Does Caffeine Reduce Postoperative Bowel Paralysis After Elective Colectomy?

NCT ID: NCT02510911

Last Updated: 2021-08-04

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

TERMINATED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2020-12-22

Brief Summary

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Postoperative bowel paralysis is common after abdominal operations, including colectomy. As a result, hospitalization may be prolonged leading to increased cost. A recent randomized controlled trial from the University of Heidelberg showed that consumption of regular black coffee after colectomy is safe and associated with a significantly faster resumption of intestinal motility (Müller 2012). The mechanism how coffee stimulates intestinal motility is unknown but caffeine seems to be the most likely stimulating agent.

Thus, this trial addresses the question: Does caffeine reduce postoperative bowel paralysis after elective laparoscopic colectomy?

Patients after laparoscopic colectomy will receive either 100 mg caffeine, 200 mg caffeine, or 250mg corn starch (placebo) 3 times daily in identically looking gelatin capsules.

The study is a randomized, controlled trial, with blinding of physicians, patients and nursing stuff (evaluating the endpoints).

Primary endpoint will be the time to first bowel movement.

Detailed Description

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Conditions

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Postoperative Ileus Laparoscopic Colectomy Without Stoma Formation Colorectal Neoplasm Diverticulitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Caffeine (100 mg)

Verum 1 with 100 mg caffeine

Group Type EXPERIMENTAL

Caffeine (100 mg)

Intervention Type DRUG

Patients after laparoscopic colectomy will receive 3 times daily capsules with 100 mg caffeine together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Radiopaque marker

Intervention Type OTHER

On the morning of the first, second and third day after surgery patients will take 1 capsule each day with radiopaque markers .

On day 4 after surgery an abdominal X-ray will be performed to localize the markers.

Each gelatin capsule contains 10 markers consisting of polyurethane encapsulated barium sulfate (40%).

Caffeine (200 mg)

Verum 2 with 200 mg caffeine

Group Type EXPERIMENTAL

Caffeine (200 mg)

Intervention Type DRUG

Patients after laparoscopic colectomy will receive 3 times daily capsules with 200 mg caffeine together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Radiopaque marker

Intervention Type OTHER

On the morning of the first, second and third day after surgery patients will take 1 capsule each day with radiopaque markers .

On day 4 after surgery an abdominal X-ray will be performed to localize the markers.

Each gelatin capsule contains 10 markers consisting of polyurethane encapsulated barium sulfate (40%).

corn starch (250 mg approx.)

approx. 250 mg corn starch as placebo

Group Type PLACEBO_COMPARATOR

corn starch (250 mg approx.)

Intervention Type DRUG

Patients after laparoscopic colectomy will receive 3 times daily capsules with 250 mg corn starch together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Radiopaque marker

Intervention Type OTHER

On the morning of the first, second and third day after surgery patients will take 1 capsule each day with radiopaque markers .

On day 4 after surgery an abdominal X-ray will be performed to localize the markers.

Each gelatin capsule contains 10 markers consisting of polyurethane encapsulated barium sulfate (40%).

Interventions

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Caffeine (100 mg)

Patients after laparoscopic colectomy will receive 3 times daily capsules with 100 mg caffeine together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Intervention Type DRUG

Caffeine (200 mg)

Patients after laparoscopic colectomy will receive 3 times daily capsules with 200 mg caffeine together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Intervention Type DRUG

corn starch (250 mg approx.)

Patients after laparoscopic colectomy will receive 3 times daily capsules with 250 mg corn starch together with the meals.

First capsule will be taken on the evening of surgery if surgery was completed before 1 pm, otherwise the first capsule will be taken on the morning of the next day.

Treatment consists of 10 capsules and will be stopped after the first solid bowel movement.

Intervention Type DRUG

Radiopaque marker

On the morning of the first, second and third day after surgery patients will take 1 capsule each day with radiopaque markers .

On day 4 after surgery an abdominal X-ray will be performed to localize the markers.

Each gelatin capsule contains 10 markers consisting of polyurethane encapsulated barium sulfate (40%).

