Does IVPCA Increase Opioid Consumption and Side Effects in Fast Track Orthopedic Procedures?

NCT ID: NCT02880800

Last Updated: 2016-08-26

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

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2017-08-31

Brief Summary

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The study aims to compare the use of intravenous patient controlled analgesia (IVPCA) versus the delivery of pain relief (per oral and intravenous (IV) medications as rescues analgesia) on an as needed basis within a well defined fast track protocol that includes multimodal analgesia for patients who are undergoing elective primary knee replacement surgery. The investigators assumed that with the multimodal analgesia regimen without the use of IVPCA will demonstrate decreased consumption of postoperative opioids, reduced incidence of opioids related side effects and decreased length of stay in the hospital.

Detailed Description

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Conditions

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Pain, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Analgesia, patient controlled

Patients will be given a patient controlled analgesia (PCA) pump containing a standard solution of either morphine or hydromorphone.

Group Type EXPERIMENTAL

Morphine as IVPCA

Intervention Type DRUG

Morphine as IVPCA: Patients will be given a patient controlled analgesia (PCA) pump containing a standard solution of morphine as below:

Morphine bolus 1mg with a lockout interval of 5 minutes, no background infusion and maximum 30 mg in 4 hours

Hydromorphone as IVPCA

Intervention Type DRUG

Hydromorphone as IVPCA: Patients will be given a patient controlled analgesia (PCA) pump containing a standard solution of Hydromorphone as below:

Hydromorphone bolus 0.2 mg with a lockout interval of 5 minutes and a maximum dose of 6 mg in 4 hours.

Analgesia, as per needed

Patients will receive intravenous (IV) opioids as per needed.

Group Type ACTIVE_COMPARATOR

Morphine

Intervention Type DRUG

IV opioids: Morphine 2 to 5 mg every 1h PRN (max. 20 mg/4h)

Hydromorphone

Intervention Type DRUG

Hydromorphone 0.5 - 1 mg every 1h PRN (max. 4 mg/4h)

Interventions

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Morphine as IVPCA

Morphine as IVPCA: Patients will be given a patient controlled analgesia (PCA) pump containing a standard solution of morphine as below:

Morphine bolus 1mg with a lockout interval of 5 minutes, no background infusion and maximum 30 mg in 4 hours

Intervention Type DRUG

Hydromorphone as IVPCA

Hydromorphone as IVPCA: Patients will be given a patient controlled analgesia (PCA) pump containing a standard solution of Hydromorphone as below:

Hydromorphone bolus 0.2 mg with a lockout interval of 5 minutes and a maximum dose of 6 mg in 4 hours.

Intervention Type DRUG

Morphine

IV opioids: Morphine 2 to 5 mg every 1h PRN (max. 20 mg/4h)

Intervention Type DRUG

Hydromorphone

Hydromorphone 0.5 - 1 mg every 1h PRN (max. 4 mg/4h)

Intervention Type DRUG

Other Intervention Names

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Morphine Dilaudid Dilaudid

Eligibility Criteria

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Inclusion Criteria

* Male or female patients aged 18 to 80 years old
* Provision of written informed consent
* Patients scheduled to undergo primary knee surgery included in the fast track protocol under regional anesthesia only
* Patients with Body Mass Index (BMI) between 18 to 34.9
* Patients with American Society of Anesthesiologists (ASA) physical status classification of 1 to 3

Exclusion Criteria

* Patients on chronic (more than twice a week) opioid treatment including Tylenol #3, percocet, morphine, methadone, hydromorphone, fentanyl patch and other potent opioids
* Patients with language barrier or difficulty in communication in English
* Patients who are allergic to morphine and hydromorphone, fentanyl, gabapentin, celecoxib or acetaminophen
* Patients with increased risk for respiratory depression with intrathecal morphine (OSA, central apnea)
* Patients with documented Renal or hepatic impairment
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Mount Sinai Hospital, Canada

OTHER

Sponsor Role lead

Responsible Party

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Naveed Siddiqui

Assistant professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Mount Sinai Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Facility Contacts

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Naveed Siddiqui

Role: primary

416-586-5270

Other Identifiers

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16-0098-A

Identifier Type: -

Identifier Source: org_study_id

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