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Status unknownNCT05028049Updated Aug 31, 2021

Comparison of Remifentanil-induced Postoperative Hyperalgesia Between Patients From Plain Area and Plateau Area

An observational study in Pain, Postoperative and Anesthesia, sponsored by Tianjin Medical University General Hospital. Status unknown at 2 sites in China. Open to female participants aged 20 Years to 60 Years. Per ClinicalTrials.gov, last updated 2021-08-31.

Sponsored by Tianjin Medical University General Hospital · Observational

The sponsor has not verified this record recently (last verified Aug 2021), so the status shown — last known as Not yet recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
160
Ages
20 Years to 60 Years
Sex
Female
01

Study summary

Purpose:

  1. To compare the incidence of postoperative hyperalgesia induced by remifentanil in patients undergoing gynecological laparoscopic surgery in plateau and plain areas
  2. To compare the peri-operative analgesic requirements of patients in plain and plateau areas
Read the detailed description

Our research group has been committed to the research of remifentanil-induced hyperalgesia for a long time. In the previous study, it was found that intraoperative infusion of remifentanil (0.3ug/kg•min) >1h can lead to remifentanil-induced hyperalgesia and the incidence rate is relative high in the plain area. Due to the long-term low pressure and hypoxia of people living in plateau areas, a series of changes will occur in the respiratory and circulatory systems, and their anesthesia management needs to be adjusted accordingly. However, there is no relevant research on whether or not hyperalgesia occurs in people in plateau areas (altitude level >3000 meters). Therefore, this study hopes to compare the incidence and degree of remifentanil-induced hyperalgesia after gynecological laparoscopic surgery in plain areas and plateau areas.

02

Conditions studied

  • Pain, Postoperative
  • Anesthesia

Keywords

  • Remifentanil
  • Opioid-induced hyperalgesia
  • Postoperative pain
  • pain intensity
03

Who can participate

Ages eligible
20 Years to 60 Years
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients in plateau areas are long staying residents in above 3000 meters above sea level for enrollment, while patients in plain areas are long staying residents below 1000 meters above sea level.

Inclusion criteria

  1. Subject is scheduled to undergo gynecological laparoscopic surgery under a short general anesthesia of less than 2 hours
  2. Subject's American Society of Anesthesiologists physical status is I-II.
  3. The subject's parent/legally authorized guardian has given written informed consent to participate.
  4. Patients in plateau areas are long staying residents in above 3000 meters above sea level for enrollment, while patients in plain areas are long staying residents below 1000 meters above sea level.

Exclusion criteria

Exclusion Criteria:

  1. Subject has a diagnosis of renal or liver failure.
  2. Subject has a diagnosis of Insulin dependent diabetes.
  3. Subject is allergy and contraindication to any drugs used during general anesthesia.
  4. Subject has a history of chronic pain, a history of alcohol or opioid abuse, pre-existing therapy with opioids, intake of any analgesic drug within 48 hours before surgery.
  5. Subject has any contraindication for the use of patient-controlled analgesia (PCA).
  6. Subject is pregnant or breast-feeding.
  7. Subject is obese (body mass index >30kg/m2).
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
160 participants (estimated)
Target follow-up
7 Days
Patient registry
Yes

Groups and cohorts

  • Sufentanil-analgesia in plain area patients

    Sufentanil 0.3 μg/kg is intravenously administrated to maintain intraoperative analgesia in plain area patients.

    Drug: Sufentanil injection · Other: plain areas

  • Remifentanil-analgesia in plain area patients

    Remifentanil 0.3ug/kg/min is intravenously administrated to maintain intraoperative analgesia in plain area patients.

    Drug: Remifentanil Hydrochloride · Other: plain areas

  • Sufentanil-analgesia in plateau area patients

    Sufentanil 0.3 μg/kg is intravenously administrated to maintain intraoperative analgesia in plateau area patients.

    Drug: Sufentanil injection · Other: plateau areas

  • Remifentanil-analgesia in plateau area patients

    Remifentanil 0.3ug/kg/min is intravenously administrated to maintain intraoperative analgesia in plateau area patients.

