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Opioid Free Versus Opioid Based Anaesthesia for Free Flap Reconstruction Surgery of the Breast: A Phase III Multicentric Randomized Controlled Study.

Phase 3
Recruiting
Conditions
Breast Cancer
Interventions
Registration Number
NCT05439005
Lead Sponsor
Institut Curie
Brief Summary

This study will compare morphine consumption during the first 48 hours postoperatively between the OFA group and the CA control group.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
158
Inclusion Criteria
  1. Women aged 18 or older.
  2. Patients with a French health insurance coverage (having a French social security number).
  3. Patient eligible for free flap reconstruction surgery of the breastunder general anaesthesia.
  4. Patient who has given written consent to participate in accordance with the regulations.
  5. Having a negative blood pregnancy test for patients of childbea ring age.
Exclusion Criteria
  1. Allergy or intolerance to any of the drugs (dexmedetomidine, remifentanil, lidocaine, propofol, dexamethasone, kétamine, ketoprofen, nefopam, paracetamol, morphine, ropivacaine, droperidol, ondansetron).
  2. Known history of heart failure, arrhythmias and/or ischemic heart disease and/or severe renal insufficiency.
  3. Pulse below 50bpm during anaesthesia consultation and/or under beta blocker treatment.
  4. Treatment with ACEI/ARB.
  5. Severe asthma.
  6. Symptomatic gastric or duodenal ulcer with or without treatment.
  7. Baseline systolic blood pressure < 100 mmHg.
  8. Chronic preoperative pain and/or use of WHO ladder step 2 or 3 analgesics preoperatively.
  9. Patient already included in another therapeutic trial evaluating an experimental molecule.
  10. Persons deprived of liberty or under guardianship.
  11. Patients with suspected difficulties in assessing pain on a scale.
  12. Inability to undergo trial medical monitoring due to geographic, social or psychological reasons.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
OFA groupDexmedetomidineOFA (Opioid Free Anaesthesia) group:
Primary Outcome Measures
NameTimeMethod
comparison of Morphine consumption in the two groupsduring the first 48 hours postoperatively
Secondary Outcome Measures
NameTimeMethod
Maximum VAS at rest and mobilization in the PACU, at D0, D1 and D2in the PACU, at D0, D1 and D2
Pain management satisfaction scores (score from 0 to 10) at dischargeat discharge
Morphine consumption during the first 48 hours post-operatively (mg) in each breast reconstruction subgroup (immediate and secondary);the first 48 hours postoperatively
Dose of morphine given in titration in the PACU (mg)in the PACU
DN3 score (Neuropathic Pain 3) on D2, D4, M1, M3 and M6on D2, D4, M1, M3 and M6
Collection of serious adverse events between D0 (date of surgery) and D30between D0 (date of surgery) and D30
Assessment of the flap failure rate (flap removal surgery) and flap micro-anastomosis re-exploration rateat discharge
Dose of intraoperative rescue remifentanil in the OFA group (mcg)at discharge
Assessment of vasopressor requirement and total intraoperative filling volumeend of surgery
Assessment of the state of consciousness on arrival in the PACUon arrival in the PACU
Number of boluses demand on PCA during the first 48 hours postoperativelythe first 48 hours postoperatively
Assessment of the incidence of PONV in the PACU, at D0, D1 and D2in the PACU, at D0, D1 and D2
Length of stay in PACU (h) and length of in-hospital postoperative length of stay (D)at discharge

Trial Locations

Locations (3)

Institut Curie Saint-Cloud

🇫🇷

Saint-Cloud, France

Gustave Roussy, Cancer Campus, Grand Paris

🇫🇷

Villejuif, France

Institut Curie Paris

🇫🇷

Paris, France

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