Effects of tDCS and VNS on Postoperative Analgesia

NCT ID: NCT06554067

Last Updated: 2024-08-14

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-31

Study Completion Date

2026-08-31

Brief Summary

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This study seeks to evaluate the efficacy of transcranial direct current stimulation (tDCS) and Afferent Vagus nerve simulation (VNS) in treating acute postoperative pain of patients in the post-anesthesia care unit after general surgery.

Study outcomes will include changes in pain levels and vital signs. For patients who are admitted after surgery, opioid consumption in the 24 hours after surgery and time from surgery to discharge are recorded as secondary outcomes.

Patients will be divided in the following comparison groups:

* Group +/+ will receive ten minutes of active tDCS followed by ten minutes of active VNS.
* Group +/- will receive ten minutes of active tDCS followed by ten minutes of sham VNS.
* Group -/+ will receive ten minutes of sham tDCS followed by ten minutes of active VNS.
* Group -/- will receive ten minutes of sham tDCS followed by ten minutes of sham VNS.

Detailed Description

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Two nonpharmacologic interventions have shown promise in treatment of chronic pain. Afferent Vagus nerve simulation (VNS) can modulate nociception, even though the exact mechanism is unclear. Clinically, it has found uses in chronic pain as well as early evidence of potential use in postoperative pain. Alternatively, transcranial direct current stimulation (tDCS) is a form of non-invasive and polarity-specific technique of modulating neuronal circuitry using a weak electric current delivered by a battery. tDCS has also been shown to modulate chronic pain and has been shown to produce EEG signatures similar to those seen in states of adequate intraoperative analgesia.

This study seeks to evaluate the efficacy of tDCS and VNS in treating acute postoperative pain of patients in the post-anesthesia care unit after general surgery by randomizing 200 subjects in 4 groups:

* Group +/+ will receive ten minutes of active tDCS followed by ten minutes of active VNS.
* Group +/- will receive ten minutes of active tDCS followed by ten minutes of sham VNS.
* Group -/+ will receive ten minutes of sham tDCS followed by ten minutes of active VNS.
* Group -/- will receive ten minutes of sham tDCS followed by ten minutes of sham VNS.

Patient's vital signs and pain level will be obtained before the procedure and after. Patients that have to stay in hospital will also be evaluated by opioid consumption and time from surgery to discharge.

Conditions

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Acute Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a parallel-group, double blinded, randomized trial where 200 subjects will be randomized following a 2x2 structure.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Patients will be assigned a Study ID that will determine the assigned procedure. At the study's completion the blind will be broken, and data will be turned over for analysis.

Study Groups

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Group +/+

Group +/+ will receive ten minutes of active tDCS followed by ten minutes of active VNS.

Group Type EXPERIMENTAL

Active transcranial direct current stimulation

Intervention Type DEVICE

Ten minutes of active transcranial direct current stimulation

Active vagus nerve stimulation

Intervention Type DEVICE

Ten minutes of active vagus nerve stimulation

Group +/-

Group +/- will receive ten minutes of active tDCS followed by ten minutes of sham VNS.

Group Type ACTIVE_COMPARATOR

Active transcranial direct current stimulation

Intervention Type DEVICE

Ten minutes of active transcranial direct current stimulation

Sham vagus nerve stimulation

Intervention Type OTHER

Ten minutes of sham VNS

Group -/+

Group -/+ will receive ten minutes of sham tDCS followed by ten minutes of active VNS.

Group Type ACTIVE_COMPARATOR

Active vagus nerve stimulation

Intervention Type DEVICE

Ten minutes of active vagus nerve stimulation

Sham transcranial direct current stimulation

Intervention Type OTHER

Ten minutes of sham tDCS

Group -/-

Group -/- will receive ten minutes of sham tDCS followed by ten minutes of sham VNS.

Group Type SHAM_COMPARATOR

Sham transcranial direct current stimulation

Intervention Type OTHER

Ten minutes of sham tDCS

Sham vagus nerve stimulation

Intervention Type OTHER

Ten minutes of sham VNS

Interventions

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Active transcranial direct current stimulation

Ten minutes of active transcranial direct current stimulation

Intervention Type DEVICE

Active vagus nerve stimulation

Ten minutes of active vagus nerve stimulation

Intervention Type DEVICE

Sham transcranial direct current stimulation

Ten minutes of sham tDCS

Intervention Type OTHER

Sham vagus nerve stimulation

Ten minutes of sham VNS

Intervention Type OTHER

Other Intervention Names

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tDCS VNS

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18 years or above with the capacity to provide informed consent who are undergoing an elective surgery requiring general anesthesia

Exclusion Criteria

* cardiac bradyarrhythmia: taking beta-blockers;
* patients with metal implants around the chest, neck, or head (e.g. implantable pacemakers and defibrillators, deep brain stimulation devices);
* pregnancy
* history of epilepsy or seizures.
* patients undergoing surgical procedures involving the head, neck or spine, or those requiring the use of cardiopulmonary bypass
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Columbia University

OTHER

Sponsor Role lead

Responsible Party

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Paul Garcia

Associate Professor of Anesthesiology, Division Chief of Neuroanesthesia

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Paul S. Garcia, MD PhD

Role: CONTACT

212-304-7523

Oriana Lujan, MD

Role: CONTACT

212-3047523

Other Identifiers

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AAAV2033

Identifier Type: -

Identifier Source: org_study_id

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