Modulation of Remifentanil-induced Postinfusion Hyperalgesia

NCT ID: NCT00785863

Last Updated: 2011-07-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-12-31

Study Completion Date

2009-04-30

Brief Summary

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In addition to alleviate pain there is growing evidence that µ-opioids enhance pain. This problem is known as opioid induced hyperalgesia(OIH).The NMDA receptor is involved in opioid induced hyperalgesia it may be possible to block OIH by cyclooxygenase inhibitors. This has been demonstrated with parecoxib, a COX-II inhibitor, in a experimental pain model.Both COX-1 and COX-2 are expressed in the spinal cord. It would be of interest to investigate whether a COX-1 preferring inhibitor like ketorolac also can reduce opioid induced hyperalgesic in this experimental pain model.

Detailed Description

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Remifentanil is an fast acting opioid which has become very popular to use during surgery.

There are studies, both experimental 1-3 and clinical 4;5, which indicate that remifentanil after end of infusion trigger enhanced pain experience and enhanced opioid consumption postoperatively.

Therefore it is important to look at possibilities to block this enhanced pain experience (opioid induced hyperalgesia - OIH). Ketamin has demonstrated to block this effect 5;6 through the NMDA receptor. Unfortunately ketamin has some seriously side-effects like hallucinations, and is therefore not suitable in ordenary clinical use.

Recently, it has been demonstrated that parecoxib (a COX-2 inhibitor) can prevent remifentanil-induced postinfusion hyperalgesia in a study on healthy volunteers.7 COX-2 inhibitors have some disadvantages because of the longterm adverse effects like cardiac arrest. Therefore it would be of interest to look at a COX-1 preferring NSAID, like ketorolac, to see if also non-selective NSAIDs can partly block remifentanil-induced postinfusion hyperalgesia.

To investigate this and to provoke pain and secondary hyperalgesia we use an intradermal electrical pain model which is well established.1;7-9 Detailed description of this model look at reference 7. H0 : Parecoxib prevents remifentanil postinfusion secondary hyperalgesi. Ketorolac does not prevent remifentanil postinfusion secondary hyperalgesi HA : Parecoxib and ketorolac prevent remifentanil postinfusion secondary hyperalgesi.

Conditions

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Hyperalgesia, Secondary

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo IV before placebo infusion

Remifentanil

Group Type ACTIVE_COMPARATOR

Remifentanil

Intervention Type DRUG

placebo IV and remifentanil infusion

Ketorolac and remifentanil

Group Type ACTIVE_COMPARATOR

Ketorolac and remifentanil

Intervention Type DRUG

Ketorolac IV and remifentanil infusion

Parecoxib and remifentanil

Group Type ACTIVE_COMPARATOR

Parecoxib and remifentanil

Intervention Type DRUG

Parecoxib IV and remifentanil infusion

Interventions

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Placebo

Placebo IV before placebo infusion

Intervention Type OTHER

Remifentanil

placebo IV and remifentanil infusion

Intervention Type DRUG

Ketorolac and remifentanil

Ketorolac IV and remifentanil infusion

Intervention Type DRUG

Parecoxib and remifentanil

Parecoxib IV and remifentanil infusion

Intervention Type DRUG

Other Intervention Names

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Ultiva Toradol Dynastat

Eligibility Criteria

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Inclusion Criteria

* Healthy volunteers

Exclusion Criteria

* Allergy to the drugs used in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Oslo

OTHER

Sponsor Role collaborator

Rikshospitalet University Hospital

OTHER

Sponsor Role collaborator

Ullevaal University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ullevaal University Hospital

Principal Investigators

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Harald Lenz, MD

Role: PRINCIPAL_INVESTIGATOR

Ullevaal University Hospital

Johan Raeder, Prof.,MD,PhD

Role: STUDY_DIRECTOR

Ullevaal University Hospital

Audun Stubhaug, Prof.,MD,PhD

Role: STUDY_DIRECTOR

Rikshospitalet University Hospital

Locations

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Ullevaal University Hospital

Oslo, Oslo County, Norway

Site Status

Countries

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Norway

Other Identifiers

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2008-000904-10

Identifier Type: -

Identifier Source: org_study_id

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