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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05017246
Other study ID # 202105007
Secondary ID
Status Recruiting
Phase Phase 2
First received
Last updated
Start date January 18, 2022
Est. completion date June 30, 2025

Study information

Verified date May 2024
Source Washington University School of Medicine
Contact Premal H Thaker, M.D., MS
Phone 314-747-3604
Email thakerp@wustl.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

To determine if opioid consumption postoperatively among patients undergoing non-emergent laparotomy by the gynecologic oncology service who receive intrathecal morphine with intraoperative lidocaine (IML) infusion are lower than patients who have epidural anesthesia with PCA (EPCA).


Recruitment information / eligibility

Status Recruiting
Enrollment 174
Est. completion date June 30, 2025
Est. primary completion date May 31, 2025
Accepts healthy volunteers No
Gender Female
Age group 18 Years and older
Eligibility Inclusion Criteria: - Female patients =18 years old - Undergoing non-emergent exploratory laparotomy with the Gynecologic Oncology service - No clinical or laboratory evidence of end organ failure: If available: - Platelets > 100 K/cumm - Hemoglobin > 8.0 g/dl - Serum creatinine <1.5 mg/dl - Creatine clearance (CrCl) =30 based on the original Cockcroft-Gault formula adjusted for weight. - INR <1.3 reference range - All other lab values obtained as part of general preoperative work-up must be =1.5x normal laboratory value. Exclusion Criteria: - Patients not giving consent to participate in the study - Unable to complete self-report pain questionnaire - Moderate to severe kidney or liver failure per lab criteria as outlined - Inability to hold anticoagulant medications for a safe amount of time per current ASRA guidelines - Contraindication to lumbar puncture or epidural placement, per acute pain management service such as known coagulopathy or history of clotting disorders, history of scoliosis or lumbar fusion, infection at site of entry, or current systemic infection - Complete bowel obstruction - Contraindication to intravenous lidocaine - No known pregnancy and not lactating. - Currently septic - Patient currently taking more than 30 MME a day preoperatively (for >30 days) - BMI >50kg/m2 - Intolerance/contraindication or allergy to receiving non-steroidal anti-inflammatory drugs or acetaminophen or any other medications in the pre-operative order set

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bupivacaine
-Epidural bupivacaine 0.1% 2-6ml/hr based on MAP within 10% of patient's baseline MAP
Morphine
-Preservative-free intrathecal morphine (duramorph) 150mcg injection (0.15ml or a 0.5mg/0.5ml prepared solution)
Lidocaine
-Lidocaine infusion 1 mg/kg ideal body weight (IBW)

Locations

Country Name City State
United States Washington University School of Medicine Saint Louis Missouri

Sponsors (1)

Lead Sponsor Collaborator
Washington University School of Medicine

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Morphine milligram equivalent (MME) in the postoperative hospital course Postoperatively while patient is in hospital (estimated to be 4 days)
Secondary Rate of postoperative ileus -Defined by bilious emesis requiring a change in diet to nothing-per-mouth (NPO) status or nasogastric tube placement (NGT) in the absence of other indications. Patients who had NGT placed prophylactically at the time of surgery were not considered to have an ileus unless an NGT was reinserted or they met the above criteria. Participants will be assigned a value of yes ileus or no ileus. The rate of post op ileus is defined as the observed number of yes ileus in each study arm divided by the total number of subjects in the study arm. Fisher's exact test will be used to compare non-paired nominal data. Postoperatively while patient is in hospital (estimated to be 4 days)
Secondary Length of hospital stay -Length of stay will be determined by the dates of admission as recorded on EPIC (days). Estimated to be 4 days
Secondary Rate of postoperative hypotension -Postoperative hypotension will be defined as <90/50 (as previously defined by Huepenbecker, et al.) or a 20% decrease from the preoperative office visit. Up to 48 hours after surgery
Secondary Patient satisfaction with pain control -Patients will be asked on day of discharge if they were satisfied with their pain control during their hospitalization. They will be able to choose from the following: 0=satisfied, 1= somewhat satisfied, 2= neutral, 3=somewhat dissatisfied, 4=dissatisfied). Day of hospital discharge (estimated to be day 4)
Secondary Change in pain scores -Pain scores will be determined by the 0-10 numeric rating scale (NRS). 0=no pain and 10=the most pain. Preoperative, each post-operative day while inpatient, 2 week follow-up, and 6 week follow-up
Secondary 30 day readmission rate Through day 30
Secondary Rate of deep vein thrombosis (DVT) From day of surgery (day 1) to 6 weeks after surgery
Secondary Rate of pulmonary thromboembolism (PTE) From day of surgery (day 1) to 6 weeks after surgery
Secondary Rate of persistent pain -As determined by an NRS pain score = 5 At 6 week follow-up
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