The cryoICE™ CryoAnalgesia Study For Pain Management in Post thoRacic Procedures Via intercOSTal Cryoanalgesia (FROST)

NCT ID: NCT02922153

Last Updated: 2020-09-04

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-13

Study Completion Date

2019-08-28

Brief Summary

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The investigators propose to assess whether intra-operative intercostal cryoanalgesia using the cryoICE® probe (AtriCure®, Inc., 7555 Innovation Way, Mason, Ohio) provides superior post-operative analgesic efficacy as compared to current pain management in patients undergoing unilateral thoracotomy cardiac procedures.

Detailed Description

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Completion of the proposed study will for the first time demonstrate efficacy of intercostal cryoanalgesia in patients undergoing minimally invasive cardiac procedures. Furthermore, results of this study may have a pivotal role in supporting future clinical outcome trials for intercostal cryoanalgesia therapy.

Conditions

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Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Cryoanalgesia + Standard of Care (SOC)

Cryoanalgesia in Conjunction with Standard of Care. Up to 5 sessions of cryoanalgesia for 120 seconds per session.

Group Type EXPERIMENTAL

Cryoanalgesia

Intervention Type DEVICE

AtriCure® cryoICE cryo-ablation system

Standard of Care

Intervention Type DRUG

Institutional SOC for pain management will be followed.

Standard of Care

Institutional SOC for pain management will be followed. The use of local post-operative pain management techniques (i.e., intercostal, peri-vertebral, or any other acceptable method) is permitted for both treatment groups up to 24 hours post-operatively according to institutional standard of care.

Group Type ACTIVE_COMPARATOR

Standard of Care

Intervention Type DRUG

Institutional SOC for pain management will be followed.

Interventions

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Cryoanalgesia

AtriCure® cryoICE cryo-ablation system

Intervention Type DEVICE

Standard of Care

Institutional SOC for pain management will be followed.

Intervention Type DRUG

Other Intervention Names

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cryoICE SOC

Eligibility Criteria

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Inclusion Criteria

* Age 18 - 85 years male or female
* Patients undergoing unilateral thoracotomy cardiac procedures (with the exception of Aortic Aneurysm repair as sole treatment)
* Acceptable surgical candidate, including use of general anesthesia
* Willing and able to provide written informed consent
* Willing and able to return for scheduled follow-up visits

Exclusion Criteria

* Cardiac valve surgical procedure via conventional full sternotomy
* Procedures that require a posterolateral thoracotomy
* Current pregnancy
* Current use of prescription opioids
* FEV1 \< 40% predicted
* Documented myocardial infarction within 30 days of signing Informed Consent Form (ICF)
* Documented psychiatric disease
* Documented chronic pain syndrome
* Documented history of substance abuse
* Patient currently enrolled in another research study that could directly affect results of either study
* Physical or mental condition that would interfere with patient's self-assessment of pain
* Disqualifying medical condition per investigator
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AtriCure, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wei Lau, MD

Role: PRINCIPAL_INVESTIGATOR

William Beaumont Hospitals

Locations

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University of Southern California (USC)

Los Angeles, California, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

William Beaumont Hospital

Royal Oak, Michigan, United States

Site Status

United Heart and Vascular Institute - Allina

Saint Paul, Minnesota, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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Sepsas E, Misthos P, Anagnostopulu M, Toparlaki O, Voyagis G, Kakaris S. The role of intercostal cryoanalgesia in post-thoracotomy analgesia. Interact Cardiovasc Thorac Surg. 2013 Jun;16(6):814-8. doi: 10.1093/icvts/ivs516. Epub 2013 Feb 19.

Reference Type BACKGROUND
PMID: 23424242 (View on PubMed)

Moorjani N, Zhao F, Tian Y, Liang C, Kaluba J, Maiwand MO. Effects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostal nerves: a human prospective randomized trial and a histological study. Eur J Cardiothorac Surg. 2001 Sep;20(3):502-7. doi: 10.1016/s1010-7940(01)00815-6.

Reference Type BACKGROUND
PMID: 11509270 (View on PubMed)

Glauber M, Karimov JH, Farneti PA, Cerillo AG, Santarelli F, Ferrarini M, Del Sarto P, Murzi M, Solinas M. Minimally invasive mitral valve surgery via right minithoracotomy. Multimed Man Cardiothorac Surg. 2009 Jan 1;2009(122):mmcts.2008.003350. doi: 10.1510/mmcts.2008.003350.

Reference Type BACKGROUND
PMID: 24415737 (View on PubMed)

Loan WB, Dundee JW. The clinical assessment of pain. Practitioner. 1967 Jun;198(188):759-68. No abstract available.

Reference Type BACKGROUND
PMID: 4859864 (View on PubMed)

PAPPER EM, BRODIE BB, ROVENSTINE EA. Postoperative pain; its use in the comparative evaluation of analgesics. Surgery. 1952 Jul;32(1):107-9. No abstract available.

Reference Type BACKGROUND
PMID: 14950594 (View on PubMed)

Katz J. Cryoanalgesia for postthoracotomy pain. Ann Thorac Surg. 1989 Jul;48(1):5. doi: 10.1016/0003-4975(89)90166-5. No abstract available.

Reference Type BACKGROUND
PMID: 2764599 (View on PubMed)

Cook TM, Riley RH. Analgesia following thoracotomy: a survey of Australian practice. Anaesth Intensive Care. 1997 Oct;25(5):520-4.

Reference Type BACKGROUND
PMID: 9352765 (View on PubMed)

SIMPSON BR, PARKHOUSE J, MARSHALL R, LAMBRECHTS W. Extradural analgesia and the prevention of postoperative respiratory complications. Br J Anaesth. 1961 Dec;33:628-41. doi: 10.1093/bja/33.12.628. No abstract available.

Reference Type BACKGROUND
PMID: 13913200 (View on PubMed)

Maiwand MO, Makey AR, Rees A. Cryoanalgesia after thoracotomy. Improvement of technique and review of 600 cases. J Thorac Cardiovasc Surg. 1986 Aug;92(2):291-5.

Reference Type BACKGROUND
PMID: 3736085 (View on PubMed)

Gough JD, Williams AB, Vaughan RS, Khalil JF, Butchart EG. The control of post-thoracotomy pain. A comparative evaluation of thoracic epidural fentanyl infusions and cryo-analgesia. Anaesthesia. 1988 Sep;43(9):780-3. doi: 10.1111/j.1365-2044.1988.tb05757.x.

Reference Type BACKGROUND
PMID: 3255292 (View on PubMed)

Gwak MS, Yang M, Hahm TS, Cho HS, Cho CH, Song JG. Effect of cryoanalgesia combined with intravenous continuous analgesia in thoracotomy patients. J Korean Med Sci. 2004 Feb;19(1):74-8. doi: 10.3346/jkms.2004.19.1.74.

Reference Type BACKGROUND
PMID: 14966345 (View on PubMed)

Lau WC, Shannon FL, Bolling SF, Romano MA, Sakwa MP, Trescot A, Shi L, Johnson RL, Starnes VA, Grehan JF. Intercostal Cryo Nerve Block in Minimally Invasive Cardiac Surgery: The Prospective Randomized FROST Trial. Pain Ther. 2021 Dec;10(2):1579-1592. doi: 10.1007/s40122-021-00318-0. Epub 2021 Sep 20.

Reference Type DERIVED
PMID: 34545530 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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CP2015-4

Identifier Type: -

Identifier Source: org_study_id

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