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TerminatedNCT03176316FusionIleusUpdated Jul 1, 2024Results posted

The Use of Oral Naloxone to Prevent Post Spinal Fusion Ileus

A Phase 4 interventional study of Naloxone in Ileus and Fusion of Spine, sponsored by Loyola University. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-07-01.

Sponsored by Loyola University · Phase 4, Interventional, and Prevention

Why this study was terminated
The study was terminated by the Institutional Review Board.
Phase
Phase 4
Study type
Interventional
Enrollment
53
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Postoperative ileus and opioid induced constipation are well-known post-operative complications. Previously, research has shown that using peripherally acting opioid antagonists can help alleviate the condition. There has not been a prospective study to investigate whether use of peripherally acting opioid antagonists are effective in preventing post-operative ileus in patients having spinal fusion surgeries.

Read the detailed description

Post operative ileus is a well-known complication following spinal fusion surgery. There has been some literature to demonstrate the safety and efficacy of oral naloxone to decrease the time to bowel movements after gastrointestinal surgery, to date, there have been no studies within the spine fusion literature to investigate oral naloxone's effects on the time to bowel movements.

The aim of the present study is to use the previously established protocols and doses established in the gastrointestinal literature to see whether oral naloxone can decrease the time to first bowel movements.

02

Conditions studied

  • Ileus
  • Fusion of Spine

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Keywords

  • ileus
  • fusion of spine
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients will be included if they are having an in-patient spinal fusion procedure, are 18 years or older, post and post-operative pain control plan includes opioid medications.

Exclusion criteria

Exclusion Criteria:

  • Pregnancy, age \< 18, nursing, or documented allergy to naloxone
04

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
53 participants (actual)

Study arms

  • Experimental
    Naloxone

    1 mg/ml oral solution administered enterally every eight hours for 48 hours

    Drug: Naloxone

Interventions

  • DrugNaloxone

    Naloxone is an opioid antagonist (i.e., a medication used to reverse or reduce the effects of opioids)

05

What researchers measure

Primary outcomes

  1. Time to First Bowel Movement

    We will monitor the patients' bowel movements and record the time to the first bowel movement in hours

    Time frame: 1 week

06

Results

Posted Jul 1, 2024

Participant flow

Recruitment began on September 20, 2017 and ended on February 20, 2020 when the Institutional Review Board placed the project on administrative hold. Recruitment occurred at a Loyola University Medical Center clinic.

Participant flow — Overall Study
MilestoneNaloxone
Started53
Completed53
Not completed0

Outcome measures

PrimaryTime to First Bowel Movement

We will monitor the patients' bowel movements and record the time to the first bowel movement in hours

Time frame:
1 week
Reported as:
Number · Hours
Time to First Bowel Movement
HoursNaloxone
Time to First Bowel Movement43.62

Adverse events

Collected over Adverse event data were collected for 2 years and 5 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Naloxone0/53 (0%)0/53 (0%)0/53 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Naloxone
Mean65.91 ± 9.99
Sex: Female, Male
Sex: Female, Male(Participants)Naloxone
Female25
Male28
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Naloxone
American Indian or Alaska Native0
Asian1
Native Hawaiian or Other Pacific Islander0
Black or African American2
White19
More than one race0
Unknown or Not Reported31
Region of Enrollment
Region of Enrollment(Participants)Naloxone
United States53
07

Study locations

1 site
  • Loyola University Medical Center
    Maywood, Illinois 60153, United States
08

References and documents

Publications

  • Arpino PA, Thompson BT. Safety of enteral naloxone for the reversal of opiate-induced constipation in the intensive care unit. J Clin Pharm Ther. 2009 Apr;34(2):171-5. doi: 10.1111/j.1365-2710.2008.00982.x. PubMed 19250137 ↗
  • McNicol E, Boyce DB, Schumann R, Carr D. Efficacy and safety of mu-opioid antagonists in the treatment of opioid-induced bowel dysfunction: systematic review and meta-analysis of randomized controlled trials. Pain Med. 2008 Sep;9(6):634-59. doi: 10.1111/j.1526-4637.2007.00335.x. PubMed 18828197 ↗
  • Fineberg SJ, Nandyala SV, Kurd MF, Marquez-Lara A, Noureldin M, Sankaranarayanan S, Patel AA, Oglesby M, Singh K. Incidence and risk factors for postoperative ileus following anterior, posterior, and circumferential lumbar fusion. Spine J. 2014 Aug 1;14(8):1680-5. doi: 10.1016/j.spinee.2013.10.015. Epub 2013 Oct 31. PubMed 24184650 ↗
  • Meissner W, Leyendecker P, Mueller-Lissner S, Nadstawek J, Hopp M, Ruckes C, Wirz S, Fleischer W, Reimer K. A randomised controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-induced constipation. Eur J Pain. 2009 Jan;13(1):56-64. doi: 10.1016/j.ejpain.2008.06.012. Epub 2008 Aug 31. PubMed 18762438 ↗
  • Meissner W, Schmidt U, Hartmann M, Kath R, Reinhart K. Oral naloxone reverses opioid-associated constipation. Pain. 2000 Jan;84(1):105-109. doi: 10.1016/S0304-3959(99)00185-2. PubMed 10601678 ↗
  • Sykes NP. An investigation of the ability of oral naloxone to correct opioid-related constipation in patients with advanced cancer. Palliat Med. 1996 Apr;10(2):135-44. doi: 10.1177/026921639601000208. PubMed 8800821 ↗
  • Lee J, Shim JY, Choi JH, Kim ES, Kwon OK, Moon DE, Choi JH, Bishop MJ. Epidural naloxone reduces intestinal hypomotility but not analgesia of epidural morphine. Can J Anaesth. 2001 Jan;48(1):54-8. doi: 10.1007/BF03019815. PubMed 11212050 ↗

Study documents

  • Protocol and statistical analysis plan · Sep 3, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — There are no plans to share individual participant data with other researchers

09

Registry details

Key details

Study ID
NCT03176316
Lead sponsor
Loyola University
Responsible party
Sponsor
First posted
Jun 5, 2017
Start date
Sep 20, 2017
Primary completion
Feb 20, 2020
Completion
Feb 20, 2020
Results posted
Jul 1, 2024
Last update
Jul 1, 2024

Study contacts

Russell Nockels, MD
principal investigator · Loyola University

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.

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