Nodular Goiter Clinical Trial
Official title:
Comparison of Different Doses of Remifentanil on Postoperative Pain in Patients Undergoing Thyroidectomy: a Prospective, Double-blinded Randomized Control Trial
Extensive clinical studies have shown that intraoperative infusion high dose of remifentanil (0.2ug/kg/min) induced postoperative hyperalgesia. Recent experimental study however suggests that higher dose of remifentanil may attenuate postoperative hyperalgesia. Thus, the present study is designed as a "proof of principle" study and hypothesizes that higher dose of remifentanil may reduce postoperative pain in patients.
Remifentanil, an ultra-short acting opioid, is widely used in the patients undergoing
surgery. However, extensive studies report that remifentanil,administered at 0.2ug/kg/min or
0.4ug/kg/min intraoperatively, can result in postoperative hyperalgesia and increase the
consumption of analgesics when compared with low dose (0.05ug/kg/min). However, a recent
experimental study shows that large dose of remifentanil can inhibit pain hypersensitivity
through erasing the spinal sensitization of pain. The present study thus hypothesizes that
higher dose of remifentanil (1.2ug/kg/min) may attenuate postoperative pain. The present
study will compare the effect of two different dose of remifentanil (0.2ug/kg/min and
1.2ug/kg/min) on postoperative pain. Patients undergoing thyroidectomy will be recruited,
and mechanical threshold will be measured in the remote region of surgical site
preoperatively. The patients will be randomly divided by two groups, 0.2ug/kg/min (group I)
and 1.2ug/kg/min (group II). After operation, mechanical threshold and visual analogue scale
(VAS) will be measured as the indicators of postoperative pain. The consumption of morphine
will also be compared between these two doses of remifentanil.
The present study may find optimized dose of opioid usage in the patients undergoing surgery
to relieve the postoperative pain.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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