Opioid Sparing Anesthesia in Cervical Spine Surgery

NCT ID: NCT05717361

Last Updated: 2023-02-08

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

2022-11-01

Study Completion Date

2024-11-01

Brief Summary

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The aim of this double blind randomized study will be to investigate the effect of an opioid-free anesthesia regimen with a mixture of lidocaine and ketamine in the same syringe versus remifentanyl analgesia in cervical spine surgery.

Detailed Description

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Cervical spine surgery is associated with medium pain scores and perioperative disability. Ketamine and lidocaine have all proven but varied analgesic effects. High opioid consumption has been associated with multiple side effects.

This double blind clinical trial aims to investigate the possible reduction of opioid use during lumbar spine surgery by administering ketamine and lidocaine. Sixty patients will be randomly allocated into two groups. The control group will receive a continuous infusion of remifentanil, while the Ketamine-Lidocaine (KL) group will receive a continuous infusion of ketamine and lidocaine, during the surgery and shortly after.

Both infusions will be administered blindly. Fentanyl and morphine will be administered to each patient so as to maintain hemodynamic stability and pain relief. The study will eventually compare the need for bolus doses of fentanyl during the surgery and morphine shortly after in each group.

Multiple hemodynamic parameters, analgesic consumption, possible side effects, patient satisfaction and the Oswestry low back pain disability questionnaire will be recorded.

Conditions

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Pain, Postoperative Pain, Acute Pain, Chronic Pain, Nociceptive Ketamine Lidocaine Analgesia Analgesics Cervical Spine Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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ketamine-lidocaine (KL) group combination of ketamine and lidocaine in one syringe

Group Type ACTIVE_COMPARATOR

ketamine-lidocaine

Intervention Type DRUG

In the KL group, patients will be administered in a total volume of 20 mL,1mL/10 kg of the solution containing ketamine, lidocaine at predefined concentrations.

As maintenance, they will be receiving 1mL/10kg/h of the aforementioned solution

: remifentanil group syringe of remifentanil

Group Type ACTIVE_COMPARATOR

Remifentanil

Intervention Type DRUG

In the Remifentanil group, patients will be administered in a total volume of 20 mL, 2 mcg/kg of fentanyl. As maintenance, they will be receiving 1 mL/10kg/h of a remifentanil solution

Interventions

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ketamine-lidocaine

In the KL group, patients will be administered in a total volume of 20 mL,1mL/10 kg of the solution containing ketamine, lidocaine at predefined concentrations.

As maintenance, they will be receiving 1mL/10kg/h of the aforementioned solution

Intervention Type DRUG

Remifentanil

In the Remifentanil group, patients will be administered in a total volume of 20 mL, 2 mcg/kg of fentanyl. As maintenance, they will be receiving 1 mL/10kg/h of a remifentanil solution

Intervention Type DRUG

Other Intervention Names

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KL group Remifentanil group

Eligibility Criteria

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Inclusion Criteria

* Adult patents
* American Society of Anesthesiologists (ASA) class I-III
* elective spine surgery

Exclusion Criteria

* body mass index (BMI) \>35 kg/m2
* contraindications to local anesthetic administration
* systematic use of analgesic agents preoperatively
* chronic pain syndromes preoperatively
* neurological or psychiatric disease on treatment
* pregnancy
* severe hepatic or renal disease
* history of cardiovascular diseases/ arrhythmias/ conduction abnormalities
* bradycardia(\<55 beats/minute)
* drug or alcohol abuse
* language or communication barriers lack of informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aretaieion University Hospital

OTHER

Sponsor Role collaborator

Evangelismos Hospital

OTHER

Sponsor Role lead

Responsible Party

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Athanasios Vaiopoulos

Anesthesia Resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kassiani Theodoraki

Role: PRINCIPAL_INVESTIGATOR

Aretaieion University Hospital, Athens, Greece

Locations

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Evangelismos General Hospital

Athens, , Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Kassiani Theodoraki, PhD, DESA

Role: CONTACT

+306974634162

Athanasios Vaiopoulos

Role: CONTACT

Facility Contacts

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Athanasios Vaiopoulos

Role: primary

Other Identifiers

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254/13-07-2022Β

Identifier Type: -

Identifier Source: org_study_id

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