Fractures Clinical Trial
Official title:
Preemptive Analgesia With OxyContin Versus Placebo Before Surgery for Long Bone Fractures
We would like to check whether pre-operative administration of an oral controlled-release opioid formulation (Oxycodone hydrochloride (OxyContin)) could result in a clear effect of preemptive analgesia.
Preemptive analgesia is based on the concept of treating pain before inflicting the painful
stimulus. One suggested mechanism is that transmission of pain signals is altered when the
patient is treated before infliction of noxious stimulation. That prevents changes from
happening in the nervous system, making transformation from acute to chronic pain ("central
sensitization") less likely, and thus reducing post operative pain.
Clinically, good post operative pain control has been shown to be an effective method for
hastening patient convalescence and discharge. It makes part of a general approach aiming to
accelerate surgical recovery through earlier enteric feeding and ambulation
OxyContin tablets deliver Oxycodone at a controlled release manner, over 12 hours. After
oral administration oral bioavailability is 60-87%.
A biphasic absorption pattern is observed, describing the initial (0.6 hours) and prolonged
(6.9 hours) release of Oxycodone from the OxyContin tablets. Clinical analgesia is observed
within 1 hour of administration.
We believe that this mode of oral drug release is more appropriate for the perioperative
pain treatment of patients undergoing short to medium term operations: with timely
administration, the first absorbed part of the drug reaches the plasma before infliction of
the noxious stimuli, possibly counteracting primary sensitization, and the second part
absorbed, acts on post operative ongoing pain, possibly counteracting more advanced stages
of neuronal plasticity.
Study Hypothesis:
Our hypothesis is that post operative pain will be lowered by pre-operative administration
of OxyContin. When comparing the two groups we will look for differences in observed
parameters, especially VAS numbers, time to first analgesic request, post operative
analgesic requirements, time to first oral intake and length of hospitalization, to confirm
or deny our hypothesis.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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