Comparing Protocols for Analgesia Following Elective Cesarean Section

NCT ID: NCT03622489

Last Updated: 2018-08-09

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

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-01

Study Completion Date

2018-08-31

Brief Summary

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Women undergoing elective cesarian section will be assigned to 3 groups for postoperative analgesia:

1. Scheduled doses of IV acetaminophen + PO Ibuprofen
2. Scheduled doses of PO acetaminophen + PO Ibuprofen
3. "On demand" doses of acetaminophen, dipyrone and ibuprofen.

Detailed Description

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A prospective randomised trial. Women undergoing elective cesarean section will be randomized to three groups. The treatment will be given for 48 hours after surgery. For evealuating objective pain sensation the investigators will be using the Visual Numerical Score (VNS). Demographic characteristics and information about breastfeeding and medications' side effects, will be reviewed from patients' medical scores.

Exclusion criteria: known allergies to one or more of the studies' drugs, general anesthesia, woman undergoing her 3rd cesarean section or more, elective tubal ligation performed at the time of current cesarean section, contraindication for use of one or more of the studies' drugs.

Number of participants: 120

Treatment:

All women will receive immediately after surgery, in the recovery room:

1. IV morphin 5 mg, repeat doses every 10 minutes for VNS\>3
2. IV Tramal 100 mg, once

After Admitted to Mternity ward:

* 1st group will be receiving scheduled doses: 08:00 hr, Tab. Ibuprofen 400 mg, and IV Acetaminophen 1 gr 14:00 hr, IV Acetaminophen 1 gr 19:00 hr, Tab. Ibuprofen 400 mg 00:00 hr, IV Acetaminophen 1 gr
* 2nd group will be receiving scheduled doses: 08:00 hr, Tab. Ibuprofen 400 mg, and PO Acetaminophen 1 gr 14:00 hr, PO Acetaminophen 1 gr 19:00 hr, Tab. Ibuprofen 400 mg 00:00 hr, PO Acetaminophen 1 gr
* 1st+2nd group will be given additional analgesia if needed according to VNS scale: PO drops Dipyrone 1 gr, for VNS\>4, up to 4 times a day, at least 6 hours between doses.

Tab Tramadex 100 mg, for VNS\>6, or if pain persists for 1 hour after receiving Dipyrone, up to 3 times a day, at least 4 hours between doses.

\- 3rd group will not receive scheduled pain medication, but offered some only upon patients' request according to VNS score:

* Tab. Acetaminophen 1 gr, for VNS 1-3, up to 4 times a day, at east 6 hours between doses.
* PO drops Dipyrone 1 gr, for VNS 4-7, or if pain persists for 1 hour after receiving Acetaminophen, up to 4 times a day, at least 6 hours between doses.
* Tab Ibuprofen 400 mg, for VNS 8-10, or if pain persists for 1 hour after receiving Dipyrone, up to 3 times a day, at least 8 hours between doses.

Conditions

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Postoperative Pain Post-Cesarean Section

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Tab ibuprofen + IV acetaminophen

All women will receive immediately after surgery, in the recovery room:

1. IV morphin 5 mg, repeat doses every 10 minutes for VNS\>3
2. IV Tramal 100 mg, once

After Admitted to Maternity ward:

\- Scheduled doses: 08:00 hr, Tab. Ibuprofen 400 mg, and IV Acetaminophen 1 gr 14:00 hr, IV Acetaminophen 1 gr 19:00 hr, Tab. Ibuprofen 400 mg 00:00 hr, IV Acetaminophen 1 gr

-Additional analgesia if needed according to VNS scale: PO drops Dipyrone 1 gr, for VNS\>4, up to 4 times a day, at least 6 hours between doses.

Tab Tramadex 100 mg, for VNS\>6, or if pain persists for 1 hour after receiving Dipyrone, up to 3 times a day, at least 4 hours between doses.

