Tonsillectomy Clinical Trial
Official title:
Analgesic Efficacy and Safety of Etoricoxib in Ear Nose Throat Surgery
The aim of this study is to test the analgesic efficacy of etoricoxib (90 mg or 120 mg qd.
perioperatively) for post-operative pain relief.
The primary endpoint is as follows:
- does preoperative etoricoxib reduce the post-operative opioid utilization in patients
undergoing elective tonsillectomy under general anaesthesia (i.e. the post-operative
opioid-sparing effect of etoricoxib in humans).
The secondary endpoints are as follows:
- does the etoricoxib medication have an impact on PONV or activities of daily
- does the etoricoxib medication influence the blood loss during surgery or the incidence
of postoperative bleeding
- does the etoricoxib medication influence the operation time. In addition, adverse
effects of etoricoxib will be documented.
On day of surgery (day 0) the patients will be randomly assigned to one of the three groups
using a sealed envelope method. The etoricoxib 90 mg group receives etoricoxib (Arcoxia®,
Merck Sharp & Dohme GmbH, Haar, Germany) 90 mg orally, the etoricoxib 120 mg group receives
etoricoxib 120 mg orally and the control group receives a placebo tablet orally 1 h before
surgery (day 0). All patients receive a standard general anesthesia with intravenous
propofol (2-3 mg/kg), fentanyl (2 µg/kg) and mivacurium (0.2 mg/kg) for induction. Patients
are ventilated via a tracheal tube, anesthesia being maintained with sevoflurane (0.8 - 1.5%
end-tidal concentration). If mean arterial blood pressure or heart rate increase to more
than 25% above the pre-operative baseline value despite an end-tidal concentration of 1.5%
sevoflurane, an intravenous bolus of fentanyl 0.05 mg will be administered. Monitoring
includes electrocardiogram (ECG), non-invasive arterial blood pressure, pulse oximetry,
end-tidal CO2 and end-tidal sevoflurane. On days 1 to 3 patients will receive etoricoxib (90
mg or 120 mg qd.) or placebo. After discharge on day 3, patients will receive etoricoxib (90
mg or 120 mg qd.) or placebo until cessation of pain during activity (swallowing). According
to the current label for Arcoxia® 120 mg in Germany, patients taking etoricoxib 120 mg will
switch to etoricoxib 90 mg on day 8. Rescue medication will be piritramid i.v. (day 0),
oxycodone p.o. (day 1-2) and paracetamol p.o. (day 3-14).
Day -7 to -1: Inclusion/exclusion criteria, medical history, concomitant medications,
laboratory, serum pregnancy test, informed consent Day 0: Study medication 1 h before
surgery, intra-operative blood loss, pain score, opioid utilization, PONV score and
anti-emetic medication Day 1: pain score, opioid utilization, PONV score, anti-emetic
medication, bleeding Day 2: pain score, opioid utilization, PONV score, anti-emetic
medication, bleeding Day 3: pain score, opioid utilization, PONV score, anti-emetic
medication, bleeding Day 7: pain score, paracetamol utilization, bleeding Day 14: first day
with no pain, last study medication, paracetamol utilization, bleeding
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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