Effect of Perioperative Oral Pregabalin in Total Knee Replacement

NCT ID: NCT06187922

Last Updated: 2024-01-03

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

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-01

Study Completion Date

2025-07-30

Brief Summary

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This interventional randomized control trial aim to determine efficacy and safety of Oral pregabalin in improving after surgery pain control in patients undergoing total knee replacement surgeries under regional anesthesia. We'll compare the efficacy of pregabalin between two groups, pregabalin group and control group on the basis of their opioid consumption after knee operation.

Detailed Description

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After obtaining approval from the institutional ethical committee and informed written consent, 120 patients fulfilling the inclusion criteria will be included in this study. The patients will be randomly assigned into two equal groups; Group P: Pregabalin group and Group C: control group. Group P will receive oral capsule pregabalin 75mg one hour preoperatively and Group C will not receive any premedication preoperatively.

Intraoperatively both groups will receive inj. Midazolam 2 mg before subarachnoid block with hyperbaric Bupivacaine 0.5% 2.5-3ml and fentanyl 15mcg in the operation theatre (OT). Both groups will also receive parecoxib 40mg IV and paracetamol 1G Intravenous (IV) as part of multimodal analgesia. Both groups will receive dexamethasone 8mg IV prophylactically.

Postoperatively both groups will receive Ultrasound guided Adductor canal saphenous Nerve block in the PACU with 0.2% Bupivacaine 20-30ml \& dexmeditomidine1.0mcg/kg. Group P will receive oral capsule pregabalin 75 mg Q12hourly from the 1st dose for next 60 hours. Group C will not receive any medication. Both groups will receive paracetamol 1G IV Q6Hourly and Rescue Analgesia will be provided with oral oxycodone 5mg TDS and Morphine PCA, in escalating manner as per patient requirement.

for 24 hrs. After 24 hours Both groups with receive tab paracetamol1 g Q4hourly, ibuprofen 400 Q8hourly along with Tab oxycodone as PRN Q8Hourly and PCA morphine.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The patients will be randomly assigned into two equal groups; Group P: Pregablain group and Group C: control group. Group P will receive oral capsule pregabalin 75mg one hour preoperatively and will continue as B.D for 72 hrs, Group C will not receive any premedication preoperatively.

Intraoperatively both groups will receive inj. Midazolam 2 mg before subarachnoid block with hyperbaric Bupivacaine 0.5% 2.5-3ml and fentanyl 15mcg in the operation theatre (OT). Both groups will also receive parecoxib 40mg IV and paracetamol 1G Intravenous (IV) as part of multimodal analgesia. Both groups will receive dexamethasone 8mg IV prophylactically. Postoperatively both groups will receive adductor canal block with bupivacaine and dexmedetomidine.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pregabalin group

this group of patient will receive cap pregabalin 75mg as premedication and will continue as twice daily dose for 72 hrs.

Group Type ACTIVE_COMPARATOR

Pregabalin 75mg

Intervention Type DRUG

Group pregabalin will receive cap pregabalin 75mg as premedication and will continue as B.D dose for 72 Hrs.

adductor canal block

Intervention Type PROCEDURE

Both group will receive ultrasound guided Adductor canal block with bupivacaine 0.2% 20-30ml and dexmedetomidine 1mcg/Kg

Control group

This group of patient will not receive cap pregabalin but it will receive standard medical care as routine

Group Type SHAM_COMPARATOR

adductor canal block

Intervention Type PROCEDURE

Both group will receive ultrasound guided Adductor canal block with bupivacaine 0.2% 20-30ml and dexmedetomidine 1mcg/Kg

Interventions

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Pregabalin 75mg

Group pregabalin will receive cap pregabalin 75mg as premedication and will continue as B.D dose for 72 Hrs.

