Remifentanil and Fentanyl in Dental Surgery (REFEDS)

NCT ID: NCT02619032

Last Updated: 2015-12-02

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

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-10-31

Study Completion Date

2009-09-30

Brief Summary

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This study was a prospective comparative study. The purpose of this study was to investigate the hypothesis whether remifentanil compared to fentanyl can induce less inflammatory and stress response to the day-case dental surgery in Persons with special needs (PSN). Secondary aims were to investigate comparatively their effect on patients intraoperative hemodynamic response and postoperative analgesia.

Detailed Description

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The study included 46 adult patients with cognitive impairment who underwent day-case dental surgery under general anesthesia with propofol aiming to keep a BIS-values range between 40-45. Nasal tracheal intubation was performed in all patients while neuromuscular blockade was achieved by rocuronium 0.6 mg/kg iv and repetitive doses of rocuronium of 10 mg iv, if needed.

Patients were randomly allocated receive for intraoperative analgesia either fentanyl 50 μg iv bolus (group F, n=23) or continuous infusion of remifentanil 0.5-1 μg/kg/min (group R, n=23). Randomization was performed using using a computer-generated randomization schedule.

Intraoperatively, patients in both groups received IV granisetron 3 mg, methylprednisolone 125 mg and clindamycin 600 mg, while atropine 0.02 mg/kg and neostigmine (0.05 mg/kg) was administered to to reverse neuromuscular blockade. Intraoperative monitoring included non-invasive measurement of arterial blood pressure, electrocardiogram, pulse oxymetry, capnography and Bispectral Sedation Index (BIS®).

Postoperatively, patients remained under surveillance in the post-anesthesia care unit \[PACU\] for 3 h. Postoperative pain was assessed for the first 12 postoperative hours, at 30 min time-intervals for the first 3 hours, and every 3 hours thereafter by an independent observer, blinded to the study group, using the Wong-Baker faces pain rating scale (0-6). If pain scores were ≥3 a rescue dose of paracetamol 12.5 mg/kg iv was administered.

Inflammation markers and stress hormones \[cortisol, Tumor necrosis factor (TNF-a), substance-P, melatonin and β-endorphin\] were measured in each patient before induction of anesthesia, after tracheal intubation and at the end of operation.

Statistical Analysis was performed using Kolmogorov-Smirnov test, Student's unpaired t-test or Repeated Measures ANOVA with Holm's post-hoc analysis appropriately. A p value less than 0.05 was considered statistically significant.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Remifentanil

Drug: Remifentanil (Ultiva). Intraoperative intravenous infusion of remifentanil 0.5-1 μg/kg/min for up to 1 h.

Group Type ACTIVE_COMPARATOR

Remifentanil

Intervention Type DRUG

Intraoperative continuous infusion of remifenatanil. Remifentanil infusion was interrupted upon completion of surgical intervention.

Fentanyl

Intervention Type DRUG

Fentanyl 50 μg iv bolus at the induction of anesthesia and before the start of surgery.

Fentanyl

Drug: Fentanyl (FNT). Intraoperative administration of fentanyl given as one single bolus dose of 50 μg at the time of induction of anesthesia.

Group Type ACTIVE_COMPARATOR

Remifentanil

Intervention Type DRUG

Intraoperative continuous infusion of remifenatanil. Remifentanil infusion was interrupted upon completion of surgical intervention.

Fentanyl

Intervention Type DRUG

Fentanyl 50 μg iv bolus at the induction of anesthesia and before the start of surgery.

Interventions

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Remifentanil

Intraoperative continuous infusion of remifenatanil. Remifentanil infusion was interrupted upon completion of surgical intervention.

Intervention Type DRUG

Fentanyl

Fentanyl 50 μg iv bolus at the induction of anesthesia and before the start of surgery.

Intervention Type DRUG

Other Intervention Names

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Ultiva FNT

Eligibility Criteria

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Inclusion Criteria

* Patients with cognitive impairment
* of category II according to the American Society of Anesthesiology (ASA) classification
* scheduled for elective dental surgery with short duration

Exclusion Criteria

* Patients of more than category II of American Society of Anesthesiology (ASA) classification
* Prolonged duration of surgery (\>1 hour)
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asklepieion Voulas General Hospital

OTHER_GOV

Sponsor Role collaborator

Attikon Hospital

OTHER

Sponsor Role lead

Responsible Party

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Paraskevi Matsota

Assoc. Prof. of Anaesthesiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eirini A Sklika, Consultant

Role: PRINCIPAL_INVESTIGATOR

Asklepeion Voulas General Hospital

Locations

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2nd Department of Anesthesiology, Attikon University Hospital

Athens, Attica, Greece

Site Status

Countries

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Greece

Other Identifiers

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ATT968

Identifier Type: -

Identifier Source: org_study_id