NCT00553553

Brief Summary

The patient population requiring hepatic resection can demonstrate an unpredictable risk of exhibiting peri-operative coagulopathy resulting either from the pre-operative hepatic pathophysiology or volume of parenchymal resection. Choice of analgesia can be severely limited. Currently, the most commonly described use of combined remifentanil infusion and intrathecal morphine has been in fast-track cardiac surgery. To date, there are no published data describing its use in the context of major hepatobiliary where the investigators predict it may provide adequate analgesia with a lower rate of adverse effects over the first 24 hours after surgery.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
45

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2007

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2007

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

November 2, 2007

Completed
3 days until next milestone

First Posted

Study publicly available on registry

November 5, 2007

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2008

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2008

Completed
Last Updated

December 31, 2008

Status Verified

December 1, 2008

Enrollment Period

8 months

First QC Date

November 2, 2007

Last Update Submit

December 30, 2008

Conditions

Keywords

Intrathecal morphine ITM intravenous morphine remifentanil hepatic resectionAdultASA I-III (stable)Liver dysfunction requiring primary parenchymal resection

Outcome Measures

Primary Outcomes (1)

  • Opioid-related side effects

    First 24 hours post-operatively

Secondary Outcomes (1)

  • IV opioid analgesic supplementation

    First 24 hours post-operatively

Study Arms (2)

1

ACTIVE COMPARATOR

IV morphine group

Drug: Morphine sulphate

2

EXPERIMENTAL

Remifentanil-intrathecal morphine group

Drug: Morphine hydrochloride, remifentanil hydrochloride

Interventions

Intravenous morphine titrated up to 0.25 milligrams/kilogram prior to end of resection phase or within first 2 hours of surgery

1

Pre-induction intrathecal morphine HCl (\< 3 attempts), single shot via 25 G pencil point spinal needle at 10 micrograms/kilogram Intra-operative intravenous remifentanil HCl at titratable dose range 0.1-0.25 micrograms/kilogram/minute until start of wound closure

2

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult
  • ASA I, II or stable III
  • Undergoing primary elective hepatic resection of \< 50% predicted parenchymal resection

You may not qualify if:

  • Previous major upper GI surgery:
  • liver resection or transplant
  • gastrectomy
  • oesophagectomy
  • Whipple's procedure
  • Contraindications to dural puncture:
  • coagulopathy
  • uncorrected anti-coagulant therapy
  • spinal deformity
  • neurological disorder
  • psychiatric disorder
  • Morphine allergy
  • Co-morbidity predisposing to failure of extubation at conclusion of surgery:
  • severe cardiopulmonary pathology scoring ASA III (unstable)
  • sleep apnoea
  • +9 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

St. Vincent's University Hospital

Dublin, County Dublin, 4, Ireland

RECRUITING

MeSH Terms

Conditions

Liver DiseasesPain

Interventions

MorphineRemifentanil

Condition Hierarchy (Ancestors)

Digestive System DiseasesNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Morphine DerivativesMorphinansOpiate AlkaloidsAlkaloidsHeterocyclic CompoundsHeterocyclic Compounds, Bridged-RingHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingPhenanthrenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsPropionatesAcids, AcyclicCarboxylic AcidsOrganic ChemicalsPiperidinesHeterocyclic Compounds, 1-Ring

Study Officials

  • Neil J. McDonald, MB BCh

    St Vincent's University Hospital, Ireland

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Debbie A. D'Oyley, MB BS

CONTACT

Neil J. McDonald, MB BCh

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

November 2, 2007

First Posted

November 5, 2007

Study Start

September 1, 2007

Primary Completion

May 1, 2008

Study Completion

June 1, 2008

Last Updated

December 31, 2008

Record last verified: 2008-12

Locations