Intraoperative Clonidine for Postoperative Pain Management in Patients Undergoing Surgical Treatment for Endometriosis: a Prospective, Double-blind, Randomized Controlled Trial
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Cumulative opioid consumption 0-3 hours
研究概览
简要总结
The role of a single dose of intraoperative clonidine on postoperative opioid requirements, pain intensity and opioid-related side effects in patients undergoing surgical treatment for endometriosis remains scarcely explored. A prospective double-blind, randomised controlled trial investigating the effect of a single-dose of intraoperative clonidine in patients undergoing surgical treatment for endometriosis is therefore conducted.
详细描述
Background with aim: Acute postoperative pain is a major and common concern for the large number of patients who undergo surgery each year. Despite advances in pain management strategies, many patients continue to suffer from moderate-to-severe pain during the early postoperative period. This is concerning as unrelieved pain can result in decreased patient satisfaction, increased morbidity, prolonged hospital length-of-stay and increased risk of persistent pain. Effective treatment of acute postoperative pain should therefore be prioritized. Opioid analgesics remain the mainstay treatment for postoperative pain. The potential benefits of opioid therapy for acute pain are short-term pain control. However, there are several potential harms associated with opioid use which may outweigh the benefits including sedation, nausea, vomiting, constipation and risk of long-term use. In this respect, a single dose of clonidine could provide stable analgesia and potentially reduce the need for shorter-acting opioids. Therefore, the investigators decided to carry out the present study with the aim to examine the analgesic efficacy and safety of intraoperatively administered intravenous clonidine in patients undergoing surgical treatment for endometriosis on postoperative opioid consumption, pain intensity and opioid-related side effects.
Method: 120 patients undergoing surgical treatment for endometriosis will be included in this prospective, randomized, double-blind, controlled trial with two arms: an intervention arm (clonidine 150 microgram) and a control arm (isotonic saline). The study will be GCP-monitored, and is approved by the Danish Medicines Agency (2022064017) and the National Committee on Health Research Ethics (2209269).
Hypothesis
The investigators hypothesize that a single dose of intraoperatively administered intravenous clonidine will be effective in reducing postoperative opioid requirements, pain intensity and opioid-related side effects.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Randomization and study medication will be handled by the hospital pharmacy. All research team members, caregiving clinicians and enrolled patients will be blinded to the study allocation arms and the randomisation list will be concealed until all statistical analyses are made.
入排标准
- 年龄范围
- 18 Years 至 110 Years(Adult, Older Adult)
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Patients scheduled for surgical laparoscopic treatment of endometriosis at Aarhus University Hospital
排除标准
- •Age < 18 years
- •American Society of Anesthesiologists (ASA) physical status IV or V
- •Allergy to clonidine
- •Inability to provide informed consent
- •Known severe renal insufficiency
- •Known severe bradyarrhythmia
- •Pregnancy, lactation:
- •Daily opioid consumption the last 7 days before surgery
- •Pain intensity >5 on more than half of the days during the last month
研究组 & 干预措施
Clonidine
A 100 ml isotonic saline will be mixed with 1 ml clonidine (150 μg). The blinded 100 ml bag including isotonic saline and clonidine 150 μg will be infused over 5-10 min., immediately after intubation.
干预措施: Clonidine (Drug)
Isotonic saline
A 100 ml isotonic saline will be mixed with 1 ml isotonic saline. The blinded 100 ml bag including isotonic saline will be infused over 5-10 min., immediately after intubation.
干预措施: Isotonic saline (Drug)
结局指标
主要结局
Cumulative opioid consumption 0-3 hours
时间窗: 3 hours after arrival at the PACU
Opioid consumption within the first 3 hours after arrival at the PACU
次要结局
- Shivering(0, 60 and 120 minutes after arrival at the PACU)
- Cumulative opioid consumption 0-6 hours(6 hours after arrival at the PACU)
- Pain intensity during coughing(0, 30, 60, 90 and 120 minutes after arrival at the PACU)
- Pain intensity at rest(0, 30, 60, 90 and 120 minutes after arrival at the PACU)
- Sedation (Ramsey Sedation Score 1-6)(0, 60 and 120 minutes after arrival at the PACU)
- PONV(0, 60 and 120 minutes after arrival at the PACU)
- Discharge from the PACU(24 hours)
