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The Effect of Periarticular Multi-Drug Regimen on Pain After Partial Hip Replacement

Phase 4
Conditions
Femoral Neck Fracture
Interventions
Drug: none of medication preoperatively and intraoperatively
Drug: periarticular injection of multidrug regimen
Registration Number
NCT01112436
Lead Sponsor
Chung-Ang University Hosptial, Chung-Ang University College of Medicine
Brief Summary

This prospective randomized study aims to evaluate the effectiveness of periarticular multi-drug regimen injection on the relief of pain in patients undergoing partial hip replacement.

Total 258 patients will be randomized into one of two groups (groupC or groupI) based on Excel number generation.

Patients in group C will receive no medication intraoperatively, and patients in group I will receive oral oxycodone and celecoxib preoperatively and a periarticular injection of multi-drug regimen during operation.

Visual analogue scale pain scores, fentanyl consumption and the frequency at which patients pushed the button (FPB) of a patient-controlled analgesia system will be recorded at 1, 4, 7 postoperative day.

Detailed Description

Patients in group I will receive oxycodone SR 10 mg, and celecoxib 200 mg with 10 ml of water 1 hour before surgery.

And patients in group I will receive periarticular injection of 50 ml solution which contains ropivacaine 15 mg, epinephrine 0.3 mg, cefmetazole 1000mg, ketorolac 30 mg and morphine HCL 10mg before closure of surgical wound.

Patients in group C will receive no medication.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
258
Inclusion Criteria
  • femoral neck fracture
  • partial hip replacement
Exclusion Criteria
  • r/o infection
  • reoperation
  • mental change

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
control group (group C)none of medication preoperatively and intraoperativelycontrol group will receive no medication preoperatively and during operation
periarticular injecion group (group I)periarticular injection of multidrug regimenpatients in Group I will receive oral oxycodone SR 10 mg and celecoxib 200 mg 1 hour preoperatively with sips of water, and receive periarticular injection of combination of ropivacaine 15 mg, morphine 10 mg, ketorolac 30 mg epinephrine 0.3 mg and cefmetazole 1000mg during operation.
Primary Outcome Measures
NameTimeMethod
Visual analogue scale 1dayPost Op 1 day

Patients will be assessed for pain using a visual analogue pain scale (VAS). It is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end; left side end which represents 0 is 'No pain', right side end with 100 is 'Very severe pain'. The patient marks on the line the point that they feel represents their perception of their current state. The VAS score is determined by measuring in millimeters from the left hand end of the line to the point that the patient marks.

To check the severity of pain VAS will be measured at post op 1day.

Secondary Outcome Measures
NameTimeMethod
Opioid consumption 1dayPost Op 1 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. In the case of persistent pain greater than a visual analogue scale (VAS) pain score of 30 mm, an additional 50 μg of fentanyl will be injected intra-venously by nursing staff until the pain was relieved to a level less than a VAS pain score of 30 mm. And sum of delivery from PCA system and additional opioid fom immediately after operation to post op 1daywill be measured.

FPB 1dayPost Op 1 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. And total frequency of patient to push the button of the PCA machine (FPB) fom immediately after operation to post op 1day will be measured.

delirium rating scale at admissionat admission

Delirium rating scale wiil be measured to compare with the post op delerium scale at admisssion.

Visual Analogue Scale 4dayPost OP 4day

Patients will be assessed for pain using a visual analogue pain scale (VAS). It is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end; left side end which represents 0 is 'No pain', right side end with 100 is 'Very severe pain'. The patient marks on the line the point that they feel represents their perception of their current state. The VAS score is determined by measuring in millimeters from the left hand end of the line to the point that the patient marks.

To check the severity of pain VAS will be measured at post op 4day.

Visual Analogue Scale 7dayPost Op 7day

Patients will be assessed for pain using a visual analogue pain scale (VAS). It is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end; left side end which represents 0 is 'No pain', right side end with 100 is 'Very severe pain'. The patient marks on the line the point that they feel represents their perception of their current state. The VAS score is determined by measuring in millimeters from the left hand end of the line to the point that the patient marks.

To check the severity of pain VAS will be measured at post op 7day.

Opioid consumption 4dayPost Op 4 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. In the case of persistent pain greater than a visual analogue scale (VAS) pain score of 30 mm, an additional 50 μg of fentanyl will be injected intra-venously by nursing staff until the pain was relieved to a level less than a VAS pain score of 30 mm. And sum of delivery from PCA system and additional opioid fom post op 1day to post op 4 day will be measured.

Opioid consumption 7dayPost Op 7 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. In the case of persistent pain greater than a visual analogue scale (VAS) pain score of 30 mm, an additional 50 μg of fentanyl will be injected intra-venously by nursing staff until the pain was relieved to a level less than a VAS pain score of 30 mm. And sum of delivery from PCA system and additional opioid fom post op 4day to post op 7 day will be measured.

FPB 4dayPost Op 4 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. And total frequency of patient to push the button of the PCA machine (FPB) fom post op 1day to post op 4 day will be measured.

FPB 7dayPost Op 7 day

The patients will be taught to push the button of the PCA system, which delivered a bolus of drug, each time pain occurred. And frequency of patient to push the button of the PCA machine (FPB) fom post op 4day to post op 7day will be measured.

delirium rating scale 1dayPost Op 1day

Delirium rating scale wiil be measured to check the incidence and severity of delirium at post-op 1day.

delirium rating scale 4dayPost Op 4day

Delirium rating scale wiil be measured to check the incidence and severity of delirium at post-op 4day.

delirium rating scale 7dayPost Op 7day

Delirium rating scale wiil be measured to check the incidence and severity of delirium at post-op 7day.

Trial Locations

Locations (1)

ChungAng University

🇰🇷

Seoul, Korea, Republic of

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