Comparing the Safety and Effectiveness of Different Doses of Morphine Administered in Spinal Anethesia for Pain Relief After Hip Replacement Surgery

NCT ID: NCT06878014

Last Updated: 2025-03-14

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

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-04

Study Completion Date

2026-02-28

Brief Summary

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Pain management after total hip replacement is one of the most important aspects of postoperative care for patients and clinicians alike. One of the most common techniques used in anesthesia for this procedure is spinal anesthesia with concurrent administration of opioids into spinal sac. Addition of opioids not only prolongs the anesthesia but also provides pain relief after the procedure for a limited amount of time. Because of its unique chemical properties morphine provides the longest pain relief amongst currently known opioids lasting up to 24 hours. Unfortunately this beneficial effect is associated with both minor and serious adverse effects, most important of which is respiratory depression.

To limit this potenitialy fatal adverse effect dosing of morphine must be very precise in order to balance advantages and risks.

The aim of the study was to assess effectiveness and safety profile of different doses of morphine administered during spinal anesthesia for pain control.

Detailed Description

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Conditions

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Analgesics, Opioid Anesthesia, Spinal Total Hip Replacement Adverse Anesthesia Outcome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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M50

In addition to bupivacaine patients received 50 mcg morphine sulphate intrathecaly.

Group Type ACTIVE_COMPARATOR

Spinal Anesthesia (bupivacaine)

Intervention Type PROCEDURE

Patients were positioned in sitting position on operating table, interspinous space was identified using anatomical landmarks (intercristal line) and palpation. Entire procedure was conducted with aseptic technique, puncture site was prepared with izopropyl alcohol solution. Skin was anesthetized with subcutaneous injection of 1% lidocaine. Spinal puncture was achieved using median or paramedian technique with 27G pencil-point spinal needle. After confirmation of free flow of cerebrospinal fluid 15 mg of 0,5% bupivacaine was administered intrathecaly. Block level was assessed by lack of sensation to alcohol swab in periumbilical area and complete motor block (Bromage 3).

Postoperative pain management with acetaminophen

Intervention Type DRUG

Postoperatively patients received 1,0g of paracetamol every 6 hours,

PCA IV Oxycodone

Intervention Type DEVICE

All patients were equipped with PCA capable syringe pump (Perfusor Space, B. Braun) with 40 milligrams of oxycodone. Care provider explained thoroughly how to operate the device and educated about possible adverse effects.

Postoperative pain management with dexketoprofen

Intervention Type DRUG

Postoperatively patients received 50mg of dexketoprofen intravenously every 8 hours.

Postoperative pain management with metamizole

Intervention Type DRUG

Postoperatively patients received 1,0g of metamizole intravenously every 6 hours.

Preemptive Analgesics

Intervention Type DRUG

After securing intravenous line each patient received preemptive analgesia with 1,0g paracetamol and 1,0g metamizole.

Patient monitor

Intervention Type DEVICE

Postoperatively each patient's vital signs were monitored continuously using patient monitor for 48 hours.

M100

In addition to bupivacaine patients received 100 mcg morphine sulphate intrathecaly.

Group Type ACTIVE_COMPARATOR

Spinal Anesthesia (bupivacaine)

Intervention Type PROCEDURE

Patients were positioned in sitting position on operating table, interspinous space was identified using anatomical landmarks (intercristal line) and palpation. Entire procedure was conducted with aseptic technique, puncture site was prepared with izopropyl alcohol solution. Skin was anesthetized with subcutaneous injection of 1% lidocaine. Spinal puncture was achieved using median or paramedian technique with 27G pencil-point spinal needle. After confirmation of free flow of cerebrospinal fluid 15 mg of 0,5% bupivacaine was administered intrathecaly. Block level was assessed by lack of sensation to alcohol swab in periumbilical area and complete motor block (Bromage 3).

Postoperative pain management with acetaminophen

Intervention Type DRUG

Postoperatively patients received 1,0g of paracetamol every 6 hours,

PCA IV Oxycodone

Intervention Type DEVICE

All patients were equipped with PCA capable syringe pump (Perfusor Space, B. Braun) with 40 milligrams of oxycodone. Care provider explained thoroughly how to operate the device and educated about possible adverse effects.

Postoperative pain management with dexketoprofen

Intervention Type DRUG

Postoperatively patients received 50mg of dexketoprofen intravenously every 8 hours.

Postoperative pain management with metamizole

Intervention Type DRUG

Postoperatively patients received 1,0g of metamizole intravenously every 6 hours.

Preemptive Analgesics

Intervention Type DRUG

After securing intravenous line each patient received preemptive analgesia with 1,0g paracetamol and 1,0g metamizole.

