Superiority Study for Pain Treatment After Cesarean
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Purpose
The purpose of this study is to investigate adequate pain treatment for patients after cesarean. In this study oral opioids were compared to intravenous opioids as they are supposed to provide superior pain control.
| Condition | Intervention | Phase |
|---|---|---|
|
Pain |
Drug: Oral Oxycodon Drug: Piritramid |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Controlled Trial: Pain Management After Cesarean Section: Oxycodon vs. Intravenous Piritramide |
- Difference of Pain Scores on the Visual Analog Scale [ Time Frame: Pain level was evaluated before therapy (2h after CS), 12h, 24h, 32h, 40h, 48 and 72h after CS. ] [ Designated as safety issue: No ]
The primary outcome measure was the change in patients assessment of pain after cesarean (CS) from baseline.
For pain assessment a visual analog scale (VAS) was used. Women were asked to quantify pain using an eleven point numerical rating score from 0 to 10, with 0 indicating no pain, and 10 the worst pain.
- Subgroups [ Time Frame: 6 month ] [ Designated as safety issue: No ]Secondary Outcome Measures were to identify subgroups in benefit of either therapy.
- Side Effects [ Time Frame: 6 month ] [ Designated as safety issue: No ]Evaluation of side effects
- Mobilisation [ Time Frame: 6 month ] [ Designated as safety issue: No ]Evaluation of time to post surgical mobilization
- Costs [ Time Frame: 6 month ] [ Designated as safety issue: No ]Evaluation costs between groups
| Enrollment: | 239 |
| Study Start Date: | July 2009 |
| Study Completion Date: | November 2009 |
| Primary Completion Date: | November 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Oxycodon |
Drug: Oral Oxycodon
Patients assigned to the oral analgesia group received 20mg oxycodon at fixed intervals: 2 hours (h) and between 12h and 14h after cesarean.
|
| Active Comparator: Patient controlled analgesia (PCA) device with Pritramid |
Drug: Piritramid
Patients assigned to the PCA group received a single use intravenous PCA device (Vygon, Medical Products, Aachen, Germany) with a 30ml deposit of 9% sodium chloride solution containing 60mg piritramide. Bolus injection of 0.5ml was administered by the patient herself if needed, with a lock out interval of 5 minutes Patients assigned to the oral analgesia group received 20mg oxycodon at fixed intervals: 2 hours (h) and between 12h and 14h after cesarean. The PCA was discontinued after 24 hours or earlier if demanded. |
Detailed Description:
Pain management after cesarean is an important topic for women. Pain during and after surgery is their greatest concern.
After surgery quick mobilization is important to take care of the newborn. When using a patient controlled analgesia (PCA) device mobilization is limited and women can not meet their expectations to take care of the newborn. Oral analgesia in comparison offers superior patient satisfaction.
This trial was conducted to investigate the effectiveness of both treatment options and improve patients pain management and overall content after cesarean.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Study participation was offered to all pts. aged > 18 years in labor and delivery for elective or unplanned secondary cesarean in the 37th or higher week of gestation.
Inclusion Criteria:
- cesarean in spinal anesthesia,
- no history of opioid or metamizol treatment
- written consent
- ability to use a Patient-controlled analgesia device
Exclusion Criteria:
- cesarean in general anaesthesia
- use of peridural catheter for pre-, peri- or post cesarean analgesia
- additional post cesarean metamizol use
- allergy/hypersensitivity to morphine, oxycodon, acetaminophen or ibuprofen
- chronic use of general anaesthesia
- history of known pain syndrome
Contacts and Locations| Germany | |
| University of Rostock, Department of Obstetrics and Gynecology | |
| Rostock, MV, Germany, 18055 | |
| Principal Investigator: | Max Dieterich, MD | University of Rostock, Department of Obstetrics and Gynecology |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Max Dieterich, Dr. Max Dieterich, University of Rostock |
| ClinicalTrials.gov Identifier: | NCT01115101 History of Changes |
| Other Study ID Numbers: | KJ-2009-MD |
| Study First Received: | April 27, 2010 |
| Results First Received: | February 21, 2012 |
| Last Updated: | January 15, 2013 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Keywords provided by University of Rostock:
|
pain after cesarean visual analog scale oxycodon piritramid |
Additional relevant MeSH terms:
|
Pirinitramide Analgesics, Opioid Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs |
Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Central Nervous System Depressants Narcotics |
ClinicalTrials.gov processed this record on June 18, 2013