Preemptive Versus Preventive Antiemetic Treatment

NCT ID: NCT03023306

Last Updated: 2018-11-02

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

115 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-30

Study Completion Date

2020-11-30

Brief Summary

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Patients aged between 20 and 70 years, ASA physical status I-III, and scheduled for laparoscopic cholecystectomy under general anaesthesia will be enrolled in the study.

Patients will be randomized to the preemptive group to receive an antiemetic regime 1h before the start of surgery or to the intraoperative group to receive the same antiemetic drugs in the same doses intraoperatively, 30 min before the end of surgery.

In the operating room standard monitoring and a standardized anesthetic technique will be implemented in all patients. Nausea, vomiting, retching and PONV (cumulative) will be recorded at PACU, at 4h, 8h and 24h postoperatively. Pain scores assessed by NRS (numerical rating scale) will be recorded at the same time points. Also, when patients received fluids and solid food by mouth will be recorded.

Detailed Description

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Conditions

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Postoperative Nausea and Vomiting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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preemptive group

The preemptive group will receive the anti-emetic regimen i.v. (4 mg of ondansetron) 1h before the start of surgery. During surgery, 30 min before the end of operation, this group will receive i.v. 0.9% NaCl in equal volumes.The intervention consists of the different time points of antiemetic treatment, thus 1h before surgery vs intraopertively.

Intervention: Antiemetic treatment 1h before surgery

Group Type ACTIVE_COMPARATOR

Antiemetics perioperatively

Intervention Type OTHER

Preemptive group ondansetron 4 mg will be administered 1h before surgery Intraoperative group Ondansetron 4 mg will be administered intraoperatively

intraoperative group

The preventive group will receive i.v. 0.9% NaCl 1h before surgery and ondansetron 4 mg 30 min before the end of surgery at equal volumes.

Intervention: Antiemetic treatment intraoperatively

Group Type OTHER

Antiemetics perioperatively

Intervention Type OTHER

Preemptive group ondansetron 4 mg will be administered 1h before surgery Intraoperative group Ondansetron 4 mg will be administered intraoperatively

Interventions

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Antiemetics perioperatively

Preemptive group ondansetron 4 mg will be administered 1h before surgery Intraoperative group Ondansetron 4 mg will be administered intraoperatively

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ASA physical status I-III patients
* Surgical procedure: scheduled for laparoscopic cholecystectomy
* Type of anesthesia: general

Exclusion Criteria

* Antihistamines the last three days
* Antiemetic drugs the last three days
* Hiatus hernia
* reflux
* Gastrointestinal disease
* Pregnancy
* BMI \> 35
* parkinson
* known allergy to the drugs of the protocol
* epilepsy
Minimum Eligible Age

20 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Athens

OTHER

Sponsor Role lead

Responsible Party

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Argyro Fassoulaki

Professor Emeritus

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Aretaieio University Hospital

Athens, Attica, Greece

Site Status

Countries

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Greece

Central Contacts

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Argyro Fassoulaki, MD PhD DEAA

Role: CONTACT

306936701333

Chryssoula Staikou, MD, PhD, DESA

Role: CONTACT

00306932352742

Facility Contacts

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Argyro Fassoulaki, MD PhD DEAA

Role: primary

306936701333

Chryssoula Staikou, MD PhD DESA

Role: backup

00306932352742

References

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Odom-Forren J, Rayens MK, Gokun Y, Jalota L, Radke O, Hooper V, Wiggins AT, Apfel CC. The Relationship of Pain and Nausea in Postoperative Patients for 1 Week After Ambulatory Surgery. Clin J Pain. 2015 Oct;31(10):845-51. doi: 10.1097/AJP.0000000000000170.

Reference Type BACKGROUND
PMID: 25370136 (View on PubMed)

Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo-Deenadayalan S, Myles P, Nezat G, Philip BK, Tramer MR; Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014 Jan;118(1):85-113. doi: 10.1213/ANE.0000000000000002.

Reference Type BACKGROUND
PMID: 24356162 (View on PubMed)

Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, Zhang K, Cakmakkaya OS. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012 Nov;109(5):742-53. doi: 10.1093/bja/aes276. Epub 2012 Oct 3.

Reference Type BACKGROUND
PMID: 23035051 (View on PubMed)

Apfel CC, Meyer A, Orhan-Sungur M, Jalota L, Whelan RP, Jukar-Rao S. Supplemental intravenous crystalloids for the prevention of postoperative nausea and vomiting: quantitative review. Br J Anaesth. 2012 Jun;108(6):893-902. doi: 10.1093/bja/aes138.

Reference Type BACKGROUND
PMID: 22593126 (View on PubMed)

Wallden J, Flodin J, Hultin M. Validation of a prediction model for post-discharge nausea and vomiting after general anaesthesia in a cohort of Swedish ambulatory surgery patients. Eur J Anaesthesiol. 2016 Oct;33(10):743-9. doi: 10.1097/EJA.0000000000000473.

Reference Type BACKGROUND
PMID: 27270883 (View on PubMed)

Theodosopoulou P, Staikou C, Fassoulaki A. Preoperative versus intraoperative antiemetic strategies in patients undergoing laparoscopic cholecystectomy: A randomised double-blind study. Eur J Anaesthesiol. 2023 Oct 1;40(10):769-776. doi: 10.1097/EJA.0000000000001888. Epub 2023 Jul 19.

Reference Type DERIVED
PMID: 37466110 (View on PubMed)

Other Identifiers

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IRB No 65/19-06-18

Identifier Type: -

Identifier Source: org_study_id

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