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Not yet recruitingNCT03440086DRAIN-1Updated Nov 2, 2022

Temporary Application of Abdominal Jackson-Pratt Drain to Reduce Pain After Laparoscopic Surgery in Gynecology

An interventional study of abdominal Jackson-Pratt drain in Postoperative Pain, sponsored by Università degli Studi dell'Insubria. Not yet recruiting at 1 site in Italy. Open to female participants. Per ClinicalTrials.gov, last updated 2022-11-02.

Sponsored by Università degli Studi dell'Insubria · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
94
Allocation
Randomized
Sex
Female
01

Study summary

Recent evidence has shown that the onset and intensity of post-operative pain are significantly related to the amount of residual pneumoperitoneum at the end of the surgical procedure. In addition, the use of low pressures of carbon dioxide (CO2) for induction of the pnemoperitoneum has been associated with a reduction in post-operative pain, probably due to a lower abdominal distension and a consequent reduced compression of the pelvic, abdominal and sub-diaphragmatic pain nerve fibers.

The reduction of the residual pnemoperitoneum at the end of the surgical procedure could therefore play a key role in the reduction of post-operative pain, with consequent greater comfort for the patient and reduction of the use of analgesics.

In view of the available evidence, the aim of the present study is to evaluate whether the application of Jackson-Pratt drain, for one hour from the end of the surgical procedure, can significantly reduce post-operative pain and the need of analgesics in patients undergoing laparoscopic gynecological surgery.

Read the detailed description

Laparoscopy in gynecological surgery offers numerous advantages, such as the reduction of operative time, intra-operative blood loss, post-operative pain and the possibility of early hospital discharge and return to normal daily activities in a short time.

Despite these points arewidely validated in the literature, sometimes patients undergoing laparoscopy complain of abdominal pains (although slight in intensity and temporary) in the post-operative period. In some cases, the pain is characteristically irradiated at the shoulders, due to a probable irritation/compression of the phrenic nerve that runs on the lower surface of the diaphragm.

Recent evidence has shown that the onset and intensity of post-operative pain are significantly related to the amount of residual pneumoperitoneum at the end of the surgical procedure. In addition, the use of low pressures of carbon dioxide (CO2) for induction of the pnemoperitoneum has been associated with a reduction in post-operative pain, probably due to a lower abdominal distension and a consequent reduced compression of the pelvic, abdominal and sub-diaphragmatic pain nerve fibers.

The reduction of the residual pnemoperitoneum at the end of the surgical procedure could therefore play a key role in the reduction of post-operative pain, with consequent greater comfort for the patient and reduction of the use of analgesics.

In view of the available evidence, the aim of the present study is to evaluate whether the application of Jackson-Pratt drain, for one hour from the end of the surgical procedure, can significantly reduce post-operative pain and the need of analgesics in patients undergoing laparoscopic gynecological surgery.

02

Conditions studied

  • Postoperative Pain

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Keywords

  • Laparoscopic surgery
  • Pain
  • Jackson-Pratt drain
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Patients affected by uterine fibroids, undergoing laparoscopic surgery;
  • American Society of Anesthesiologists physical status classification I-II.

Exclusion criteria

Exclusion Criteria:

  • inability to express pain;
  • any concomitant diseases requiring upper abdominal surgery, such as cholecystectomy or adhesiolysis;
  • laparoscopic procedures that were converted to open surgery;
  • other causes of known pain;
  • oncological cases;
  • use of drugs for chronic pelvic pain or hormones in the previous 3 months (wash-out period);
  • application of other drainages;
  • intra- or post-operative complications.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
94 participants (estimated)

Study arms

  • Experimental
    Abdominal Jackson-Pratt drain

    Patients in this arm will undergo one-hour application of abdominal Jackson-Pratt drain at the end of laparoscopic procedure.

    Device: abdominal Jackson-Pratt drain

  • No intervention
    Controls

    Patients in this arm will not undergo one-hour application of abdominal Jackson-Pratt drain at the end of laparoscopic procedure.

Interventions

  • Deviceabdominal Jackson-Pratt drain

    One-hour application of abdominal Jackson-Pratt drain at the end of laparoscopic procedure.

05

What researchers measure

Primary outcomes

  1. Pain

    Pain perception, expressed as Visual Analogue Score (0-10).

    Time frame: 6 hours after surgery.

Secondary outcomes

  1. Pain

    Pain perception, expressed as Visual Analogue Score (0-10).

    Time frame: 12 hours after surgery.

  2. Pain

    Pain perception, expressed as Visual Analogue Score (0-10).

    Time frame: 24 hours after surgery.

  3. Use of Analgesic

    Number of requests for rescue analgesia (30 mg ketorolac tromethamine, administrated intravenously).

    Time frame: During the 48 hours after surgery.

06

Study locations

1 site
  • University of Insubria
    Varese, 21100, Italy
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03440086
Lead sponsor
Università degli Studi dell'Insubria
Responsible party
Antonio Simone Laganà (Medical Doctor, Università degli Studi dell'Insubria) — Principal investigator
First posted
Feb 20, 2018
Start date
Jun 1, 2025 (estimated)
Primary completion
Jun 1, 2026 (estimated)
Completion
Jun 15, 2027 (estimated)
Last update
Nov 2, 2022

Study contacts

Antonio Simone Laganà, M.D.
Contact
antoniosimone.lagana@asst-settelaghi.it
3296279579

Oversight

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

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