Clinical Trials Logo
NCT number NCT03496194
Study type Observational
Source Zealand University Hospital
Contact Laura S Kruuse, Med.Student
Phone +4520180876
Email lsmk@regionsjaelland.dk
Status Not yet recruiting
Phase
Start date April 15, 2018
Completion date August 15, 2018

Clinical Trial Summary

This study aims to investigate the current organization and management of postoperative pain in Denmark, especially for invasive pain treatment modalities (epidural infusions, PCA and regional blocks), in a national survey covering the activities in Danish Hospitals.

This study is an electronic questionnaire survey, that aim to describe and map the foundation for future developments within, and improvement of, postoperative pain management.


Clinical Trial Description

Postoperative pain is one of the major challenges in postoperative care and several studies continue to demonstrate that postoperative pain is generally undertreated. A key focus for postoperative pain is to identify gold standards within procedure-specific pain treatment. However, results from single randomized trials do not per se lead to better treatment, as this requires both efforts within implementation of best evidence, quality control of efficacy, including efficacy on the individual level, and education of staff and physicians.

It has been suggested, that a way forward must include changes at the organizational level. For basic postoperative pain treatment, the major responsibility for planning and execution often rests on the surgical departments. For invasive pain treatment methods, e.g. epidural analgesia with continual infusion, patient controlled epidural analgesia (PCEA), patient controlled analgesia (PCA), and regional blocks, both single and continuing, this treatment is instituted at the departments of anaesthesia, but the responsibility for follow up is rarely described.

Generally, epidural analgesia is widely recommended because of superior benefits in reducing postoperative pain, pulmonal complications and surgical stress, as compared to systemic opioid treatment. However, epidural analgesia is not without complications especially not for abdominal and thoracic surgery. The accompanying unwanted motor blockade may delay recovery and recent studies question this treatment. Likewise, up to 20 % percent of patients will not receive adequate analgesia for the first 48 hours postoperative with this method. Finally, it is possible, that adverse effects and complications from epidural treatment are currently being underestimated, due to lack of routine monitoring and missing protocols.

Besides epidural analgesia, the use of Patient controlled analgesia (PCA), Patient controlled epidural analgesia (PCEA) and regional blocks have gained ground the last decades. With these techniques it might be possible to reduce overall opioid requirements. Nevertheless, a daily evaluation of benefits and harms of such analgesic techniques may be required to justify these treatment modalities. It is suggested, that regularly monitoring of invasive analgesic methods is of great concern when it comes to optimal postoperative pain management and reduction of adverse effects.

A structured organizational approach has the potential to improve benefit and harm of postoperative pain management. A number of studies argues that in order to obtain optimal postoperative pain treatment there need to be regular monitoring, and optimization of the analgesic regimens and techniques, preferably in a clinical setting with either an Acute Pain Service (APS) or a similar setup. With the decline of the use of APS's in Denmark it seems that the organization and management around postoperative pain treatment in general, and for invasive pain treatment methods in particular, needs to be investigated. As of today, it is not known how patients with such pain treatment are monitored and taken care of after leaving the post anaesthesia care unit, and where the responsibility for this pain treatment lies


Study Design


Related Conditions & MeSH terms


See also
  Status Clinical Trial Phase
Recruiting NCT02481999 - Pre- and Postoperative EEG-Monitoring for Children Aged From 0,5 to 8 Years N/A
Recruiting NCT03277872 - NoL, HR and MABP Responses to Tracheal Intubation Performed With MAC Blade Versus Glidescope N/A
Recruiting NCT02894996 - Does the Response to a Mini-fluid Challenge of 3ml/kg in 2 Minutes Predict Fluid Responsiveness for Pediatric Patient? N/A
Completed NCT03294213 - Prospective Non-interventional Evaluation of Intubation and Intensive Care Use of the New aScopeā„¢ 4 Broncho and aView N/A
Completed NCT02908945 - The Effect of Ketamine on the WAVCNS Index During General Anesthesia: A Feasibility Study N/A
Recruiting NCT02529696 - Measuring Sedation in the Intensive Care Unit Using Wireless Accelerometers N/A
Recruiting NCT02544854 - Pharmacokinetic/Pharmacodynamic Model of Propofol in Children Phase 4
Active, not recruiting NCT02550587 - Patient Satisfaction With Anesthesia Care N/A
Completed NCT02620566 - Caudal Block vs Local Wound Infiltration for Hernia Repair in Children Phase 1/Phase 2
Recruiting NCT02864212 - Development of a Methodology to Design a High Order Sliding Mode Controller for Drug Dosage N/A
Recruiting NCT02228473 - Effect of Glycopyrrolate and Atropine on Catheter-Related Bladder Discomfort N/A
Enrolling by invitation NCT02379221 - Efficacy of Injected Local Anesthetic vs Topical Anesthetic in Cosmetic Injectable Fillers. N/A
Not yet recruiting NCT02202239 - Effect of Induction and Maintenance of Anesthesia With Etomidate on Hemodynamics and Oxidative Stress in Diabetic Patients Phase 4
Completed NCT02121574 - Accuracy of Zero-flux and Ingestible Thermometers N/A
Completed NCT02300649 - Transesophageal Echocardiographic Evaluation of the Effect of Dexmedetomidine Infusion as an Adjuvant to General Anesthesia on the Cardiac Function N/A
Not yet recruiting NCT02208596 - The Feasibility of Different Doses of Etomidate Admixed With Propofol in Induced Abortion: A Randomized, Double Blind Controlled Trial Phase 4
Completed NCT02882035 - Opioid Free Anesthesia: What About Patient Comfort? Phase 4
Completed NCT01952990 - Safety and Pharmacokinetics of Kovacaine Nasal Spray in Pediatric Subjects Phase 2
Completed NCT02985567 - An Observational Study of the Use of Chloral Hydrate for Ophthalmic Procedures in Children N/A
Completed NCT01823328 - Ketamine Versus Etomidate for Rapid Sequence Intubation Phase 4