Trial Outcomes & Findings for Gabapentin as an Adjunct to Paracervical Block for Perioperative Pain Management (NCT NCT02944656)

NCT ID: NCT02944656

Last Updated: 2019-08-08

Results Overview

The primary outcome measure is a pain score using a 100-mm visual analog scale (VAS) measured intraoperatively at time of evacuation. "No pain" is scored as 0 and "worst pain imaginable" is scored as 100.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

114 participants

Primary outcome timeframe

During the procedure on Study Day 1

Results posted on

2019-08-08

Participant Flow

Participants were recruited from the Atlanta Women's Center in Atlanta, Georgia. Enrollment began on December 8, 2016 and all study procedures concluded on June 26, 2018.

A total of 122 individuals were eligible and consented to participate in the study. Six withdrew prior to randomization and an additional 2 withdrew prior to beginning the study, resulting in 114 receiving the intervention.

Participant milestones

Participant milestones
Measure
Gabapentin Group
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Overall Study
STARTED
57
57
Overall Study
Completed Procedure Day
54
57
Overall Study
Completed Day 1 Follow up
47
47
Overall Study
COMPLETED
47
47
Overall Study
NOT COMPLETED
10
10

Reasons for withdrawal

Reasons for withdrawal
Measure
Gabapentin Group
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Overall Study
No longer eligible
3
0
Overall Study
Lost to Follow-up
7
10

Baseline Characteristics

Gabapentin as an Adjunct to Paracervical Block for Perioperative Pain Management

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Total
n=111 Participants
Total of all reporting groups
Age, Continuous
25.2 years
STANDARD_DEVIATION 5.5 • n=5 Participants
26.8 years
STANDARD_DEVIATION 5.5 • n=7 Participants
26.01 years
STANDARD_DEVIATION 5.52 • n=5 Participants
Sex: Female, Male
Female
54 Participants
n=5 Participants
57 Participants
n=7 Participants
111 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
51 Participants
n=5 Participants
55 Participants
n=7 Participants
106 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Black/African American
35 Participants
n=5 Participants
41 Participants
n=7 Participants
76 Participants
n=5 Participants
Race/Ethnicity, Customized
White/Caucasian
15 Participants
n=5 Participants
12 Participants
n=7 Participants
27 Participants
n=5 Participants
Race/Ethnicity, Customized
Mixed or multi-racial
0 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian/Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Don't know/Refused/Not Specified
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Region of Enrollment
United States
54 participants
n=5 Participants
57 participants
n=7 Participants
111 participants
n=5 Participants
Gestational age
60.1 days
STANDARD_DEVIATION 15.1 • n=5 Participants
62.5 days
STANDARD_DEVIATION 13.2 • n=7 Participants
61.3 days
STANDARD_DEVIATION 14.10 • n=5 Participants

PRIMARY outcome

Timeframe: During the procedure on Study Day 1

Population: Participants completing all assessments on the day of the procedure are included in this analysis.

The primary outcome measure is a pain score using a 100-mm visual analog scale (VAS) measured intraoperatively at time of evacuation. "No pain" is scored as 0 and "worst pain imaginable" is scored as 100.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Pain at Time of Uterine Evacuation
Aspiration
67.77 score on a scale
Standard Error 3.63
71.06 score on a scale
Standard Error 3.49
Pain at Time of Uterine Evacuation
Paracervical block
63.79 score on a scale
Standard Error 3.77
62.21 score on a scale
Standard Error 3.52
Pain at Time of Uterine Evacuation
Dilation
64.58 score on a scale
Standard Error 3.74
66.12 score on a scale
Standard Error 3.54

SECONDARY outcome

Timeframe: Pre-procedure through post-procedure on Study Day 1

Population: Participants completing all assessments on the day of the procedure are included in this analysis.

Pain level at a variety of time points will be measured using a 100-mm visual analog scale (VAS) to log the change in pain levels between the study arms. "No pain" is scored as 0 and "worst pain imaginable" is scored as 100. Pain will be assessed immediately prior to the procedure, at completion of the procedure (removal of the speculum), 10 minutes following the procedure, and 30 minutes following the procedure (at discharge).