Intervention Type OTHER

Other Intervention Names

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coffeinum methyltheobromine 1,3,7-trimethyl-3,7-dihydro-1H-purin-2,4-dion CAS No: 56-08-2 Ph.Eur: 6.0/027 ATC code: N06BC01 coffeinum methyltheobromine 1,3,7-trimethyl-3,7-dihydro-1H-purin-2,4-dion CAS No: 56-08-2 Ph.Eur: 6.0/027 ATC code: N06BC01 Amylum maydis Colon Transit PZN 3351272 GTIN Code 7629999004153

Eligibility Criteria

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Inclusion Criteria

* Patients scheduled for elective laparoscopic colectomy (right or left hemicolectomy, segmental resection, extended hemicolectomy, sigmoid resection, upper rectum (anastomosis higher than 7 cm ab ano))
* There will be no upper age limit. If elderly patients are considered fit for surgery, they will be included in the study.
* Informed consent
* Application of epidural analgesia

Exclusion Criteria

* Participation in another concurrent interventional trial
* Need for a stoma (colostomy or ileostomy) or reversal of a stoma, if the patient had a complete bowel obstruction
* Known hypersensitivity or allergy to caffeine/coffee
* Expected lack of compliance
* American Society of Anesthesiologists (ASA) Physical Status Score of IV or V
* Impaired mental state or language problems
* Alcoholism or drug abuse
* Previous extensive abdominal surgery
* Inflammatory bowel disease
* Clinically significant cardiac arrhythmia
* Cardiac insufficiency
* Pregnancy, lactation, or childbearing potential without using adequate contraception
* Intake of opioid analgesics, or steroids \>5mg/d for ≥7 days before surgery
* Under anti-depressive medication
* Liver cirrhosis or compromised liver function (MELD score \>15)
* Emergency procedure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gottfried und Julia Bangerter- Rhyner-Stiftung, Basel

OTHER

Sponsor Role collaborator

Thomas Steffen

OTHER

Sponsor Role lead

Responsible Party

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Thomas Steffen

Deputy head of department

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Thomas Steffen, MD

Role: PRINCIPAL_INVESTIGATOR

Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen

Locations

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Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen

Rorschach, , Switzerland

Site Status

Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen

Sankt Gallen, , Switzerland

Site Status

Countries

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Switzerland

References

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Muller SA, Rahbari NN, Schneider F, Warschkow R, Simon T, von Frankenberg M, Bork U, Weitz J, Schmied BM, Buchler MW. Randomized clinical trial on the effect of coffee on postoperative ileus following elective colectomy. Br J Surg. 2012 Nov;99(11):1530-8. doi: 10.1002/bjs.8885. Epub 2012 Sep 14.

Reference Type BACKGROUND
PMID: 22987303 (View on PubMed)

Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology. 1987 Jan;92(1):40-7. doi: 10.1016/0016-5085(87)90837-7.

Reference Type BACKGROUND
PMID: 3023168 (View on PubMed)

Hobi V, Gerhard U, Gutzwiller F. [A report on experiences using Goldberg's GHQ (General Health Questionnaire)]. Schweiz Rundsch Med Prax. 1989 Feb 28;78(9):219-25. German.

Reference Type BACKGROUND
PMID: 2928619 (View on PubMed)

Hobi V. Basler Befindlichkeits-Skala. Ein Self-Rating zur Verlaufsmessung der Befindlichkeit. Manual. 1 ed. Weinheim: Beltz Test GmbH, 1985.

Reference Type BACKGROUND

Parrott AC, Hindmarch I. The Leeds Sleep Evaluation Questionnaire in psychopharmacological investigations - a review. Psychopharmacology (Berl). 1980;71(2):173-9. doi: 10.1007/BF00434408.

Reference Type BACKGROUND
PMID: 6777817 (View on PubMed)

Abbassi F, Muller SA, Steffen T, Schmied BM, Warschkow R, Beutner U, Tarantino I. Caffeine for intestinal transit after laparoscopic colectomy: randomized clinical trial (CaCo trial). Br J Surg. 2022 Nov 22;109(12):1216-1223. doi: 10.1093/bjs/znac265.

Reference Type DERIVED
PMID: 35909263 (View on PubMed)

Kruse C, Muller SA, Warschkow R, Luthi C, Brunner W, Marti L, Sulz MC, Schmied BM, Tarantino I, Beutner U. Does caffeine reduce postoperative bowel paralysis after elective laparoscopic colectomy? (CaCo trial): study protocol for a randomized controlled trial. Trials. 2016 Apr 4;17:186. doi: 10.1186/s13063-016-1297-1.

Reference Type DERIVED
PMID: 27044596 (View on PubMed)

Related Links

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http://www.chirurgie.kssg.ch/

Web site of the Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen (German only)

Other Identifiers

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CaCo, Chir201401

Identifier Type: -

Identifier Source: org_study_id

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