Pain, Postoperative Clinical Trial
Official title:
Preoperative Controlled-Release Oxycodone or Intraoperative Morphine As Transition Opioid After Intravenous Anesthesia For Video-Assisted Thoracic Surgery: a Randomized, Double-blind, Controlled Trial.
The main hypothesis of this study is that preoperative administration of controlled-release
(CR) oxycodone may reduce acute postoperative pain and improve time to discharge from the
post-anesthesia care unit in patients undergoing video-assisted thoracoscopy for spontaneous
pneumothorax.
The study drug will be compared with intravenous morphine administered 30 minutes before the
end of anesthesia.
Although spontaneous pneumothorax may be treated conservatively by simple observation or
chest tube insertion, up to 50% of patients treated conservatively may experience recurrence
in subsequent months or years.
Video-assisted thoracic surgery (VATS) is a minimally-invasive surgical approach to treat
spontaneous pneumothorax and reduce the risk of recurrence. Compared to open thoracotomy,
VATS may facilitate a faster recovery and lead to earlier home discharge.
Totally-intravenous anesthesia (TIVA) with propofol and remifentanil is a useful anesthetic
technique for VATS, as the drugs are rapidly eliminated after the end of the procedure,
leading to fast recovery from anesthesia.
One drawback of ultra-short-acting opioid remifentanil is residual hyperalgesia after the
end of the infusion, particularly after VATS, which is associated with relatively short but
intense pain after surgery.
Intravenous morphine, administered just before the end of anesthesia, is the typical choice
for pain relief after TIVA. However, this drug may require repeated titration and may be
associated with postoperative nausea and vomiting, itchiness or drowsiness in the early
postoperative period.
Oxycodone, another opioid, is available in an oral controlled-release (CR) formulation which
grants relatively constant plasma levels of the drug after 1 h of administration.
The investigators hypothesize that administration of CR oxycodone 20 mg 1 hour before
surgery may lead to better recovery parameters in the post-anesthesia care unit, thus
granting earlier discharge to the surgical ward.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Treatment
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