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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05624359
Other study ID # 2018-034-02-10
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date November 1, 2023
Est. completion date July 1, 2024

Study information

Verified date November 2023
Source Beijing Tiantan Hospital
Contact Fang Luo, Doctor
Phone 86-13611326978
Email 13611326978@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Post-craniotomy pain remains a major challenge in patient care following neurosurgery.Flurbiprofen axetil (FA), as an injectable nonselective cyclooxygenase inhibitor, is a widely prescribed NSAID for postoperative pain. As FA is highly lipophilic by merging into emulsified lipid microspheres, it has a high affinity to the surgical incision and inflammatory tissues to achieve targeted drug therapy and prolonged duration of action, thus providing a basis for its local use to achieve efficacy and safety comparable to or greater than systemic administration. In this study, we attempt to evaluate the clinical effects of FA as an adjunct to ropivacaine in pre-emptive scalp infiltration to prevent or reduce pain after craniotomy.


Recruitment information / eligibility

Status Recruiting
Enrollment 216
Est. completion date July 1, 2024
Est. primary completion date April 1, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years to 64 Years
Eligibility Inclusion Criteria: 1. Age minimum 18 years; 2. ASA physical status of I - II; 3. Body mass index (BMI) of 15 - 30; 4. Scheduled for supratentorial craniotomy under general anesthesia; 5. Anticipated tracheal extubation, recovery of consciousness and orientation within 2 hours after craniotomy. Exclusion Criteria: 1. Glasgow Coma Scale <15; 2. Unable to use the PCIA device or comprehend the pain NRS; 3. History of opioid dependence, chronic headache or intake of any drugs with known analgesic properties within the 24 hours before surgery; 4. History of craniotomy or scalp infection; 5. Any contraindication to flurbiprofen axetil, such as gastrointestinal ulcer, coagulation disorders, renal dysfunction, heart failure and ischemic heart disease; 6. History of allergy to any drug used in the study; 7. Pregnancy and breastfeeding.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
FA plus ropivacaine
Th group will receive 0.17% FA and 0.5% ropivacaine for pre-emptive scalp infiltration at about 30 min before surgical incision. The assigned solution was injected along the planned surgical incision and pin fixation sites of the Mayfield head holder, using a 22-gauge needle introduced throughout the entire thickness of the scalp at a 45° angle.
ropivacaine alone
The ropivacaine alone group will receive 0.5% ropivacaine alone for pre-emptive scalp infiltration at about 30 min before surgical incision. The assigned solution was injected along the planned surgical incision and pin fixation sites of the Mayfield head holder, using a 22-gauge needle introduced throughout the entire thickness of the scalp at a 45° angle.

Locations

Country Name City State
China Beijing Tiantan Hospital Beijing

Sponsors (1)

Lead Sponsor Collaborator
Beijing Tiantan Hospital

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Total consumption of sufentanil with PCIA device at 48 hours postoperatively. A postoperative Patient Controlled Intravenous Analgesia (PCIA) pump containing sufentanil 200µg in 100 mL saline will be administered from admission to the PACU until postoperative 48 hours.
The PCIA pump will be set for 0.5 mL bolus doses with a lockout time of 15 min without initial dose or continuous infusion. The maximum dose will be limited to 2 mL (sufentanil 4 µg) per hour.
at 48 hours postoperatively
Secondary Total consumption of sufentanil with PCIA pump at 24 hours after craniotomy A postoperative Patient Controlled Intravenous Analgesia (PCIA) pump containing sufentanil 200µg in 100 mL saline will be administered from admission to the PACU until postoperative 48 hours.
The PCIA pump will be set for 0.5 mL bolus doses with a lockout time of 15 min without initial dose or continuous infusion. The maximum dose will be limited to 2 mL (sufentanil 4 µg) per hour.
at 24 hours postoperatively
Secondary Time to first PCIA button press after craniotomy A postoperative Patient Controlled Intravenous Analgesia (PCIA) pump containing sufentanil 200µg in 100 mL saline will be administered from admission to the PACU until postoperative 48 hours.
The PCIA pump will be set for 0.5 mL bolus doses with a lockout time of 15 min without initial dose or continuous infusion. The maximum dose will be limited to 2 mL (sufentanil 4 µg) per hour.
after craniotomy
Secondary Pain NRS scores at 2 hours after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 2 hours after craniotomy
Secondary Pain NRS scores at 4 hours after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 4 hours after craniotomy
Secondary Pain NRS scores at 12 hours after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 12 hours after craniotomy
Secondary Pain NRS scores at 24 hours after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 24 hours after craniotomy
Secondary Pain NRS scores at 48 hours after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 48 hours after craniotomy
Secondary Pain NRS scores at 1 mon after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 1 mon after craniotomy
Secondary Pain NRS scores at 3 mons after craniotomy 0 indicates no pain and 10 indicates the worst pain imaginable at 3 mons after craniotomy
Secondary The time to first prescription of OC/APAP after craniotomy In the ward, if a patient scores > 4 in pain NRS after receiving a maximum dose of 2 mL per hour from PCIA device, an oral supplementary tablet of oxycodone (OC)/acetaminophen (APAP) (5/325 mg; by MallinckrodtInc, USA) will be prescribed as a rescue analgesic at an interval of at least 6 hours. up to 48 hours after craniotmy
Secondary Hospital duration after craniotomy The duration from end of surgery to discharge from hospital From surgery day until the discharge date from hospital, assessed up to one week
Secondary WHOQOL-BREF score It is a questionnaire consisting of social relationships, physical health, psychological health, environment, overall QoL and general health. The mean score of each domain ranges between 4 and 20. A higher score indicates a better QoL at 1month after craniotomy
Secondary WHOQOL-BREF score It is a questionnaire consisting of social relationships, physical health, psychological health, environment, overall QoL and general health. The mean score of each domain ranges between 4 and 20. A higher score indicates a better QoL at 3 months after craniotomy
Secondary PONV scores It is rated as: 0, absent; 1, nausea not requiring treatment; 2, nausea requiring treatment; 3, vomiting at 24 hours after surgery
Secondary PONV scores It is rated as: 0, absent; 1, nausea not requiring treatment; 2, nausea requiring treatment; 3, vomiting at 48 hours after surgery
Secondary Wound healing score It is rated as excellent, good and suboptimal at 1 month after craniotomy
Secondary Wound healing score It is rated as excellent, good and suboptimal at 3 months after craniotomy
Secondary Patient and Observer Scar Assessment Scale It consists of 2 numeric scales regarding the observer component (6 items) and the patient component (6 items). All included items are scored on the same 10-point scale. And a higher score represents a poorer scar quality. at 1 month after craniotomy
Secondary Patient and Observer Scar Assessment Scale It consists of 2 numeric scales regarding the observer component (6 items) and the patient component (6 items). All included items are scored on the same 10-point scale. And a higher score represents a poorer scar quality. at 3 months after craniotomy
Secondary The occurrence of other AEs Other AEs include cerebral hematoma, respiratory depression, gastrointestinal ulcerations and perforation, renal risks, coagulation dysfunction, allergic reaction and wound infection, oozing, hemorrhage, burning sensation and mild pruritus throughout both the treatment and follow-up periods (up to 3 months)
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