    Drug: Remifentanil Hydrochloride · Other: plateau areas

Interventions

  • DrugSufentanil injection

    Sufentanil 0.3 μg/kg is intravenously administrated to maintain intraoperative analgesia

    Also known as: Sufentanil

  • DrugRemifentanil Hydrochloride

    Remifentanil 0.3ug/kg/min is intravenously administrated to maintain intraoperative analgesia

    Also known as: Remifentanil

  • Otherplain areas

    Patients should be long staying residents in plain areas (altitude level below 1,000 meters above sea level)

  • Otherplateau areas

    Patients should be long staying residents in plateau areas (altitude level\>3000 meters above sea level)

05

What researchers measure

Primary outcomes

  1. Mechanical Hyperalgesia Threshold on the Dominant Inner Forearm

    The mechanical hyperalgesia threshold was defined as the lowest force (g) necessary to bend a Von Frey filament, which was perceived to be painful by the patient and measured by Von Frey filament after surgery

    Time frame: 48 hours after surgery

Secondary outcomes

  1. Pain Score (NRS)

    The pain score at rest or after movement was evaluated by pain 11-point numerical rating scale (NRS): 0 = no pain, 10= greatest imaginable pain.

    Time frame: 48 hours after surgery

  2. Normalized Area of Hyperalgesia Around the Incision

    The skin around the incision is stimulated in steps of 5 mm at intervals of 1 s starting outside of the hyperalgesic area in the direction of the incision. The distance from the incision to the first point where a'painful', 'sore' or 'sharper' feeling occurred is measured and noted. This measurement is repeated at predefined radial lines around the incision. To eliminate the variable length of incision, this length is subtracted from the longer diameter leaving four radial distances from the end and from the middle of the incision. The normalized area of hyperalgesia is calculated by summing up the areas of the remaining four triangles measured by and Von Frey filament.

    Time frame: 48 hours after surgery

  3. Mechanical hyperalgesia threshold around the incision

    The mechanical hyperalgesia threshold was defined as the lowest force (g) necessary to bend a Von Frey filament, which was perceived to be painful by the patient and measured by Von Frey filament.

    Time frame: 48 hours after surgery

  4. Time of First Postoperative Analgesic Requirement

    First postoperative pain (NRS≥5) is initially controlled by titration of Hydromorphone.

    Time frame: 1 hour after surgery

  5. Total Dose of First Postoperative Analgesic Requirement

    First postoperative pain (NRS≥5) is initially controlled by titration of Hydromorphone.

    Time frame: 1 hour after surgery

  6. Cumulative Hydromorphone Consumption

    Each patient was administered analgesics using a PCA (Patient-controlled analgesia) pump containing Hydromorphone (200μg) in normal saline at a total volume of 100 ml after leaving PACU (Postanesthesia care unit). This device was set to deliver a basal infusion of 2 ml/h and bolus doses of 0.5 ml with a 15-min lockout period. Hydromorphone cumulative consumption is recorded 48 hours postoperatively

    Time frame: 48 hours after surgery

  7. Occurrence of Side Effects

    Occurrence of side effects: nausea, vomiting, dizziness, headache, shivering, pruritus

    Time frame: 48 hours after surgery

06

Study locations

2 sites
  • Gannan Tibetan Autonomous Prefecture People's Hospital
    Hezuo, Gansu, China
  • Tianjin Medical University General Hospital
    Tianjin, 300052, China
    • Guolin Wang · Contact · +8618604755166
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT05028049
Lead sponsor
Tianjin Medical University General Hospital
Responsible party
Guolin Wang (Professor, Tianjin Medical University General Hospital) — Principal investigator
First posted
Aug 31, 2021
Start date
Aug 30, 2021 (estimated)
Primary completion
Dec 15, 2021 (estimated)
Completion
Dec 31, 2021 (estimated)
Last update
Aug 31, 2021

Study contacts

Guolin Wang, MD
Contact
wangguolinghad@hotmail.com
+8618604755166
Guolin Wang, MD
study director · Tianjin Medical University General Hospital

Oversight

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

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