Avoid With Locoregional Analgesia Persistant Postoperative Pain In Children

NCT ID: NCT06271174

Last Updated: 2024-06-12

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

PHASE3

Total Enrollment

208 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-06

Study Completion Date

2026-06-30

Brief Summary

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Persistent postoperative pain is a substantial pain (scores 4-10 using a 0-10 numeric scale) that develops 3 months after surgery.

Persistent postoperative pain can be a problem even in ambulatory surgery. Loco-regional analgesia could prevent the occurrence of this pathology but contradictory results are found in ancient studies.

This study is the first randomized controlled study in children about loco-regional analgesia and persistent postoperative pain in traumatologic orthopedic surgery.

One interventional arm will receive a locoregional analgesia after general anesthesia and before incision. The other arm will only receive systemic analgesia during general anesthesia.

The incidence of persistent postoperative pain at 3, 6 and 12 months will be compared in these two groups.

The goal is to show the decrease of the incidence of the persistent postoperative pain in the group "locoregional analgesia".

Detailed Description

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Patients between 5 years old and 15 years, 3 months old operated for a traumatologic orthopedic surgery in CHU Nantes will be included in this study.

Patients between 5 years old and 15 years, 3 months old operated for a traumatologic orthopedic surgery in CHU Nantes will be included in this study.

They will be randomized in two groups. General anesthesia will be administered in both groups.

One arm will receive a locoregional analgesia guiding by echography before incision with a local anesthetic (Carbocaïne) and a systemic analgesia if necessary. One arm will only receive a systemic analgesia.

The drugs used for general anesthesia and systemic analgesia will be standardized in the two groups.

The incidence of persistent postoperative pain at 3, 6 and 12 months will be compared in both arms. A screening of a neuropathic pain will be realized if a pain exists.

The consumption of opioids the first 24 postoperative hours, the time spent in the post interventional care unit and the incidence of nausea, vomiting will also be compared.

The goal is to show the decrease of the incidence of the persistent postoperative pain and a better recovery in the post interventional care unit in the group "locoregional analgesia".

Conditions

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Persistent Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Loco-Regional Analgesia

Patients will receive Loco-Regional Analgesia during General Anesthesia, and systemic analgesia if necessary

* Carbocaine

Group Type EXPERIMENTAL

Carbocaine

Intervention Type DRUG

After general anesthesia and before incision, patients will receive loco-regional analgesia.

Carbocaïne will be injected around the nerve responsible of the innervation of the operated area by echography guidance.

Profofol and/or Suxaméthonium and/or Sévoflurane

Intervention Type DRUG

General anesthesia

Anesthetic induction is performed on a full stomach using :

* Intravenous hypnotic Propofol 2-5 mg/kg
* A rapid-acting intravenous curare Suxamethonium 1 mg/kg

On an empty stomach :

\- An intravenous hypnotic Propofol 2 to 5 mg/kg or/and an inhalatory hypnotic, Sevoflurane, as anesthetic co-induction by these 2 agents is generally used in pediatrics.

Systemic Analgesia Only

Patients will just receive General Anesthesia and systemic analgesia.

\_ Profofol and/or Suxaméthonium and/or Sévoflurane

Group Type ACTIVE_COMPARATOR

Profofol and/or Suxaméthonium and/or Sévoflurane

Intervention Type DRUG

General anesthesia

Anesthetic induction is performed on a full stomach using :

* Intravenous hypnotic Propofol 2-5 mg/kg
* A rapid-acting intravenous curare Suxamethonium 1 mg/kg

On an empty stomach :

\- An intravenous hypnotic Propofol 2 to 5 mg/kg or/and an inhalatory hypnotic, Sevoflurane, as anesthetic co-induction by these 2 agents is generally used in pediatrics.

Interventions

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Carbocaine

After general anesthesia and before incision, patients will receive loco-regional analgesia.

Carbocaïne will be injected around the nerve responsible of the innervation of the operated area by echography guidance.

Intervention Type DRUG

Profofol and/or Suxaméthonium and/or Sévoflurane

General anesthesia

Anesthetic induction is performed on a full stomach using :

* Intravenous hypnotic Propofol 2-5 mg/kg
* A rapid-acting intravenous curare Suxamethonium 1 mg/kg

On an empty stomach :

\- An intravenous hypnotic Propofol 2 to 5 mg/kg or/and an inhalatory hypnotic, Sevoflurane, as anesthetic co-induction by these 2 agents is generally used in pediatrics.

Intervention Type DRUG

Other Intervention Names

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Loco regional Analgesia General anesthetic

Eligibility Criteria

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Inclusion Criteria

* Age between 5 years old and 15 years and 3 months
* Traumatologic orthopedic surgery in CHU Nantes
* Conscious patient (Glasgow score =15)
* Patients able to give a verbal assessment of their pain
* No contraindication to Locoregional Analgesia
* Patient member of the social security system
* Oral consent of the patient
* Signed consent of one of the two holders of parental authority

Exclusion Criteria

* Refusal to participate of the patient or one of the two holders of parental authority
* Neurologic deficit of the operated limb before intervention
* Ischemia of the operated limb before intervention
* Polytraumatized patient
* Allergia to Carbocaïne
* Atrioventricular conduction disorders
* Patient included in an other study about analgesia
* Anticoagulant treatment
* Uncontrolled epilepsy despite treatment
* Porphyria
Minimum Eligible Age

5 Years

Maximum Eligible Age

183 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation Apicil

OTHER

Sponsor Role collaborator

Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CHU Nantes

Nantes, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Rémi Bernardon

Role: CONTACT

+33(0)2 43 48 22 15

Facility Contacts

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Rémi Bernardon

Role: primary

02.53.48.22.15

Other Identifiers

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RC23_0009

Identifier Type: -

Identifier Source: org_study_id

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