Continuous Wound Infusion in Lumbar or Thoracic Surgery
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Purpose
Introduction : Spine surgery is responsible for intense postoperative pain that can be treated by an analgesia multimodal approach (IV analgesic infusion and local anesthesia). Continuous wound infiltration is an efficient and simple technique with few adverse effects yet very few studies have investigated its potential use in spine surgery. Our randomised, controlled, double-blinded trial aims to evaluate efficacy of continuous wound infiltration after major spine surgery.
Methods : After written consent is obtained, the surgeon inserts, at the end of surgery, a multiholes catheter under muscular layers. Patients are randomised in two groups : The "treated group" receives ropivacaine 0.2% infusion (bolus of 10 milliliters (mL) followed by 8 mL/h continuous infusion during 48 hours) and the "control group" receives saline solution (0.9%). In addition, all patients receive patient-controlled intra-venous morphine analgesia. The investigators hypothesize that the "treated group" will consume morphine less than the "control group".
| Condition | Intervention | Phase |
|---|---|---|
|
Lumbar Spine Surgery Thoracic Spine Surgery |
Drug: Ropivacaine Drug: Saline solution 0.9% |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Efficacy of Continuous Wound Infusion in Major Lumbar and Thoracic Spine Surgery : A Randomised, Double-blinded, Placebo-controlled Study |
- morphine consumption [ Time Frame: 48 hours after surgery ] [ Designated as safety issue: No ]
- number of patients in need of morphine in post surgery monitoring room [ Time Frame: 1 hour after surgery ] [ Designated as safety issue: No ]
- morphine consumption in post surgery monitoring room [ Time Frame: 1 hour post surgery ] [ Designated as safety issue: No ]
- consumption of morphine [ Time Frame: 72 hours after surgery ] [ Designated as safety issue: No ]
- global self appreciation of pain management [ Time Frame: at 72 hours ] [ Designated as safety issue: No ]
- Time required for post surgery functional recovery [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks ] [ Designated as safety issue: No ]
- Adverse effects of morphine [ Time Frame: 72 hours after surgery ] [ Designated as safety issue: Yes ]
- hospitalization delay [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks ] [ Designated as safety issue: No ]
- asked bolus divided by delivered bolus [ Time Frame: until 72 hours after surgery ] [ Designated as safety issue: No ]
- Score for pain intensity [ Time Frame: until 72 hours after surgery ] [ Designated as safety issue: No ]
| Enrollment: | 60 |
| Study Start Date: | January 2011 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | January 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: ropivacaine 0.2%, wound infusion |
Drug: Ropivacaine
wound infusion, 0.2%, bolus 10mL followed by 8 mL/h infusion
|
| Placebo Comparator: saline solution 0.9%, wound infusion |
Drug: Saline solution 0.9%
wound infusion, 0.9%, bolus 10mL followed by 8 mL/h
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- adults
- > 18 years
- Physical status score I, II or III (American Society of Anesthesiologists)
- lumbar or thoracic spine surgery with arthrodesis through posterior only approach
- signed informed consent
- beneficiary of social security
Exclusion Criteria:
- vulnerable persons according to law
- scoliosis surgery
- local anesthetic allergia
- contraindication to ketamine, acetaminophene, nefopam, non steroidal anti inflammatory, ropivacaine, morphine, droperidol
- long term anti platelet aggregants
- inability to comply to protocol requirements
- psychiatric disorders or cognitive disabilities
- chronic pain or long term opioids consumption
- diabetes
- obesity (BMI > 30)
- pregnancy or lactation
Contacts and Locations
More Information
No publications provided
| Responsible Party: | University Hospital, Grenoble |
| ClinicalTrials.gov Identifier: | NCT01743794 History of Changes |
| Other Study ID Numbers: | 1008 |
| Study First Received: | May 9, 2012 |
| Last Updated: | December 5, 2012 |
| Health Authority: | France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Additional relevant MeSH terms:
|
Ropivacaine Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs |
Pharmacologic Actions Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 23, 2013