Intraoperative Methadone for Postoperative Pain in Patients Undergoing Tonsillectomy

NCT ID: NCT05445856

Last Updated: 2023-12-05

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

130 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-28

Study Completion Date

2024-08-31

Brief Summary

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A randomized controlled trial evaluating the efficacy and safety of single-shot intraoperative methadone for postoperative pain in patients undergoing tonsillectomy. Fentanyl is used as an active comparator

Detailed Description

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This study is an investigator-initiated, prospective, randomised controlled trial with two arms: an intervention arm (methadone) and a control arm (fentanyl). Patients scheduled for tonsillectomy at Randers Regional Hospital, Denmark, will be approached for study participation.

Patients are randomised in a 1:1 ratio in blocks of varying sizes (between 4 and 8) to receive either intraoperative methadone or fentanyl. The randomisation assignment will be handled by the hospital pharmacy using a web-based central randomisation procedure (www.sealedenvelope.com).

The study drug will be prepared by the hospital pharmacy at Aarhus University Hospital and delivered as kits with identical appearance, marked with the randomization number (1-130). On the day of surgery, a kit will be opened and a 10 ml syringe with study drug (methadone 2 mg/ml or fentanyl 30 microgram/ml or ) will prepared by a health care professional (nurse or medical doctor not involved in the study or the treatment of patients). Once prepared, the blinded study drug will be given to and handled by one of the research team members and administered after induction of anesthesia and prior to surgery

The dose of the study drug will be administered as intravenous bolus dose in equipotent doses (0.2 mg/kg / 3 μg/kg) corresponding to 1 ml for every 10 kg of ideal body weight (women: height (cm) - 105. Men: height (cm) - 100)) after induction of anaesthesia and before the start of surgery.

Postoperative data will be obtained by reviewing hospital records, by interview and electronic questionnaires sent by email.

Conditions

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Postoperative Pain

Keywords

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Postoperative pain Methadone

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Methadone

Single-shot intravenous methadone 0.2 mg/kg administered intraoperatively

Group Type EXPERIMENTAL

Methadone

Intervention Type DRUG

Methadone is administered as a single intravenous dose after induction of anesthesia and prior to initiation of surgery

Fentanyl

Single-shot intravenous fentanyl 3 microgram/kg administered intraoperatively

Group Type ACTIVE_COMPARATOR

Fentanyl

Intervention Type DRUG

Fentanyl is administered as a single intravenous dose after induction of anesthesia and prior to initiation of surgery

Interventions

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Methadone

Methadone is administered as a single intravenous dose after induction of anesthesia and prior to initiation of surgery

Intervention Type DRUG

Fentanyl

Fentanyl is administered as a single intravenous dose after induction of anesthesia and prior to initiation of surgery

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* All patients (≥18 years) scheduled for elective tonsillectomy

Exclusion Criteria

* American Society of Anaesthesiologists (ASA) physical status IV or V
* Allergy to study drugs
* Daily use of opioids 7 days prior to surgery
* Inability to provide informed consent
* Severe respiratory insufficiency
* Heart failure
* Acute alcohol intoxication/delirium tremens
* Increased intracranial pressure
* Acute liver disease
* Liver insufficiency
* Kidney insufficiency
* Treatment with rifampicin
* Treatment with any drug prolonging the QT-interval
* Pregnancy (every female not using contraceptives will be screened with urine human choriogonadotropin)
* Breastfeeding
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lone Nikolajsen, PhD, DMSc

Role: STUDY_CHAIR

Aarhus University Hospital, Department of Anesthesia and Intensive Care

Locations

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Department of Anaesthesiology and Intensive Care

Randers, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Michael Bøndergaard, MD

Role: CONTACT

Phone: 004578420510

Email: [email protected]

Kristian Friesgaard, MD, PhD

Role: CONTACT

Phone: 00457842332

Email: [email protected]

Facility Contacts

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Michael Bøndergaard, MD

Role: primary

References

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Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Shear TD, Deshur MA, Vender JS, Benson J, Newmark RL. Clinical Effectiveness and Safety of Intraoperative Methadone in Patients Undergoing Posterior Spinal Fusion Surgery: A Randomized, Double-blinded, Controlled Trial. Anesthesiology. 2017 May;126(5):822-833. doi: 10.1097/ALN.0000000000001609.

Reference Type BACKGROUND
PMID: 28418966 (View on PubMed)

Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Marymont JH, Shear T, Parikh KN, Patel SS, Gupta DK. Intraoperative Methadone for the Prevention of Postoperative Pain: A Randomized, Double-blinded Clinical Trial in Cardiac Surgical Patients. Anesthesiology. 2015 May;122(5):1112-22. doi: 10.1097/ALN.0000000000000633.

Reference Type BACKGROUND
PMID: 25837528 (View on PubMed)

Gottschalk A, Durieux ME, Nemergut EC. Intraoperative methadone improves postoperative pain control in patients undergoing complex spine surgery. Anesth Analg. 2011 Jan;112(1):218-23. doi: 10.1213/ANE.0b013e3181d8a095. Epub 2010 Apr 24.

Reference Type BACKGROUND
PMID: 20418538 (View on PubMed)

Udelsmann A, Maciel FG, Servian DC, Reis E, de Azevedo TM, Melo Mde S. Methadone and morphine during anesthesia induction for cardiac surgery. Repercussion in postoperative analgesia and prevalence of nausea and vomiting. Rev Bras Anestesiol. 2011 Nov-Dec;61(6):695-701. doi: 10.1016/S0034-7094(11)70078-2. English, Multiple languages.

Reference Type BACKGROUND
PMID: 22063370 (View on PubMed)

Bondergaard M, Uhrbrand PG, Karaca T, Rhode M, Kjaergaard T, Svendsen RT, Klug TE, Nikolajsen L, Friesgaard KD. Intraoperative methadone for postoperative pain in adult patients undergoing tonsillectomy-a randomised controlled trial. BJA Open. 2025 May 26;14:100418. doi: 10.1016/j.bjao.2025.100418. eCollection 2025 Jun.

Reference Type DERIVED
PMID: 40502985 (View on PubMed)

Other Identifiers

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2022-002496-11

Identifier Type: -

Identifier Source: org_study_id