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RecruitingNCT06559969Updated Apr 28, 2026

IV vs Epidural Opioids + Epidural Local Anesthetic for Laparotomy Analgesia

A Phase 2/3 interventional study of Intravenous administered opioid and Epidural administered opioid in Laparotomy, sponsored by University of Iowa. Recruiting at 1 site in United States. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-04-28.

Sponsored by University of Iowa · Phase 2/3, Interventional, and Supportive care

From the registry’s dates

  • Started Sep 2024; still recruiting 2 years later.
Phase
Phase 2/3
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

The purpose of this research study is to determine if the two common ways of administering additional opioids (morphine like substance, narcotic) with an epidural, either mixed in the epidural solution or given separately through the intravenous, are equally effective in controlling post-operative pain

Read the detailed description

Open label, observer and patient blinded randomized control study of patients age 18 to 85 who are booked to have an open upper abdominal surgical incision where an epidural would normally be offered and expected to be used for an average of 4 to 5 days.

Study will be done at University of Iowa Hospitals and Clinics main operating room and post-operative surgical wards.

Eligible patients who choose to consent to participate in the study will be randomized to either have the opioid administered intravenously using patient controlled administration (PCA) device along with a local anesthetic only continuous epidural infusion ,the control group, or to the treatment group of the opioid combined with the local anesthetic in the epidural with a continuous infusion combined with patient controlled epidural administered (PCEA) bolus. The epidural pump along with the PCA machine will be placed in such away that they can be obscured by a removable cover. The patient will be seen daily to obtain pain and satisfaction scores using the Quality of Recovery (QoR) 15. Secondary data will also be collected including presence of side effects, ability to mobilize, signs of return of bowel function, need for supplemental oxygen and total amount of opioid required. Patients will be assigned a study number, which all data will be kept under.

02

Conditions studied

  • Laparotomy

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Keywords

  • Epidural
  • PCEA
  • PCA
  • Hydromorphone
  • bupivacaine
  • analgesia
  • laparotomy
03

In context

Agnosia

1,189 studies on the registry are indexed under Agnosia; 507 are open to participants now.

This study's planned enrollment of 80 is close to the median of 77 across 1,023 interventional studies indexed under Agnosia.

Browse Agnosia studies →

Lead sponsor

University of Iowa is the lead sponsor of 276 studies on the registry; 35 are open to participants now.

Of its 44 completed or terminated interventional studies of FDA-regulated products, 39 (89%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age including and between 18 to 85 years old
  2. Planned open abdominal procedure with an incision that is or includes above the umbilicus, where epidural would normally be offered and epidural would be maintained for an average of 4 to 5 days
  3. Patient has consented for an epidural
  4. Patient is able to converse in English
  5. Patient is able to use a patient controlled pump

Exclusion criteria

Exclusion Criteria:

  1. Has a known contraindication for an epidural
  2. Known mental or cognitive disability
  3. History of chronic opioid use or substance abuse disorder
  4. Pre-operative use of opioids
  5. History of chronic pain
  6. Routine use of marijuana
  7. Incarcerated
  8. Unable to converse in English
  9. Planned to remain intubated post-operatively
  10. Need for post-operative use of anticoagulant regiment that would be contraindicated with an indwelling epidural catheter
  11. End stage renal disease or dialysis
  12. Hepatic disease that affects metabolism of drugs
  13. Known contraindication to any of the study drugs
  14. Known pregnancy or positive pre-operative pregnancy test
  15. Known neurological condition that may affect motor or sensory systems
05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
80 participants (estimated)

Study arms

  • Active comparator
    Control

    Hydromorphone administered intravenous PCA combined with a continuous bupivacaine epidural infusion

    Drug: Intravenous administered opioid

  • Active comparator
    Treatment

    Hydromorphone combined with bupivacaine in the epidural and administered as a continuous infusion with a PCEA bolus as necessary

    Drug: Epidural administered opioid

Interventions

  • DrugIntravenous administered opioid

    Hydromorphone will be received intravenously using a patient controlled administration pump, as well as patient will have a continuous bupivacaine epidural infusion

    Also known as: hydromorphone IV

  • DrugEpidural administered opioid

    Hydromorphone will be added to the bupivacaine in the epidural and will have a continuous infusion along with the ability for the patient to receive epidural boluses of the medications by a patient controlled epidural administration pump

    Also known as: Hydromorphone epidural

06

What researchers measure

Primary outcomes

  1. With a local anesthetic epidural, is the epidural administration of opioids similar to opioids administered by intravenous

    Quality of Recovery (QoR) 15 score from 0-150 with the higher the score the better

    Time frame: Once daily until one day after the epidural in discontinued which would mean a maximum of 8 days post-operatively

Secondary outcomes

  1. With a local anesthetic epidural, are there any differences in the incidence of opioid side effects between intravenous and epidural administered opioids

    will assess patient for symptoms suggestive of opioid side effects and look in the patient's chart to see if they require any medication treatments that could be linked to opioid side effects

    Time frame: Assessed daily until the epidural is removed, which is maximum of 7 days post-operatively

  2. Does the route of epidural opioid administration, intravenous vs epidural, affect the return of bowel function

    Will assess patient and chart looking for signs of bowel function return and look how patient is able to progress with diet (time in days until signs of bowel function return)

    Time frame: daily assessment until epidural removed, which is a maximum of 7 days post-operatively

  3. Does the route of epidural opioid administration, intravenous vs epidural, impact patient ability to be discharged

    Will look in chart to see when surgery documents that they feel patient has recovered enough to be discharged home (time in days until dischargeable)

    Time frame: Will follow until patient discharged or maximum 10 days post-operatively

07

Study locations

1 of 1 sites recruiting
  • University of Iowa Health Care
    Iowa City, Iowa 52242, United States
    • Yair Rubin, MD · Contact · yair-rubin@uiowa.edu · 319-353-7211
    • Rakesh Sondekoppam Vijayashanka, MD · Contact · rakesh-sondekoppam@uiowa.edu
    • Yair Rubin, MD · Principal investigator
    • Rakesh Sondekoppam Vijayashanka, MD · Sub investigator
    • Melinda Seering, MD · Sub investigator
    • Adeeb Oweidat, MD · Sub investigator
    • Anil Marian, MD · Sub investigator
    • Sangini Punia, MD · Sub investigator
    • Nada Sadek, MD · Sub investigator
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06559969
Lead sponsor
University of Iowa
Responsible party
Melinda Seering (Clinical Associate Professor, University of Iowa) — Principal investigator
First posted
Aug 19, 2024
Start date
Sep 17, 2024
Primary completion
Dec 30, 2026 (estimated)
Completion
Mar 30, 2027 (estimated)
Last update
Apr 28, 2026

Study contacts

Melinda Seering, MD
Contact
Melinda-Seering@uiowa.edu
3193848411
Yair Rubin, MD
Contact
yair-rubin@uiowa.edu
3193587989
Melinda Seering, MD
principal investigator · Univeristy of Iowa

Oversight

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

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