Patient monitor

Intervention Type DEVICE

Postoperatively each patient's vital signs were monitored continuously using patient monitor for 48 hours.

M150

In addition to bupivacaine patients received 150 mcg morphine sulphate intrathecaly.

Group Type ACTIVE_COMPARATOR

Spinal Anesthesia (bupivacaine)

Intervention Type PROCEDURE

Patients were positioned in sitting position on operating table, interspinous space was identified using anatomical landmarks (intercristal line) and palpation. Entire procedure was conducted with aseptic technique, puncture site was prepared with izopropyl alcohol solution. Skin was anesthetized with subcutaneous injection of 1% lidocaine. Spinal puncture was achieved using median or paramedian technique with 27G pencil-point spinal needle. After confirmation of free flow of cerebrospinal fluid 15 mg of 0,5% bupivacaine was administered intrathecaly. Block level was assessed by lack of sensation to alcohol swab in periumbilical area and complete motor block (Bromage 3).

Postoperative pain management with acetaminophen

Intervention Type DRUG

Postoperatively patients received 1,0g of paracetamol every 6 hours,

PCA IV Oxycodone

Intervention Type DEVICE

All patients were equipped with PCA capable syringe pump (Perfusor Space, B. Braun) with 40 milligrams of oxycodone. Care provider explained thoroughly how to operate the device and educated about possible adverse effects.

Postoperative pain management with dexketoprofen

Intervention Type DRUG

Postoperatively patients received 50mg of dexketoprofen intravenously every 8 hours.

Postoperative pain management with metamizole

Intervention Type DRUG

Postoperatively patients received 1,0g of metamizole intravenously every 6 hours.

Preemptive Analgesics

Intervention Type DRUG

After securing intravenous line each patient received preemptive analgesia with 1,0g paracetamol and 1,0g metamizole.

Patient monitor

Intervention Type DEVICE

Postoperatively each patient's vital signs were monitored continuously using patient monitor for 48 hours.

Interventions

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Spinal Anesthesia (bupivacaine)

Patients were positioned in sitting position on operating table, interspinous space was identified using anatomical landmarks (intercristal line) and palpation. Entire procedure was conducted with aseptic technique, puncture site was prepared with izopropyl alcohol solution. Skin was anesthetized with subcutaneous injection of 1% lidocaine. Spinal puncture was achieved using median or paramedian technique with 27G pencil-point spinal needle. After confirmation of free flow of cerebrospinal fluid 15 mg of 0,5% bupivacaine was administered intrathecaly. Block level was assessed by lack of sensation to alcohol swab in periumbilical area and complete motor block (Bromage 3).

Intervention Type PROCEDURE

Postoperative pain management with acetaminophen

Postoperatively patients received 1,0g of paracetamol every 6 hours,

Intervention Type DRUG

PCA IV Oxycodone

All patients were equipped with PCA capable syringe pump (Perfusor Space, B. Braun) with 40 milligrams of oxycodone. Care provider explained thoroughly how to operate the device and educated about possible adverse effects.

Intervention Type DEVICE

Postoperative pain management with dexketoprofen

Postoperatively patients received 50mg of dexketoprofen intravenously every 8 hours.

Intervention Type DRUG

Postoperative pain management with metamizole

Postoperatively patients received 1,0g of metamizole intravenously every 6 hours.

Intervention Type DRUG

Preemptive Analgesics

After securing intravenous line each patient received preemptive analgesia with 1,0g paracetamol and 1,0g metamizole.

Intervention Type DRUG

Patient monitor

Postoperatively each patient's vital signs were monitored continuously using patient monitor for 48 hours.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Informed consent to participate in trial
* Qualification for total hip replacement surgery
* ASA physical status I-III
* BMI 19-30
* Lack of contraindications for drugs and interventions used in trial

Exclusion Criteria

* Incapability to provide informed consent
* Contraindications for spinal anesthesia
* Preoperative chronic pain
* Chronic use of analgesics
* Obesity (BMI\>30)
* Allergies and other contraindications for drugs used in trial
* Mental or physical incapability to operate PCA syringe pump
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Silesia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Wojewódzki Szpital Specjalistyczny nr 5 im. św. Barbary

Sosnowiec, Silesian Voivodeship, Poland

Site Status

Zespół Opieki Zdrowotnej w Końskich

Gmina Końskie, Świętokrzyskie Voivodeship, Poland

Site Status

Countries

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Poland

Central Contacts

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Szymon Białka, MD PhD

Role: CONTACT

+48323407593

Jakub Żak, MD

Role: CONTACT

+48607936667

Facility Contacts

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Jakub Żak, MD

Role: primary

+48607936667

Wojciech Gola, MD PhD

Role: primary

+48504606247

Other Identifiers

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SMD-01

Identifier Type: -

Identifier Source: org_study_id

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