Plasma Concentration of Somatostatin and Endocannabinoids After GA and RA in Upper Extremity Trauma Surgery

NCT ID: NCT04040738

Last Updated: 2021-11-05

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-05

Study Completion Date

2022-01-10

Brief Summary

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The application of RA can decrease the central sensitization and chronic pain after trauma surgery. The plasma concentrations of somatostatin and fatty acid amides were not studied up to this time in this kind of settings, so investigators believe that this is the first work that shows how upper extremity nerve blockade changes the plasma concentration of somatostatin and fatty acid amides in upper limb surgery in trauma patients.

Detailed Description

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Total of 100 American Society of Anesthesiologist (ASA) I-III, adult patients scheduled to elective or emergency trauma surgery of hand/forearm or shoulder are planned to be randomly allocated to general anaesthesia (GA) or ultrasound-guided (UG) brachial plexus block (BPB) group, in this randomized-prospective study after approval by the University Research Ethics Board, Pécs University Medical School, Hungary. All of the patients will receive detailed information about the planned BPB or GA techniques and surgeries, then written informed consents will be obtained. Study participants are planned to be assigned randomly into 4 groups (Shoulder GA; Shoulder RA; Hand/forearm GA; Hand/forearm RA).

Standardized UG Axillary-supraclavicular (AX-SC) approach to the BP is planned to be performed under sterile conditions, or standardized GA with propofol IV, fentanyl IV, and 1 MAC (minimal alveolar concentration) sevoflurane, by experienced anesthesiologists.

Blood samples will be taken at 0-time point (straight before the administration of BP injection or the induction of GA) and straight after the surgery. The collected serum samples are stored at -70 °C for a maximum of two weeks prior to analysis. Qualitative and quantitative determination of endocannabinoids and corticosteroids is performed by supercritical fluid chromatography coupled with tandem mass spectrometry after salting-out assisted liquid-liquid microextraction. For somatostatin measurement, the samples are immediately supplemented with aprotinin (20µl/ml blood sample; Gordox 10 KIU/ml (Kallikrein Inhibitor Unit/ml), Richter Gedeon Budapest, Hungary) and transported for centrifugation on ice. The pellet is discarded, and the plasma is stored at -80⁰C until further processing. The somatostatin concentration of the plasma sample is determined with both ELISA (CEA592Hu, Cloud-Clone Corp., Wuhan, PRC) and radioimmunoassay. The results are collected and analyzed.

Demographic data, vital parameters, and verbal numeric rate of pain intensity are collected prior to and after surgery.

Conditions

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Postoperative Pain Arm Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Study participants n=25 in the S-GA, n=25 in the S-RA, n=25 in the H-GA, and n=25 in the H-RA Groups.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The labour analyst, the investigator, the statistician is unaware of group allocation.

Study Groups

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Upper extremity surgery under general anaesthesia

Fentanyl 2 mcg/kg iv, propofol 2 mg/kg iv induction, 1MAC sevoflurane maintenance

Group Type ACTIVE_COMPARATOR

Upper extremity surgery under general anaesthesia

Intervention Type PROCEDURE

Forearm, wrist and hand surgery after fentanyl and propofol induction of anaesthesia, with sevoflurane maintenance

Upper extremity surgery under regional anaesthesia

Bupivacaine brachial plexus block 0.4 ml/kg of 0.33% solution

Group Type ACTIVE_COMPARATOR

Upper extremity surgery under regional anaesthesia

Intervention Type PROCEDURE

Forearm, wrist and hand surgery under brachial plexus block with 0.4 ml/kg of 0.33% bupivacaine solution Other Names: Marcaine 5 mg/ml Astra Zeneca OGYI-T 6496/14

Interventions

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Upper extremity surgery under general anaesthesia

Forearm, wrist and hand surgery after fentanyl and propofol induction of anaesthesia, with sevoflurane maintenance

Intervention Type PROCEDURE

Upper extremity surgery under regional anaesthesia

Forearm, wrist and hand surgery under brachial plexus block with 0.4 ml/kg of 0.33% bupivacaine solution Other Names: Marcaine 5 mg/ml Astra Zeneca OGYI-T 6496/14

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* upper extremity fracture
* surgery of hand/forearm or upper arm
* unpremedicated patients
* scheduled for elective or emergency trauma

Exclusion Criteria

* psycho-mental conditions interfering with consent or assessment
* the patient refused to participate
* preexisting chronic pain condition
* daily analgesic or sedative or steroid consumption
* sedative or analgesic premedication
* pre-existing neuro-endocrine disorders
* antecedent cancer
* advanced liver or kidney disease.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pecs

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert G Almasi, PhD.Habil.

Role: STUDY_CHAIR

University of Pecs, Medical School, Clinical Centre, Pain Medicine Dept.of Anesth Int Care

Zsofia Kriszta, MD.

Role: PRINCIPAL_INVESTIGATOR

University of Pecs, Medical School, Clinical Centre, Dept.of Anesth Int Care

Locations

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University of Pécs, Medical School

Pécs, Baranya, Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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Robert G Almasi, PhD.Habil.

Role: CONTACT

Phone: +36304294450

Email: [email protected]

Erika Pintér, DSC., Prof

Role: CONTACT

Phone: +36204338395

Email: [email protected]

Facility Contacts

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Robert Almasi, PhD. habil

Role: primary

Lajos Bogar, Prof. DSC

Role: backup

Other Identifiers

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7726

Identifier Type: -

Identifier Source: org_study_id