Perioperative Epidural Anesthesia and Analgesia on Gut Microbiota

NCT ID: NCT04079673

Last Updated: 2021-10-21

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-19

Study Completion Date

2022-07-31

Brief Summary

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As the only curative treatment for end-stage liver diseases, liver transplantation has been widely carried out around the world. The shortage of organs from deceased donors facilitate the adoption of living donor liver transplantation. Living donor hepatectomy is the most massive operation a healthy person could undergo, so donor safety is of utmost importance. However, previous studies focused on the outcomes of liver transplant recipients. There are still many uncertainties about the recovery in living liver donors.

The body microorganisms that reside in the human intestinal tract, referred to as the gut microbiota, are essential to human metabolism and immunity. The physiological functions of microbiota include defense against pathogens, providing nutrients such as vitamin B12 folate and vitamin K, and modulating gut integrity and permeability. Despite relatively stable microbiota during life, different illnesses, surgeries, medications dietary factors, and lifestyle changes could contribute to the imbalance of ecosystems resulting many gastrointestinal and extra-gastrointestinal disorders. Many researches have established a relationship between the gut microbiome and patients with liver disease such as liver cirrhosis, alcoholic liver disease and obesity related liver diseases etc. These liver disorders are associated with bacterial overgrowth, dysbiosis, and increased intestinal permeability. However, the relationship between hepatectomy and microbiota has not been fully investigated, especially in healthy liver donors.

Many routine perioperative management can impact the state of the microbiome and therefore can impact clinical outcomes, like bowel preparation and antibiotics. Potential factors affecting the gut microbiota also include perioperative manipulation, stress released hormones, and opioids. Maintenance of proper anesthetic depth is beneficial to attenuate surgical stress. However, general anesthesia including volatile anesthetics and opioids, is associated with altered gut microbiota. Therefore, regional anesthesia and analgesia which effectively attenuating surgical stress while efficiently reducing general anesthetics consumption, seem to provide promising advantages. Epidural analgesia has been proved to improve gastrointestinal function in major abdominal and thoracic surgery. However, the effect of perioperative epidural anesthesia and analgesia on microbiota is not clear.

Detailed Description

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Conditions

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Living Donor Hepatectomy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Patient controlled epidural analgesia

Use of patient controlled epidural analgesia (PCEA) for postoperative pain control

Group Type ACTIVE_COMPARATOR

Patient controlled epidural analgesia

Intervention Type PROCEDURE

Patient controlled epidural analgesia with marcaine 0.66mg/ml +fentanyl 1.75mcg/ml for postoperative pain control

Intravenous patient controlled analgesia

Use of intravenous patient controlled analgesia(IVPCA) for postoperative pain control

Group Type SHAM_COMPARATOR

Intravenous patient controlled analgesia

Intervention Type DRUG

Intravenous patient controlled analgesia with morphine 1mg/ml for postoperative pain control

Interventions

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Patient controlled epidural analgesia

Patient controlled epidural analgesia with marcaine 0.66mg/ml +fentanyl 1.75mcg/ml for postoperative pain control

Intervention Type PROCEDURE

Intravenous patient controlled analgesia

Intravenous patient controlled analgesia with morphine 1mg/ml for postoperative pain control

Intervention Type DRUG

Other Intervention Names

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PCEA IVPCA

Eligibility Criteria

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Inclusion Criteria

1. Expected to receive living liver hepatectomy in National Taiwan University Hospital, age between 20 and 55 years old.

Exclusion Criteria

1. Previous use of antibiotics within four weeks.
2. Previous gastrointestinal surgery.
Minimum Eligible Age

20 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kuang-Cheng Chan, M.D.,PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Anesthesiology, Natioanal Taiwan University Hospital

Locations

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Department of Anesthesiology, National Taiwan University Hospital

Taipei, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Kuang-Cheng Chan, M.D.,PhD

Role: CONTACT

+886-2-23123456 ext. 62158

Facility Contacts

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Kuang-Cheng Chan, M.D.,PhD

Role: primary

+886-2-23123456 ext. 62158

Other Identifiers

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201812090RINC

Identifier Type: -

Identifier Source: org_study_id