Anesthesia and Postoperative Outcome in Colorectal Cancer Patients

NCT ID: NCT02786329

Last Updated: 2022-01-20

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

UNKNOWN

Clinical Phase

EARLY_PHASE1

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2022-12-31

Brief Summary

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Study aims to compare the influence of TIVA and sevoflurane anesthesia with or without lidocaine on postoperative short and long term outcome in patients with colorectal cancer undergoing surgery.

As short term endpoints postoperative pain and opioid consumption, resumption of bowel function, PONV, LOS will be registered.

Long term outcome parameters include: the incidence of chronic pain, 1 and 5 years cancer recurrences incidence and mortality.

Detailed Description

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Main goals

1. Comparative evaluation of the incidence of recurrences after TIVA vs sevoflurane anesthesia
2. Evaluation of the effect of lidocaine infusion associated with TIVA/sevoflurane on the incidence of chronic pain and of cancer recurrences and survival.

Secondary objectives

1. Evaluation of the influence of lidocaine on postoperative outcome in patients with colorectal cancer
2. Evaluation of the influence of lidocaine on postoperative inflammatory response
3. Evaluation of the influence of lidocaine on the incidence and severity of postoperative pain and outcome in patients with colorectal cancer

Conditions

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Colorectal Cancer

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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TIVA + lidocaine

TIVA-L. Patients allocated to receive TIVA (propofol-fentanyl) with lidocaine infusion.

Interventions: TIVA+lidocaine

Group Type ACTIVE_COMPARATOR

TIVA+lidocaine

Intervention Type DRUG

Patients will be subjected to total intravenous anesthesia with propofol-fentanyl+i.v. lidocaine infusion for the first 48 h postoperatively

TIVA+placebo

TIVA-P. Patients allocated to receive TIVA without lidocaine (placebo). Intervention: TIVA+placebo (saline infusion)

Group Type PLACEBO_COMPARATOR

TIVA+placebo

Intervention Type DRUG

Patients will be subjected to TIVA with propofol-fentanyl + saline infusion for the first 48 h postoperatively

Sevoflurane+placebo

Sevo-P. Patients allocated to receive Sevoflurane anesthesia without lidocaine infusion (placebo).

Intervention: sevoflurane anesthesia +placebo (saline infusion)

Group Type PLACEBO_COMPARATOR

Sevoflurane+placebo

Intervention Type DRUG

Patients will be subjected to anesthesia with sevoflurane-fentanyl + saline infusion for the first 48 h postoperatively

Sevoflurane+lidocaine

Sevo-L. Patients allocated to receive sevoflurane anesthesia with lidocaine infusion for the first 48 h postoperatively.

Intervention: sevoflurane anesthesia+ lidocaine infusion

Group Type ACTIVE_COMPARATOR

Sevoflurane+lidocaine

Intervention Type DRUG

Patients will be subjected to anesthesia with sevoflurane- fentanyl + lidocaine infusion for the first 48 h postoperatively.

Interventions

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TIVA+lidocaine

Patients will be subjected to total intravenous anesthesia with propofol-fentanyl+i.v. lidocaine infusion for the first 48 h postoperatively

Intervention Type DRUG

Sevoflurane+lidocaine

Patients will be subjected to anesthesia with sevoflurane- fentanyl + lidocaine infusion for the first 48 h postoperatively.

Intervention Type DRUG

TIVA+placebo

Patients will be subjected to TIVA with propofol-fentanyl + saline infusion for the first 48 h postoperatively

Intervention Type DRUG

Sevoflurane+placebo

Patients will be subjected to anesthesia with sevoflurane-fentanyl + saline infusion for the first 48 h postoperatively

Intervention Type DRUG

Other Intervention Names

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TIVA-L Sevo-L TIVA-P Sevo-P

Eligibility Criteria

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Inclusion Criteria

* Elective surgery

Exclusion Criteria

* • persistent chronic pain

* chronic medication that may interfere with pain: antiepileptics, NSAID, corticoids
* Contraindications for any of the study medications
* Significant psychiatric disorders (Axa I) (major depression, bipolar disorders, schizophrenia, etc.)
* Significant hepatic (ALAT and/or ASAT \> 2 normal values) or renal (plasma creatinine \> 2 mg/dl) disorders
* Convulsive disorders requiring medication during the last 2 years
* Planned regional analgesia/anesthesia (spinal or epidural)
* Corticoid dependent asthma
* Autoimmune disorders
* Anti-arrhythmic medication (verapamil, propafenone, amiodarone) that may interfere with lidocaine's anti-arrhythmic effects
* Refusal for study participation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Prof. Dr. I. Chiricuta Institute of Oncology

