Abdominal Surgery Clinical Trial
Official title:
A Randomized Double Blind Study Of The Evaluation Of The Potential Analgesic And Anti-Inflammatory Effects Of Atorvastatin In Patients Undergoing Abdominal Surgery
The study is planned to check the analgesic and anti-inflammatory properties of Atorvastatin in patients who will be undergoing abdominal surgery under spinal anesthesia. The investigators intend to monitor the analgesic requirements, the rate of wound healing and the inflammatory markers in this trial.
Study type: Double Blind Placebo Controlled
Method of Randomization: Computer Generated Table
No. of patients to be recruited: 40
Accept Healthy Volunteers: No
Drugs to be administered: Atorvastatin to 20 patients and placebo to 20 patients
Mode of drug administration: Oral
Duration of Study: 3 weeks
Patients who attend the Surgical O.P.D and the Obstetrics and Gynaecology O.P.D and are
diagnosed with any condition that requires elective abdominal surgery under spinal
anaesthesia will be chosen for screening. Patients undergoing day care surgery with spinal
anaesthesia and an abdominal incision will also be included for screening.
Two weeks before the decided date of surgery the patients will be called for screening. The
patients will first be screened for obesity, risk factors for CVS diseases and blood will be
withdrawn for estimation of serum lipid levels. Further risk assessment of these patients
will be done according to the NCEP ATP III Guidelines (2004 Revision of NCEP Adult Treatment
Panel III Guidelines). If the patient is under the moderate risk category and fits in the
inclusion criteria he/she will be called the next week for starting atorvastatin/placebo.
Patients who are defined as dyslipidemic in the moderate risk category according to NCEP ATP
III Guidelines i.e patients who would benefit from statin therapy will be given atorvastatin
10 mg or placebo started one week before their expected date of surgery. They will be
explained the possible A.D.R of statin therapy. Informed consent form will be filled.
On the day of the surgery the patient will be explained the Visual Analouge Scale and the
Wong Pain Scale. After the operation the patients will be started on S.O.S analgesic
therapy. The protocol used will be the same as followed in the surgical wards. In case of
severe pain opioids will be used. For other types of pain which can be tolerated by the
patients Diclofenac Sodium will be used.
The patient will be monitored after the surgery for the total dose of analgesics required
for the relief of pain. Further the time of first dose of analgesic required after operation
will be noted. The patient will be monitored for pain at the incision site 2, 4, 6, 12, 24
hours after the operation using the visual analogue scale and the Wong Pain Scale. Later
using the abovementioned scales the patient's pain will be monitored twice daily until the
patient is discharged. The McGill Pain Questionnaire will be given to the patient on the
first day and every day thereafter till the patient is discharged. After discharge the
patient will followed up on the day of their suture removal and pain scores will be
evaluated. The patient will be asked to come weekly till the end of the study period.
Blood will be withdrawn for the estimation of serum lipid levels, total leukocyte counts, C
- reactive protein and TNF-α levels at baseline(i.e day of starting therapy), on the day of
the surgery before the surgery and at the fourth postoperative day. All blood samples will
be taken between 10A.M-12P.M Wound healing will be monitored on a daily basis until
discharge and weekly thereafter. The attending surgeon will monitor the wound for discharge,
swelling, etc. Additional signs of inflammation and infection like swelling, fever, erythema
will also be monitored for.
The patients will be instructed to take atorvastatin or placebo once a day for three weeks
(One week preoperative and two weeks postoperative). At the end of this period the patient
will be asked to continue statins from outside. In the event that the patient is unable to
afford the medication he will be weaned off the statin in a gradual manner.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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