The Effect of an Opioid on the Lower Esophageal Sphincter During Anesthesia Induction

NCT ID: NCT01199458

Last Updated: 2016-11-09

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

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2010-10-31

Brief Summary

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This study evaluates the effects of adding an opioid (alfentanil) during anesthesia induction with respect to the barrierpressure in the esophagogastric junction.

The secondary aim was to investigate whether the effect of cricoid pressure influences the barrierpressure.

Detailed Description

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During anesthesia induction and tracheal intubation one major concern is to avoid passive regurgitation of gastric content and aspiration.

The lower esophageal sphincter is a muscle located at the distal end of the esophagus. It plays an important role in creating a barrier between the stomach and the esophagus. The term "barrierpressure" is defined as the pressure difference between the lower esophageal sphincter pressure and the pressure in the stomach (intragastric pressure).

There are studies showing that opioids given iv/im, in the vein or in the muscle, may decrease the pressure in the lower esophageal sphincter and hereby increase the risk of aspiration.

Nevertheless,other studies shows that opioids are still frequently given to patients during anesthesia induction. This is done in order to prevent the cardiovascular response to (the painful) intubation which can often be seen as an equally high risk for the patient as the risk of aspiration.

In light of the above description, the investigators are planning a study in volunteers with the primary aim of investigating the effects of an opioid (alfentanil) on the pressures in the lower esophageal sphincter.

Another safety measure taken during anesthesia induction is the so called "cricoid pressure". This is based on the theory that passive regurgitation of gastric content may be prevented by occluding the esophagus by pressing on the cricoid cartilage. However, there are studies indicating that the application of cricoid pressure also may decrease the tonus of the lower esophageal sphincter.

The secondary aim of the study is to investigate the effect of cricoid pressure application on the pressure in the lower esophageal sphincter.

Measurements are being done using high-resolution solid-state manometry.

Conditions

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Lower Esophageal Sphincter

Keywords

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Lower Esophageal Sphincter Barrier pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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opioid

Preoxygenation for 5 min. Injection of opioid (alfentanil 20 mikrogr/kg iv) after 2 min:Injection of induction drug(propofol 2-2.5mg/kg) after anesthesia induction: Application of cricoid pressure for 15 sec.

Group Type ACTIVE_COMPARATOR

alfentanil

Intervention Type DRUG

20 mikrogr/kg

placebo

Preoxygenation for 5 min. Injection of saline iv. after 2 min:Injection of induction drug(propofol 2-2.5mg/kg) after anesthesia induction: Application of cricoid pressure for 15 sec.

Group Type PLACEBO_COMPARATOR

saline

Intervention Type DRUG

The amount of saline will be equal the amount (in ml) of the study-drug (alfentanil)in order to keep it blinded.

Interventions

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alfentanil

20 mikrogr/kg

Intervention Type DRUG

saline

The amount of saline will be equal the amount (in ml) of the study-drug (alfentanil)in order to keep it blinded.

Intervention Type DRUG

Other Intervention Names

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alfentanil = rapifen

Eligibility Criteria

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Inclusion Criteria

* Healthy volunteer 18-40 years old
* Informed,signed and dated consent

Exclusion Criteria

* Pharyngoesophageal dysfunction
* Gastro/intestinal-,cardiovascular-,lung- or neurologic disease
* Ongoing medication
* Allergy to alfentanil, propofol, soya or peanuts
* Pregnancy or breast-feeding
* BMI\>30
* Participation in other clinical trial -ongoing or during last 30 days.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Region Örebro County

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Magnus Wattwil, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Anesthesia and Intensive Care, Örebro University Hospital, Örebro,Sweden

Locations

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Örebro University

Örebro, , Sweden

Site Status

Countries

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Sweden

Other Identifiers

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EudraCT nr: 2010-020697-41

Identifier Type: -

Identifier Source: org_study_id