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Perioperative Pain Level
10 minutes post-procedure
30.64 score on a scale
Standard Error 3.65
43.68 score on a scale
Standard Error 3.47
Perioperative Pain Level
Prior to procedure
20.76 score on a scale
Standard Error 3.60
22.48 score on a scale
Standard Error 3.49
Perioperative Pain Level
Speculum removal
44.10 score on a scale
Standard Error 3.60
47.61 score on a scale
Standard Error 3.52
Perioperative Pain Level
30 minutes post-procedure
20.89 score on a scale
Standard Error 3.68
31.65 score on a scale
Standard Error 3.54

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

The number of participants reporting filling and using the prescription for ibuprofen postoperatively. During the follow-up phone call on the day after the procedure, participants were asked whether or not they filled the pain medication prescription and if they took any of the medication.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Number of Participants Using Pain Medication
24 Participants
27 Participants

SECONDARY outcome

Timeframe: Pre-procedure through post-procedure on Study Day 1

Population: Participants completing all assessments on the day of the procedure are included in this analysis.

Nausea level was measured using a 100-mm visual analog scale (VAS) to log the change in nausea levels between the study arms. No nausea is reported as 0 while "worst nausea I have ever felt" is reported at 100. Nausea was reported immediately prior to the procedure, 10 minutes following the procedure, and 30 minutes following the procedure.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Perioperative Nausea
Prior to procedure
26 score on a scale
Interval 3.0 to 57.0
26 score on a scale
Interval 9.0 to 59.0
Perioperative Nausea
10 minutes post-procedure
1 score on a scale
Interval 0.0 to 22.0
12 score on a scale
Interval 0.0 to 52.0
Perioperative Nausea
30 minutes post-procedure
0 score on a scale
Interval 0.0 to 16.0
5 score on a scale
Interval 0.0 to 26.0

SECONDARY outcome

Timeframe: Pre-procedure through post-procedure on Study Day 1

Population: Participants completing all assessments on the day of the procedure are included in this analysis.

Participants reported if they vomited during the perioperative period to assess changes in vomiting incidences between the study arms. Vomiting is reported for the time periods of immediately prior to the procedure, 10 minutes following the procedure, and 30 minutes following the procedure.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Perioperative Vomiting
Prior to procedure
4 Participants
7 Participants
Perioperative Vomiting
10 minutes post-procedure
5 Participants
2 Participants
Perioperative Vomiting
30 minutes post-procedure
5 Participants
5 Participants

SECONDARY outcome

Timeframe: Pre-procedure through post-procedure on Study Day 1

Population: Participants completing all assessments on the day of the procedure are included in this analysis.

Participants reported how much anxiety they were currently experiencing on a 100-point scale where "No Anxiety" is scored as 0 and "Extremely Anxious" is scored as 100. Anxiety is reported for the time periods of immediately prior to the procedure, 10 minutes after the procedure, and 30 minutes after the procedure.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=54 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Anxiety Levels
Prior to procedure
66 score on a scale
Interval 21.0 to 83.0
72 score on a scale
Interval 52.0 to 96.5
Anxiety Levels
10 minutes post-procedure
14 score on a scale
Interval 0.0 to 36.0
17 score on a scale
Interval 0.0 to 49.0
Anxiety Levels
30 minutes post-procedure
4 score on a scale
Interval 0.0 to 29.0
2 score on a scale
Interval 0.0 to 27.0

SECONDARY outcome

Timeframe: 10 and 30 minutes post procedure on Study Day 1

Population: This analysis includes participants responding to the side effects questions. Two did not answer any questions. Two participants in the gabapentin group did not complete the side effect assessment at 30 minutes post-procedure. One participant in the placebo group did not respond to the assessment of weakness at 30 minutes post-procedure.

Participants were asked if they experienced dizziness, lack of muscle control, sleepiness or drowsiness, weakness or lack of energy, headache, or visual changes.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=53 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=56 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Side Effects
Dizziness 10 minutes post-procedure
27 Participants
23 Participants
Side Effects
Dizziness 30 minutes post-procedure
19 Participants
15 Participants
Side Effects
Lack of muscle control 10 minutes post-procedure
9 Participants
9 Participants
Side Effects
Lack of muscle control 30 minutes post-procedure
5 Participants
10 Participants
Side Effects
Sleepiness/drowsiness 10 minutes post-procedure
38 Participants
34 Participants
Side Effects
Sleepiness/drowsiness 30 minutes post-procedure
30 Participants
29 Participants
Side Effects
Weakness 10 minutes post-procedure
33 Participants
34 Participants
Side Effects
Weakness 30 minutes post-procedure
20 Participants
28 Participants
Side Effects
Headache 10 minutes post-procedure
5 Participants
4 Participants
Side Effects
Headache 30 minutes post-procedure
4 Participants
4 Participants
Side Effects
Vision changes 10 minutes post-procedure
9 Participants
11 Participants
Side Effects
Vision changes 30 minutes post-procedure
3 Participants
5 Participants

