Trial Outcomes & Findings for Intravenous Paracetamol in Combination With Caudal Ropivacaine (NCT NCT03781505)

NCT ID: NCT03781505

Last Updated: 2024-08-16

Results Overview

The requirement of postoperative analgesia of the patient will be evaluated by using Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). This scale has 5 domains. It includes crying, facial expression, verbal response, touching the wound and torso and leg movement. It is a behavioural scale and measures each domain on a numerical scale of 0 to 2. Minimum score is 0 while maximum score is 10. Aggregate score will be added. Score less than 4 will be consider adequate analgesia while score greater than 4 will be consider inadequate analgesia. CHEOPS Pain Score less than four in participants of C and P groups will be reported at different time points.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

64 participants

Primary outcome timeframe

follow till 6 hours postoperatively

Results posted on

2024-08-16

Participant Flow

Excluded patients n = 5 Parenteral refusal 2, overweight 2, case cancellation 1

Participant milestones

Participant milestones
Measure
Intravenous Paracetamol With Caudal Ropivacaine (Group P)
Patients in Group P received Caudal analgesia after the induction of anesthesia, whereas intravenous paracetamol was given approximately an hour before the end of surgery in a dose of 15mg.kg-1 over 15 to 20 minutes
Placebo (Group C)
Normal Saline (0.9%)
Overall Study
STARTED
30
29
Overall Study
COMPLETED
30
29
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intravenous Paracetamol With Caudal Ropivacaine
n=30 Participants
Paracetamol is widely accepted and most commonly used as an adjuvant for postoperative analgesia. It also improves the quality of recovery by attenuating the pain associated with the surgical position. Adverse effects associated with the paracetamol are rare \<1/10000, which includes malaise, increased level of hepatic transaminases and hypersensitivity reaction. It has been studied in combination with caudal analgesia with bupivacaine through the rectal route 7,8 with variable results. Caudal anaesthesia is effective in alleviating pain below the umbilicus. Also if the caudal block is administered at the beginning of surgery, the effect will start wearing off 2 to 3 hours post surgery. Administration of paracetamol towards end of surgery may help with both these issues. In this study we aim to investigate the effect of adding intravenous paracetamol in combination with caudal analgesia with ropivacaine, hoping that it may improve quality of postoperative analgesia and recovery. Paracetamol +caudal ropivacaine: Paracetamol + Ropivacaine
Placebo
n=29 Participants
Intravenous Normal Saline with Caudal Ropivacaine Placebo: Caudal ropivacaine
Total
n=59 Participants
Total of all reporting groups
Age, Continuous
5.00 years
n=30 Participants
4.10 years
n=29 Participants
4.60 years
n=59 Participants
Sex/Gender, Customized
Male
30 Participants
n=30 Participants
29 Participants
n=29 Participants
59 Participants
n=59 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
BMI
14.1 kg/m^2
n=30 Participants
14.8 kg/m^2
n=29 Participants
14.7 kg/m^2
n=59 Participants
Heart rate
104 beats per minute
STANDARD_DEVIATION 13.3 • n=30 Participants
103 beats per minute
STANDARD_DEVIATION 16.1 • n=29 Participants
103 beats per minute
STANDARD_DEVIATION 14.6 • n=59 Participants
Surgical Time
65.0 Minutes
n=30 Participants
65.0 Minutes
n=29 Participants
65.0 Minutes
n=59 Participants
Anaesthesia Time
109 Minutes
n=30 Participants
120 Minutes
n=29 Participants
111 Minutes
n=59 Participants
Blood Pressure (systolic)
99.0 mmHg
n=30 Participants
92.0 mmHg
n=29 Participants
95.0 mmHg
n=59 Participants
Blood Pressure (diastolic)
60.0 mmHg
n=30 Participants
51.0 mmHg
n=29 Participants
53.0 mmHg
n=59 Participants

PRIMARY outcome

Timeframe: follow till 6 hours postoperatively

The requirement of postoperative analgesia of the patient will be evaluated by using Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). This scale has 5 domains. It includes crying, facial expression, verbal response, touching the wound and torso and leg movement. It is a behavioural scale and measures each domain on a numerical scale of 0 to 2. Minimum score is 0 while maximum score is 10. Aggregate score will be added. Score less than 4 will be consider adequate analgesia while score greater than 4 will be consider inadequate analgesia. CHEOPS Pain Score less than four in participants of C and P groups will be reported at different time points.

Outcome measures

Outcome measures
Measure
Intravenous Paracetamol With Caudal Ropivacaine (Group P)
n=30 Participants
Patients in Group P received Caudal analgesia after the induction of anesthesia, whereas intravenous paracetamol was given approximately an hour before the end of surgery in a dose of 15mg.kg-1 over 15 to 20 minutes
Placebo (Group C)
n=29 Participants
Normal Saline (0.9%)
Postoperative Analgesia Requirement
15 minutes
23 Participants
25 Participants
Postoperative Analgesia Requirement
30 minutes
24 Participants
21 Participants
Postoperative Analgesia Requirement
1 hour
26 Participants
25 Participants
Postoperative Analgesia Requirement
2 hour
30 Participants
28 Participants
Postoperative Analgesia Requirement
4 hour
29 Participants
29 Participants
Postoperative Analgesia Requirement
6 hour
29 Participants
29 Participants

SECONDARY outcome

Timeframe: follow till 4 hours postoperatively

Sedation will be assessed by using Pasero Opioid-Induced Sedation Scale (POSS). This scale measures sedation on numerical score of 0 to 4. Minimum score is 0 while maximum score is 4. It comprises of; 0: awake; 1: mild sedation; 2: sleeping, but able to wake; 3: Frequently drowsy, arousable, drifts off to sleep during conversation, unable to wake and 4: Somnolent, minimal or no response to verbal or physical stimulation. A POSS score of 0, 1, or 2 indicates an acceptable level of sedation, whereas a score of 3 or 4 indicates over-sedation and the need for a reversal agent. This score is just a numerical number with no other value attached to it.

Outcome measures

Outcome measures
Measure
Intravenous Paracetamol With Caudal Ropivacaine (Group P)
n=30 Participants
Patients in Group P received Caudal analgesia after the induction of anesthesia, whereas intravenous paracetamol was given approximately an hour before the end of surgery in a dose of 15mg.kg-1 over 15 to 20 minutes
Placebo (Group C)
n=29 Participants
Normal Saline (0.9%)
Sedation
Baseline (0-2)
23 Participants
23 Participants
Sedation
Baseline (3-4)
7 Participants
6 Participants
Sedation
30 min (0-2)
26 Participants
25 Participants
Sedation
30 min (3-4)
4 Participants
4 Participants
Sedation
1 hr (0-2)
30 Participants
29 Participants
Sedation
1 hr (3-4)
0 Participants
0 Participants
Sedation
2 hr (0-2)
30 Participants
29 Participants
Sedation
2 hr (3-4)
0 Participants
0 Participants
Sedation
4 hr (0-2)
30 Participants
29 Participants
Sedation
4 hr 3-4
0 Participants
0 Participants

Adverse Events

Intravenous Paracetamol With Caudal Ropivacaine (Group P)

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

Placebo (Group C)

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Muhammad Saad Yousuf

Aga Khan University

Phone: +92213486

Results disclosure agreements

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