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Effect of Early Morphine Administration on the Development of Acute Opioid Tolerance During Pediatric Scoliosis Surgery

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00737997
Recruitment Status : Completed
First Posted : August 20, 2008
Last Update Posted : November 19, 2014
Information provided by (Responsible Party):
Mark Crawford, The Hospital for Sick Children

Brief Summary:
The purpose of this study is to examine if morphine administered by bolus before initiating Remifentanil by infusion decreases the incidence of acute post-operative opioid tolerance as demonstrated by decreased post - operative morphine consumption in children undergoing scoliosis surgery.

Condition or disease Intervention/treatment Phase
Scoliosis Drug: Morphine Other: Saline Phase 3

Detailed Description:
At our institution, a study has recently demonstrated that intraoperative infusion of remifentanil is associated with development of clinically relevant acute opioid tolerance in adolescents undergoing scoliosis surgery. This results in increased morphine consumption which in turn is associated with increased incidence of side effects such as respiratory depression, nausea and vomiting, pruritus, ileus and urinary retention. All of these side effects can result in increased consumption of rescue medications with the additional potential for increased duration of patient stay. Any measures that can be introduced to decrease the development of acute opioid tolerance in this patient population would have significant impact on patient morbidity, patient comfort and possibly duration of patient stay.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Effect of Early Administration of Morphine on the Development of Acute Opioid Tolerance During Infusion of Remifentanil for Pediatric Scoliosis Surgery
Study Start Date : December 2006
Actual Primary Completion Date : December 2007
Actual Study Completion Date : February 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Scoliosis

Arm Intervention/treatment
Placebo Comparator: 1 Other: Saline
10 ml saline alone

Experimental: 2 Drug: Morphine
150 mcg/kg diluted in normal saline to a volume of 10 ml at time of induction of anesthesia

Primary Outcome Measures :
  1. Morphine consumption [ Time Frame: Every hour for four hours and then every four hours thereafter for 48 hours ]

Secondary Outcome Measures :
  1. Propofol and remifentanil consumption [ Time Frame: 48 hours ]
  2. Incidences of post-operative nausea, vomiting, pruritus and pyrexia [ Time Frame: every hour for four hours and then every four hours thereafter for 48 hours ]

Information from the National Library of Medicine

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Ages Eligible for Study:   11 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Unpremedicated
  • ASA physical status 1 or 2
  • Aged 11 - 18
  • Scheduled to undergo posterior instrumentation for correction of idiopathic scoliosis

Exclusion Criteria:

  • Chronic opioid use within three months prior to surgery
  • Inability to self-administer morphine using a patient-controlled analgesia (PCA) device
  • Elective postoperative ventilation
  • Obesity (> 130% ideal body weight)
  • Known sensitivity to morphine, remifentanil or any other agent within the standardized protocol
  • Failure to obtain written consent or assent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00737997

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Canada, Ontario
The Hospital for Sick Children
Toronto, Ontario, Canada, M5G 1X8
Sponsors and Collaborators
The Hospital for Sick Children
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Principal Investigator: Mark Crawford, MD The Hospital for Sick Children, Toronto Canada
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Mark Crawford, Anesthesiologist-In-Chief, The Hospital for Sick Children Identifier: NCT00737997    
Other Study ID Numbers: 1000009741
First Posted: August 20, 2008    Key Record Dates
Last Update Posted: November 19, 2014
Last Verified: November 2014
Keywords provided by Mark Crawford, The Hospital for Sick Children:
Additional relevant MeSH terms:
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Spinal Curvatures
Spinal Diseases
Bone Diseases
Musculoskeletal Diseases
Analgesics, Opioid
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents