the time between the date from surgery to the date of death.

Brief Pain Inventory(BPI) pain interference subscale score3 months, 6 months, 1 year, 3 years, 5 years postoperatively

BPI pain interference subscale is a 7-item questionnaire asking participants to describe how pain has interfered general activity, mood, walking, normal work, relations with others, sleep, and enjoyment of life. Each question is answered on a scale 0(does not interfere) to 10(completely interferes). The total range of score is 0-70. The higher the scores suggest the worse the interference.

The incidence of chronic pain at 6 months ,1 year, 3 years and 5 years postoperatively6 months, 1 year and 3 years postoperatively

Chronic pain is defined as pain that lasts or recurs for longer than 3 months. For chronic postsurgical pain(CPSP), it mainly refers to the pain that persists past normal healing time. Pain scoring is performed at 3 months using the Numerical Rating Scale(NRS), with 11 digits ranging from 0 to 10 indicating the degree of pain,0 indicating no pain, and 10 indicating severe pain. Subjects choose a number to indicate the degree of pain based on their personal pain experience.

Recurrence-free survival after surgery6 months, 1 year, 3 years, 5 years postoperatively

Postoperative re-examination is based on the diagnosis of enhanced CT, MRI, ultrasound or blood examination to determine whether the patient has recurrence and metastasis. Recurrence-free time refers to the time from surgery to tumor recurrence based on the above CT, MRI, etc.

Trial Locations

Locations (1)

China

🇨🇳

Sichuan, China

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