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Osteopathic Manipulative Treatment Efficacy in Postoperative Pain

Phase 4
Completed
Conditions
Surgery
Pain
Interventions
Other: Osteopathic Manipulative Treatment
Registration Number
NCT02694991
Lead Sponsor
Fondazione Don Carlo Gnocchi Onlus
Brief Summary

Effectively controlling sternal pain during cardiac rehabilitation after heart surgery is very important as it reduces the risk of postoperative complications.

However, the contraindications and side effects of analgesic drugs may induce physicians to use them so cautiously that pain may actually be under-treated.

The aim of this open label, controlled study is to assess whether osteopathic manipulative treatment (OMT) can contribute to pain relief and improve rehabilitation outcomes.

Detailed Description

The currently predominant means of controlling postoperative pain is the peri-operative administration of opioid or non-opioid (acetaminophen) analgesics, alone or in combination, and non-steroidal anti-inflammatory drugs (NSAIDs). However, anti-inflammatory drugs are contraindicated for many patients because they may impair renal function, interact with platelet aggregation, and increase the risk of gastrointestinal damage and bleeding. The spectrum of available options is narrow.

Osteopathic manipulative Treatment (OMT) intervenes in the process that transforms nociceptive information into the subjective experience and it may be useful.

It has been found to be effective in controlling pain after abdominal surgery, it has a beneficial effect on patients recovering coronary artery by-pass surgery and also improves cardiac function The aim of this study was to assess whether complementary OMT is an effective means of reducing post-surgical sternal pain and improving rib cage mobility after heart surgery involving sternotomy, and to investigate its advantages during in-patient rehabilitation in terms of functional recovery, and perceived anxiety and depression.

This open, randomised, semi-blinded, controlled trial involves inclusion of 80 adult patients of both genders consecutively admitted as in-patients to cardiac rehabilitation unit after undergoing elective coronary artery by-pass grafting (CABG), valve replacement or repair and/or ascending aorta surgery with sternotomy, and capable of voluntarily providing their written informed consent. The patients are divided in 2 groups, the intervention group receiving OMT and the control group. Both groups are following the same rehabilitation programme and receiving usual care.

All of the subjects taking part in the study are receiving standard care in accordance with the international guidelines for in-patient cardiac rehabilitation; the only experimental intervention is the addition of OMT

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Recent artery bypass grafting (CABG)
  • Recent valve replacement or repair
  • Recent ascending aorta surgery
Exclusion Criteria
  • Heart surgery using mini-thoracotomy.
  • Heart transplantation
  • Implant of a ventricular assistance device
  • Diabetes mellitus
  • Rheumatoid arthritis
  • Autoimmune diseases
  • Altered cognitive capacities

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
OMT GroupOsteopathic Manipulative TreatmentOsteopathic Manipulative Treatment 15 minutes once a day for 8 days
Primary Outcome Measures
NameTimeMethod
Pain intensity relief21 days

Pain intensity measured with visual analogic scale (VAS)

Secondary Outcome Measures
NameTimeMethod
Respiratory function21 days

Inspiratory volume variation measured as mL of air inspired

Anxiety and Depression21 days

Hospital Anxiety and Depression Scale (HADS) score

Functional capacity improvement21 days

Distance in meters walked in six minutes

Analgesic drug consumption.21 days

Number of analgesic drug doses taken

Hospitalization length21 days

Number of days of hospitalisation

Trial Locations

Locations (1)

Fondazione Don C. Gnocchi ; Istituto S. Maria Nascente IRCCS

🇮🇹

Milano, Italy

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