OTHER

Sponsor Role collaborator

Institutul Regional de Gastroenterologie & Hepatologie Prof. dr. Octavian Fodor

OTHER

Sponsor Role lead

Responsible Party

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Prof.Dr.Daniela Ionescu

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniela Ionescu, Prof

Role: PRINCIPAL_INVESTIGATOR

Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca

Alexandru Alexa, Assist Prof

Role: PRINCIPAL_INVESTIGATOR

Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca

Locations

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Clinica ATI, str Croitorilor nr 19-21

Cluj-Napoca, Cluj, Romania

Site Status RECRUITING

Institutul Oncologic Prof Dr Ion Chiricuta

Cluj-Napoca, Cluj, Romania

Site Status RECRUITING

Countries

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Romania

Central Contacts

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Daniela IONESCU, Prof

Role: CONTACT

+40744771209

Alexandru Alexa, Assist Prof

Role: CONTACT

+40752691911

Facility Contacts

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Daniela Ionescu, Prof

Role: primary

+40744771209

Alexa Alexandru, Assit Prof

Role: backup

+40752691911

Tiberiu Tat, doctor

Role: primary

References

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Fodale V, D'Arrigo MG, Triolo S, Mondello S, La Torre D. Anesthetic techniques and cancer recurrence after surgery. ScientificWorldJournal. 2014 Feb 6;2014:328513. doi: 10.1155/2014/328513. eCollection 2014.

Reference Type BACKGROUND
PMID: 24683330 (View on PubMed)

Heaney A, Buggy DJ. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth. 2012 Dec;109 Suppl 1:i17-i28. doi: 10.1093/bja/aes421.

Reference Type BACKGROUND
PMID: 23242747 (View on PubMed)

Mao L, Lin S, Lin J. The effects of anesthetics on tumor progression. Int J Physiol Pathophysiol Pharmacol. 2013;5(1):1-10. Epub 2013 Mar 8.

Reference Type BACKGROUND
PMID: 23525301 (View on PubMed)

Cakmakkaya OS, Kolodzie K, Apfel CC, Pace NL. Anaesthetic techniques for risk of malignant tumour recurrence. Cochrane Database Syst Rev. 2014 Nov 7;2014(11):CD008877. doi: 10.1002/14651858.CD008877.pub2.

Reference Type BACKGROUND
PMID: 25379840 (View on PubMed)

Cassinello F, Prieto I, del Olmo M, Rivas S, Strichartz GR. Cancer surgery: how may anesthesia influence outcome? J Clin Anesth. 2015 May;27(3):262-72. doi: 10.1016/j.jclinane.2015.02.007. Epub 2015 Mar 11.

Reference Type BACKGROUND
PMID: 25769963 (View on PubMed)

Divatia JV, Ambulkar R. Anesthesia and cancer recurrence: What is the evidence? J Anaesthesiol Clin Pharmacol. 2014 Apr;30(2):147-50. doi: 10.4103/0970-9185.129990. No abstract available.

Reference Type BACKGROUND
PMID: 24803747 (View on PubMed)

Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, Joris JL. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007 Jan;106(1):11-8; discussion 5-6. doi: 10.1097/00000542-200701000-00007.

Reference Type RESULT
PMID: 17197840 (View on PubMed)

McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs. 2010 Jun 18;70(9):1149-63. doi: 10.2165/10898560-000000000-00000.

Reference Type RESULT
PMID: 20518581 (View on PubMed)

Alexa AL, Tat TF, Ionescu D. The influence of TIVA or inhalation anesthesia with or without intravenous lidocaine on postoperative outcome in colorectal cancer surgery: a study protocol for a prospective clinical study. Trials. 2022 Mar 18;23(1):219. doi: 10.1186/s13063-022-06157-4.

Reference Type DERIVED
PMID: 35303929 (View on PubMed)

Other Identifiers

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53/14.03.2016

Identifier Type: -

Identifier Source: org_study_id

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