Clinical Trials Logo

Clinical Trial Details — Status: Withdrawn

Administrative data

NCT number NCT00557843
Other study ID # 07-758
Secondary ID
Status Withdrawn
Phase N/A
First received
Last updated
Start date November 2007
Est. completion date June 2009

Study information

Verified date April 2017
Source The Cleveland Clinic
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The primary objective is to evaluate the influence of continuous local anesthetic infiltration on tissue oxygenation after surgical procedures requiring abdominal surgery as a major predictor for wound healing.


Description:

Patients undergoing abdominal surgery will be randomized to one of two groups.

Group 1: Wound perfusion with bupivacaine, plus patient controlled analgesia (PCA)

Group 2: Wound perfusion with placebo solution (isotonic saline) plus patient controlled analgesia (PCA)

All patients will be premedicated with IV midazolam up to 5 mg. On arrival to the operating room, a fluid bolus of 10 ml/kg/h will be administered before induction of anesthesia.

Those randomized to local wound perfusion will receive the local anesthetic or placebo via the ON-Q pain management system. At the end of surgery a catheter will be positioned in the subcutaneous layer of the wound, leaving via a separate stab incision. The wound closure will then be completed.

A loading dose of local anesthetic solution, 20 ml lidocaine 1% plus 20 ml bupivacaine 0.5%, or, the same amount of placebo will be injected into the wound before the patient leaves the operating room. Thereafter bupivacaine 0.5% alone or placebo will be injected continuously into the wound at a flow rate of 2 ml/h for 24 hours.

Subcutaneous oxygen tension (PsqO2) will be evaluated intraoperatively with a polygraphic-type tissue oxygen sensor positioned within a subcutaneous, saline filled Silastic® tonometer inserted into the patients' upper arm after induction of anesthesia.

Postoperative pain relief will be maintained by patient-controlled analgesia (PCA) with morphine (2mg bolus, 6-minute lock-out) and with local anesthetic wound perfusion.

Patients will be given supplemental oxygen via a face mask at a rate of 2 L/min. Additional oxygen will be given as necessary to maintain an oxygen saturation > 95%.

An observer blinded to group assignment will perform all the postoperative evaluations.

Patient chart review will be undertaken to screen for evidence of surgical wound infection. The presence of infection will be determined by review of the attending surgeon's documentation in the patient's chart.


Recruitment information / eligibility

Status Withdrawn
Enrollment 0
Est. completion date June 2009
Est. primary completion date June 2009
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria:

1. 18-80 years of age.

2. The patient has provided written informed consent.

3. The patient is scheduled for abdominal surgery.

4. The patient has an ASA of I, II, or III.

5. The patient understands the explanation of the protocol.

Exclusion Criteria:

1. Patients aged < 18 and > 80 years.

2. History of diabetes mellitus.

3. History of congestive heart failure.

4. History of peripheral vascular disease.

5. History of smoking.

6. History of Dysautonomia.

7. History of thyroid disease.

8. Susceptibility to malignant hyperthermia.

9. History of morbid obesity.

10. History of fever

11. History of infection.

12. Contraindication to the placement of an arterial line; e.g., Raynaud's disease.

13. The patient declines participation.

14. Any patient the investigator feels is not a candidate for this study.

15. Any patient with a history of known alcohol, analgesic, or narcotic substance abuse within two years of screening.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bupivacaine
Wound perfusion with bupivacaine, plus patient controlled analgesia (PCA)
Saline
Wound perfusion with placebo solution (isotonic saline) plus patient controlled analgesia (PCA)

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
The Cleveland Clinic

Outcome

Type Measure Description Time frame Safety issue
Primary tissue oxygenation averge tissue oxygenation on wound healing after abdominal surgery 24 hours post surgery
Secondary Verbal rating scales (VRS) 0 -10 scale with 0 = no pain and 10 = worst pain 24 hours post surgery
See also
  Status Clinical Trial Phase
Completed NCT01611376 - Impedance Cardiography During Major Abdominal Surgery Phase 4
Recruiting NCT05556174 - Intraoperative Lung Protective Ventilation Needs Periodic Lung Recruitment Maneuvers N/A
Completed NCT03633123 - D-PLEX 310: Safety and Efficacy of D-PLEX in the Prevention of Post Abdominal Surgery Incisional Infection Phase 2
Terminated NCT03684304 - The Effect of Abdominal Binder Use on Postoperative Pain and Mobility in Patients Undergoing Pelvic Surgery N/A
Active, not recruiting NCT02817893 - Comparison of Respiratory Variations of the Pulse Oximetry Plethysmographic Raw Signal and Pulse Pressure During Abdominal Surgery (PLETHYSMO) N/A
Completed NCT04120740 - Validation of Two Acitivity Monitors in Three Inpatient Populations.
Recruiting NCT03700749 - FALCON Trial Testing Measures to Reduce Surgical Site Infection Phase 3
Completed NCT01389648 - Pre-operative Physiotherapy to Prevent Post-operative Complications N/A
Active, not recruiting NCT01839617 - Study Comparing Early and Late Nutrition in Cancer Patients Undergoing Abdominal Surgery N/A
Terminated NCT04887922 - Preoperative and Postoperative Incentive Spirometry in Patients Undergoing Major Abdominal Surgery N/A
Completed NCT04730141 - Effect of Mobilization Protocol on Mobilization N/A
Completed NCT00683150 - Perioperative Kinetics of Reactive Hyperemia Using Noninvasive Digital Thermal Monitoring N/A
Active, not recruiting NCT03933306 - Intraoperative Goal-directed Blood Pressure and Dexmedetomidine on Outcomes Phase 4
Recruiting NCT05268432 - Development, Intraoperative Demonstration and Visualization of Surgical Assistance Functions
Not yet recruiting NCT04747535 - Continuous Positive Airway Pressure After Abdominal Surgery N/A
Not yet recruiting NCT05253586 - Versius Or Laparoscopic Abdominal Hernia REpair
Recruiting NCT06374849 - Intraoperative Sufentanil and Chronic Postsurgical Pain in Non-major Scheduled Abdominal Surgery Phase 4
Recruiting NCT05246605 - Postoperative Hypoxia and Body Position N/A
Recruiting NCT04685876 - Comparing TAP Blocks Bupivacaine, and Placebo for Plane Phase 3
Completed NCT04233424 - D-PLEX 311: Safety and Efficacy of D-PLEX in the Prevention of Post Abdominal Surgery Incisional Infection Phase 3