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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02241967
Other study ID # CLIN-005-13F
Secondary ID CX001078
Status Completed
Phase Phase 1
First received
Last updated
Start date January 7, 2016
Est. completion date July 2, 2020

Study information

Verified date June 2022
Source VA Office of Research and Development
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The proper control of acute and chronic pain is one of the most important areas in health care. Despite the profound advances in neuroscience over the past 20 years, the investigators still largely use opiate narcotics, much as was done in the Civil War. Total knee arthroplasty (TKA) is one of the most common orthopedic procedures performed 1. While knee pain is often a complaint that precedes TKA, the procedure itself is associated with considerable post-operative pain lasting days to weeks. Adequate postoperative pain control is an important factor in determining recovery time and hospital length of stay. New analgesic strategies are needed that can be used adjunctively to existing strategies with the potential to reduce reliance on opioid analgesia. Several novel brain stimulation technologies including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are beginning to demonstrate promise as treatments for a variety of pain conditions. Electricity has no metabolite or other residue, and can be delivered with minimal discomfort and without problems associated with drug-drug interactions. In two independent preliminary pilot studies, the Investigators have shown that tDCS can reduce post-operative PCA use by as much as 46% while simultaneously reducing subjective pain ratings. The present study aims to determine the effects of transcranial direct current stimulation (tDCS) on post-operative pain, patient-controlled analgesia (PCA) use, and post-surgical complications during the 48-hour post-operative period following total knee arthroplasty.


Description:

The proposed study employs a randomized, double-blind, sham-controlled design to evaluate the effects of tDCS on pain among Veterans receiving unilateral total knee arthroplasty (TKA) and unilateral total hip arthroplasty (THA). Further, this study will examine dose-dependency of the tDCS analgesic effects. Each tDCS session delivered either 20 min of real or sham tDCS. Real tDCS was administered at 2mA whereas sham tDCS delivered none. 120 patients undergoing TKA will be randomly assigned to one of four groups:Group 1 will have 4 sessions of real tDCS, Group 2 - 2 sessions of real tDCS (+ 2 sham-sessions), and Group 3 - 1 session of real tDCS (+ 3 sham-sessions). Group 4 is "Sham" tDCS, which does not involve any real stimulation. The participants will receive 2 tDCS treatments on the day of their surgery, and 2 tDCS treatments the day after their surgery.


Recruitment information / eligibility

Status Completed
Enrollment 119
Est. completion date July 2, 2020
Est. primary completion date July 2, 2020
Accepts healthy volunteers No
Gender All
Age group 19 Years to 90 Years
Eligibility Inclusion Criteria: Participants will be 120 patients undergoing TKA or THA surgery at the Ralph H. Johnson VAMC in Charleston SC. - Between the ages of 19 and 90 - Mentally capable of reading, writing, giving consent, and following instructions - Cleared for and scheduled for unilateral TKA or THA surgery Exclusion Criteria: - Implanted medical devices above the waist - Pregnant - History of seizures - Allergic to latex rubber - Psychiatric conditions other than for depression and/or anxiety disorders

Study Design


Related Conditions & MeSH terms

  • Pain, Postoperative
  • Total Hip Arthroplasty(Postoperative Pain)
  • Total Knee Arthroplasty (Postoperative Pain)

Intervention

Device:
4 Real sessions of Transcranial Direct Current Stimulation
Stimulation of brain areas associated with pain perception using low amplitude direct current of 2mA delivered by electrodes attached to the scalp.
2 Real Sessions of Transcranial Direct Current Stimulation
Stimulation of brain areas associated with pain perception using low amplitude direct current of 2mA delivered by electrodes attached to the scalp. 2 real sessions of tDCS and 2 sham.
1 Real Session of Transcranial Direct Current Stimulation
Stimulation of brain areas associated with pain perception using low amplitude direct current of 2mA delivered by electrodes attached to the scalp. 1 real sessions of tDCS and 3 sham.
Sham Transcranial Direct Current Stimulation
Four sessions of sham tDCS; control intervention.

Locations

Country Name City State
United States Ralph H. Johnson VA Medical Center, Charleston, SC Charleston South Carolina

Sponsors (1)

Lead Sponsor Collaborator
VA Office of Research and Development

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Post-operative Opioid Pain Medication Dose Patient Controlled Analgesia pump usage will be measured (mg of morphine-equivalent) during the acute post-operative period. 2-Days
Primary Patient-reported Pain Intensity Ratings Patients reported pain intensity using a visual analog scale (VAS) before and after each tDCS session during the 2 day routine postoperative hospital stay. Patients reported pain intensity by marking a line anchored with a minimum of "0- no pain at all" to maximum of "10- worst pain imaginable." Lower values represent a more favorable outcome. This outcome data is the sum of all VAS scores collected before and after each tDCS session during the 2-day hospital stay, thus each participant had a total of 8 VAS scores during the experimental intervention during hospital stay. 2-Days
Secondary Patient-reported Average Pain Ratings Visual analogue scale pain ratings will be collected during the perioperative and post-discharge periods . Visual analogue scale ratings range from 0-10; a blank line is anchored with a 0 and 10 with the following labels: "0- no pain," "10-worst pain imaginable." 6 Months
See also
  Status Clinical Trial Phase
Recruiting NCT04199780 - Effects of tDCS Combined With CBI on Postsurgical Pain N/A