Intervention Type DRUG

adductor canal block

Both group will receive ultrasound guided Adductor canal block with bupivacaine 0.2% 20-30ml and dexmedetomidine 1mcg/Kg

Intervention Type PROCEDURE

Other Intervention Names

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capsule peripheral nerve block

Eligibility Criteria

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Inclusion Criteria

1. Age between 18 to 85 year
2. Elective Regional anesthesia.
3. Able to follow study protocol

Exclusion Criteria

1. ASA -IV
2. Age \<18 \& \> 85 years
3. Patients on pregabalin for chronic neuropathic pain.
4. Patient under General anesthesia
5. Patients with chronic liver failure
6. Patients with chronic renal failure on Hemodialysis
7. Patients on opioid (\>3 month)
8. Patient with complicated knee surgery
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bahrain Defence Force Hospital

OTHER

Sponsor Role lead

Responsible Party

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Mehtash butt

Chief resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mohammed Al Muharraqi, FRCS,FDSRCS

Role: STUDY_CHAIR

Bahrain Defence Forces Hospital

Locations

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Bahrain Defence Force

Manama, , Bahrain

Site Status RECRUITING

Countries

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Bahrain

Central Contacts

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MEHTASH BUTT, FCPS,FCAI

Role: CONTACT

+97336681277

Jalal alkhan, MBBch,FRCA

Role: CONTACT

+97317766666 ext. 6268

Facility Contacts

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Saleha syed

Role: primary

+97317766666 ext. 7779

Ashruf

Role: backup

+97317766666 ext. 6177

References

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Li JW, Ma YS, Xiao LK. Postoperative Pain Management in Total Knee Arthroplasty. Orthop Surg. 2019 Oct;11(5):755-761. doi: 10.1111/os.12535.

Reference Type RESULT
PMID: 31663286 (View on PubMed)

Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic. Anesth Analg. 2017 Nov;125(5):1733-1740. doi: 10.1213/ANE.0000000000002458.

Reference Type RESULT
PMID: 29049117 (View on PubMed)

Attal N, Cruccu G, Baron R, Haanpaa M, Hansson P, Jensen TS, Nurmikko T. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010 Sep;17(9):1113-e88. doi: 10.1111/j.1468-1331.2010.02999.x. Epub 2010 Apr 9.

Reference Type RESULT
PMID: 20402746 (View on PubMed)

Ziyaeifard M, Mehrabanian MJ, Faritus SZ, Khazaei Koohpar M, Ferasatkish R, Hosseinnejad H, Mehrabanian M. Premedication with oral pregabalin for the prevention of acute postsurgical pain in coronary artery bypass surgery. Anesth Pain Med. 2015 Jan 17;5(1):e24837. doi: 10.5812/aapm.24837. eCollection 2015 Feb.

Reference Type RESULT
PMID: 25830118 (View on PubMed)

Chen YK, Boden KA, Schreiber KL. The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review. Anaesthesia. 2021 Jan;76 Suppl 1(Suppl 1):8-17. doi: 10.1111/anae.15256.

Reference Type RESULT
PMID: 33426669 (View on PubMed)

Sun Q, Liu S, Wu H, Ma H, Liu W, Fang M, Liu K, Pan Z. Dexmedetomidine as an Adjuvant to Local Anesthetics in Transversus Abdominis Plane Block: A Systematic Review and Meta-analysis. Clin J Pain. 2019 Apr;35(4):375-384. doi: 10.1097/AJP.0000000000000671.

Reference Type RESULT
PMID: 30475260 (View on PubMed)

Andersen JH, Jaeger P, Grevstad U, Estrup S, Geisler A, Vilhelmsen F, Dahl JB, Laier GH, Ilfeld BM, Mathiesen O. Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. Reg Anesth Pain Med. 2019 Mar;44(3):333-340. doi: 10.1136/rapm-2018-100089. Epub 2019 Jan 23.

Reference Type RESULT
PMID: 30679332 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Related Links

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Other Identifiers

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BDF/R&REC/2023/674

Identifier Type: OTHER

Identifier Source: secondary_id

BDF/R&REC/2023/674

Identifier Type: -

Identifier Source: org_study_id

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