Group Type EXPERIMENTAL

Acetaminophen

Intervention Type DRUG

mentioned above

Ibuprofen 400 mg

Intervention Type DRUG

mentioned above

Tramadol

Intervention Type DRUG

mentioned above

Morphine

Intervention Type DRUG

mentioned above

Tramal

Intervention Type DRUG

mentioned above

Tab Ibuprofen + Tab acetaminophen

All women will receive immediately after surgery, in the recovery room:

1. IV morphin 5 mg, repeat doses every 10 minutes for VNS\>3
2. IV Tramal 100 mg, once

After Admitted to Maternity ward:

\- Scheduled doses: 08:00 hr, Tab. Ibuprofen 400 mg, and PO Acetaminophen 1 gr 14:00 hr, PO Acetaminophen 1 gr 19:00 hr, Tab. Ibuprofen 400 mg 00:00 hr, PO Acetaminophen 1 gr

\- Additional analgesia if needed according to VNS scale: PO drops Dipyrone 1 gr, for VNS\>4, up to 4 times a day, at least 6 hours between doses.

Tab Tramadex 100 mg, for VNS\>6, or if pain persists for 1 hour after receiving Dipyrone, up to 3 times a day, at least 4 hours between doses.

Group Type EXPERIMENTAL

Acetaminophen

Intervention Type DRUG

mentioned above

Ibuprofen 400 mg

Intervention Type DRUG

mentioned above

Tramadol

Intervention Type DRUG

mentioned above

Morphine

Intervention Type DRUG

mentioned above

Tramal

Intervention Type DRUG

mentioned above

"On demand" analgesia

All women will receive immediately after surgery, in the recovery room:

1. IV morphin 5 mg, repeat doses every 10 minutes for VNS\>3
2. IV Tramal 100 mg, once

After Admitted to Mternity ward:

Will not receive scheduled pain medication, but offered some only upon patients' request according to VNS score:

* Tab. Acetaminophen 1 gr, for VNS 1-3, up to 4 times a day, at east 6 hours between doses.
* PO drops Dipyrone 1 gr, for VNS 4-7, or if pain persists for 1 hour after receiving Acetaminophen, up to 4 times a day, at least 6 hours between doses.
* Tab Ibuprofen 400 mg, for VNS 8-10, or if pain persists for 1 hour after receiving Dipyrone, up to 3 times a day, at least 8 hours between doses.

Group Type EXPERIMENTAL

Acetaminophen

Intervention Type DRUG

mentioned above

Ibuprofen 400 mg

Intervention Type DRUG

mentioned above

Dipyrone

Intervention Type DRUG

mentioned above

Tramadol

Intervention Type DRUG

mentioned above

Morphine

Intervention Type DRUG

mentioned above

Tramal

Intervention Type DRUG

mentioned above

Interventions

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Acetaminophen

mentioned above

Intervention Type DRUG

Ibuprofen 400 mg

mentioned above

Intervention Type DRUG

Dipyrone

mentioned above

Intervention Type DRUG

Tramadol

mentioned above

Intervention Type DRUG

Morphine

mentioned above

Intervention Type DRUG

Tramal

mentioned above

Intervention Type DRUG

Other Intervention Names

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Tramadex

Eligibility Criteria

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Inclusion Criteria

* Women undergoing elective cesarian section

Exclusion Criteria

* known allergies to one or more of the studies' drugs, general anesthesia, woman undergoing her 3rd cesarean section or more, elective tubal ligation performed at the time of current cesarean section, contraindication for use of one or more of the studies' drugs.
Minimum Eligible Age

20 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Wolfson Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michal Kovo, MD

Role: STUDY_CHAIR

Wolfson Medical Center

Locations

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Wolfson medical center

Holon, , Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Lotem Dafna, MD

Role: CONTACT

+972524205415

Facility Contacts

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Rinat Hirsh

Role: primary

+97235028346

References

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Dafna L, Herman HG, Ben-Zvi M, Bustan M, Sasson L, Bar J, Kovo M. Comparison of 3 protocols for analgesia control after cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol MFM. 2019 May;1(2):112-118. doi: 10.1016/j.ajogmf.2019.04.002. Epub 2019 Apr 8.

Reference Type DERIVED
PMID: 33345816 (View on PubMed)

Other Identifiers

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0022-17-WOMC

Identifier Type: -

Identifier Source: org_study_id

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