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

During the Postoperative Day 1 phone call, participants self reported how much they experienced moderate pain in the last 24 hours where 10 = none of the time and 0 = all of the time. "Moderate pain" was defined according to the perception of each participant.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Moderate Pain at Postoperation Follow-up Assessment
5.2 units on a scale
Standard Deviation 3.5
5.2 units on a scale
Standard Deviation 3.4

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

During the Postoperative Day 1 phone call, participants self reported how much they experienced severe pain in the last 24 hours where 10 = none of the time and 0 = all of the time. "Severe pain" was defined according to the perception of each participant.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Severe Pain at Postoperation Follow-up Assessment
3.5 units on a scale
Standard Deviation 4.1
3.2 units on a scale
Standard Deviation 4.1

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

During the Postoperative Day 1 phone call, participants self reported how much they experienced nausea or vomiting in the last 24 hours where 10 = none of the time and 0 = all of the time. Nausea and vomiting were self-reported together as a single outcome.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Nausea or Vomiting at Postoperation Follow-up Assessment
2.3 units on a scale
Standard Deviation 3.9
3.2 units on a scale
Standard Deviation 4.1

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

During the Postoperative Day 1 phone call, participants self reported whether or not they had vomited since leaving the clinic.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Vomiting Since Leaving Clinic
Vomiting at least once
1 Participants
2 Participants
Vomiting Since Leaving Clinic
No vomiting
46 Participants
45 Participants

SECONDARY outcome

Timeframe: Postoperative Day 1

Population: Participants completing the follow up assessment one day after the procedure are included in this analysis.

Overall satisfaction with the procedure was assessed on a 10-point scale on the day after the procedure, where 1 = very dissatisfied and 10 = very satisfied.

Outcome measures

Outcome measures
Measure
Gabapentin Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=47 Participants
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
Overall Satisfaction With the Procedure
1 (very dissatisfied)
0 Participants
1 Participants
Overall Satisfaction With the Procedure
2
0 Participants
0 Participants
Overall Satisfaction With the Procedure
3
0 Participants
2 Participants
Overall Satisfaction With the Procedure
4
0 Participants
2 Participants
Overall Satisfaction With the Procedure
5
5 Participants
4 Participants
Overall Satisfaction With the Procedure
6
0 Participants
1 Participants
Overall Satisfaction With the Procedure
7
4 Participants
2 Participants
Overall Satisfaction With the Procedure
8
15 Participants
7 Participants
Overall Satisfaction With the Procedure
9
5 Participants
11 Participants
Overall Satisfaction With the Procedure
10 (very satisfied)
18 Participants
17 Participants

Adverse Events

Gabapentin Group

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Placebo Group

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Gabapentin Group
n=54 participants at risk
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of gabapentin 1-2 hours prior to the procedure.
Placebo Group
n=57 participants at risk
Participants receiving local anesthesia per clinic protocol plus two 300mg capsules of a placebo to match gabapentin 1-2 hours prior to the procedure.
General disorders
Low Blood Pressure
1.9%
1/54 • Data on adverse events were collected from the time of investigational medication administration through the follow up phone call on the day after the procedure.
In addition to specific side effects collected as an outcome measure, adverse effects were tracked and monitored during the study. An adverse event is defined as any health-related reaction, effect, toxicity or abnormal laboratory result experienced during the course of the study, irrespective of relationship to the study intervention.
0.00%
0/57 • Data on adverse events were collected from the time of investigational medication administration through the follow up phone call on the day after the procedure.
In addition to specific side effects collected as an outcome measure, adverse effects were tracked and monitored during the study. An adverse event is defined as any health-related reaction, effect, toxicity or abnormal laboratory result experienced during the course of the study, irrespective of relationship to the study intervention.
Gastrointestinal disorders
Increased nausea and vomiting
0.00%
0/54 • Data on adverse events were collected from the time of investigational medication administration through the follow up phone call on the day after the procedure.
In addition to specific side effects collected as an outcome measure, adverse effects were tracked and monitored during the study. An adverse event is defined as any health-related reaction, effect, toxicity or abnormal laboratory result experienced during the course of the study, irrespective of relationship to the study intervention.
1.8%
1/57 • Data on adverse events were collected from the time of investigational medication administration through the follow up phone call on the day after the procedure.
In addition to specific side effects collected as an outcome measure, adverse effects were tracked and monitored during the study. An adverse event is defined as any health-related reaction, effect, toxicity or abnormal laboratory result experienced during the course of the study, irrespective of relationship to the study intervention.

Additional Information

Tiffany Hailstorks, MD, MPH

Emory University

Phone: 404-778-1385

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place