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Effects of Surgery Start Time on Postoperative Interleukin-6, Interleukin-8, and Cortisol

Not Applicable
Completed
Conditions
Hemiarthroplasty
Arthroplasty, Replacement, Hip
Interventions
Procedure: Total hip replacement
Procedure: Hemi-arthroplasty
Registration Number
NCT03076827
Lead Sponsor
Chuncheon Sacred Heart Hospital
Brief Summary

Cortisol is a hormone that increases after trauma or surgery and has circadian rhythm. It has a form that is increased in the morning and decreased in the evening. The investigators expected to be influenced by circadian rhythm according to the time of operation, and compared morning and afternoon surgery.

Detailed Description

44 patients to undergo hip hemiarthroplasty or total hip replacement were divided to morning surgery group(Group A) and afternoon surgery group(Group P). All surgery was done by the same orthopedic surgeon. Anesthesia of Group A was started at 8 a.m. and Group P was at 12\~2 p.m. Blood sampling was performed at 7:30 a.m., after induction of anesthesia, 6, 12, 24 and 48 hours after surgery in all patients of both groups. Cortisol, IL-6, and IL-8 was measured immediately after blood sampling. Visual analogue scale(VAS) was used to assess the degree of pain at before start of anesthesia, 6, 12, 24 and 48 hours after surgery. The postoperative hospital stay was calculated. Postoperative management was done by the same management team. Surgical wounds were treated at the same 24 hour intervals.

A sample size was calculated to differentiate between groups. Because difference of cortisol according to groups in ANOVA based on pilot study, the sample size was 20 patients per group. (Effect size f(v)= 0.5297047, α=0.05, 1-β=0.90) The investigators recruited total 44 patients to cover dropout 10%.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Patients scheduled for hip hemiarthroplasty
  • Patients scheduled for total hip replacement
Exclusion Criteria
  • Sleep disorder
  • Mental disorder
  • Psychiatric medication

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group PTotal hip replacementGroup to begin surgery(total hip replacement or hip hemi-arthroplasty) in the afternoon
Group AHemi-arthroplastyGroup to begin surgery(total hip replacement or hip hemi-arthroplasty) in the morning
Group PHemi-arthroplastyGroup to begin surgery(total hip replacement or hip hemi-arthroplasty) in the afternoon
Group ATotal hip replacementGroup to begin surgery(total hip replacement or hip hemi-arthroplasty) in the morning
Primary Outcome Measures
NameTimeMethod
Cortisol levelwithin the first 2 days after surgery

Cortisol levels over time

Secondary Outcome Measures
NameTimeMethod
Post-operative hospital stayHospital day after surgery.

Hospital day after surgery.

Interleukin-6within the first 2 days after surgery

Interleukin-6 levels over time

Interleukin-8within the first 2 days after surgery

Interleukin-8 levels over time

Visual analogue scalewithin the first 2 days after surgery

pain scale over time

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