Clinical Validation of Medasense Pain Response Index (PRI)

NCT ID: NCT01762332

Last Updated: 2019-03-08

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

NA

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2014-05-25

Brief Summary

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In our previous study, NCT01631695, we proposed and clinically evaluated the Medasense pain response index, PRI, in anesthetized patients undergoing surgery. Note: the name PRI has been changed to NoL (Nociception Level) Index.

The PRI is based on a non-linear combination of several pain-related physiological parameters into a one unique index (0-100).

In this study we aim to validate the performance of the PRI by:

1. investigating the patient's PRI response to surgical painful stimuli under different levels of analgesia:

* Investigating patient's PRI response to surgical painful stimuli under two different levels of Remifentanil Target Control Infusion (TCI) rates.
* Investigating patient's PRI response to standardized painful stimulus (Tetanic stimulus) with and without opioids.
2. investigating the effect of beta-blockers on PRI performance in patients taking chronic beta-blocker treatment.

The study is based on recording and analyzing the subject's physiological signals, while recording painful events, medication dosing and different clinical signs.

Detailed Description

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Pain is an unpleasant sensation, ranging from slight discomfort to intense suffering. Since pain is a subjective phenomenon, it has frequently defied objective, quantitative measurements. Today, in order to measure pain, subjective uni-dimensional scales are used to quantify pain. One of the most common scale used to rate a patient's pain intensity is the Numeric Pain Scale (NPS), usually scored from 0 to 100. Hitherto, those scales are based on the subjective evaluation of pain by the patient.

During anesthesia the patient cannot communicate and therefore the verbal or other report is impossible. As a consequence, due to misrepresentation of the existence or extent of pain, care providers may fail to estimate the correct measure of pain and give too much or too little medication, leading to possible complications and adverse reactions. A validated scoring system of subject's pain level, or as in the case of an anaesthetised patient, subject's nociception level, is therefore needed.

In this study the investigators intend to test and analyze the performances of Medasense pain response index, PRI, by comparing it with other standard pain related indicators (Heart Rate (HR), Heart Rate Variability (HRV), Skin Conductance, etc) before and after painful stimuli at different levels of analgesia. In addition, in order to reduce the variability between stimuli, a standardized stimulus (Tetanic ,30 sec, 100Hz, 60mA) will be given to all patients after sleep induction and before intubation, with and without administration of Fentanyl and the values of the PRI during these stimuli will be investigated.

Conditions

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Surgery Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Low opioid level

Base level of remifentanil effect side concentration: 2ng/ml Stopped recruitment (May 2014)

Group Type ACTIVE_COMPARATOR

Base level of remifentanil effect side concentration: 2ng/ml

Intervention Type DRUG

constant remifentanil level of 2ng/ml administered using Target Control Infusion pumps.

High opioid level

Base level of remifentanil effect side concentration: 4ng/ml Stopped recruitment (May 2014)

Group Type ACTIVE_COMPARATOR

Base level of remifentanil effect side concentration: 4ng/ml

Intervention Type DRUG

constant remifentanil level of 4ng/ml administered using Target Control Infusion pumps.

chronic beta-blocker treatment

Intervention Type OTHER

Patients from the chronic beta-blocker treatment group will not be randomized, and will all be allocated to the high opioid level group.

chronic beta-blocker treatment

Patients with chronic beta-blocker treatment prior to surgery and study. Will all be allocated to the high opioid level arm without randomization.

Continue recruitment.

Group Type OTHER

chronic beta-blocker treatment

Intervention Type OTHER

Patients from the chronic beta-blocker treatment group will not be randomized, and will all be allocated to the high opioid level group.

Interventions

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Base level of remifentanil effect side concentration: 2ng/ml

constant remifentanil level of 2ng/ml administered using Target Control Infusion pumps.

Intervention Type DRUG

Base level of remifentanil effect side concentration: 4ng/ml

constant remifentanil level of 4ng/ml administered using Target Control Infusion pumps.

Intervention Type DRUG

chronic beta-blocker treatment

Patients from the chronic beta-blocker treatment group will not be randomized, and will all be allocated to the high opioid level group.

Intervention Type OTHER

Other Intervention Names

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Ultiva Ultiva

Eligibility Criteria

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Inclusion Criteria

* ASA physical status 1-3
* Elective surgery

Exclusion Criteria

* Pregnancy or lactation
* History of severe cardiac arrhythmias
* Abuse of alcohol or illicit drugs
* History of mental retardation, dementia, psychiatric disorders
* Allergy to any of the drugs to be used during anesthesia and recovery
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medasense Biometrics Ltd

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ruth Edry, MD

Role: PRINCIPAL_INVESTIGATOR

Rambam Health Care Campus

Locations

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Rambam Health Care Campus

Haifa, , Israel

Site Status

Countries

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Israel

References

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Treister R, Kliger M, Zuckerman G, Aryeh IG, Eisenberg E. Differentiating between heat pain intensities: the combined effect of multiple autonomic parameters. Pain. 2012 Sep;153(9):1807-1814. doi: 10.1016/j.pain.2012.04.008. Epub 2012 May 29.

Reference Type BACKGROUND
PMID: 22647429 (View on PubMed)

Ben-Israel N, Kliger M, Zuckerman G, Katz Y, Edry R. Monitoring the nociception level: a multi-parameter approach. J Clin Monit Comput. 2013 Dec;27(6):659-68. doi: 10.1007/s10877-013-9487-9. Epub 2013 Jul 9.

Reference Type BACKGROUND
PMID: 23835792 (View on PubMed)

Other Identifiers

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0326-12-RMB

Identifier Type: OTHER

Identifier Source: secondary_id

Medasense003

Identifier Type: -

Identifier Source: org_study_id

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