Antinociceptive Modalities on Ischemia Reperfusion Injury

NCT01932918 | Completed

• 1 other identifier: 201001020R
• Study Type: observational
• Target: 142
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative pain caused by surgery-associated tissue injury is a major concern for all the clinical practitioners. Because it affects multiple systems and induces physiological, immunological and psychological changes. Previous literature showed surgical injury induces a systemic inflammatory metabolic-endocrine response that is proportional to the severity of the surgical stress. In surgeries such as liver transplantation, the patients suffer not only from postoperative pain but also an additional oxidative stress caused by ischemia reperfusion. Previous report have proved that an adequate postoperative pain control improves the recovery and reduces the inflammatory cascade by suppression of physiological and psychological stresses. However, the effect of postoperative pain management on ischemia reperfusion injury is unclear so far. In this three year study, we plan to continue our previous study to test the following two hypothesis: (1) postoperative pain exacerbate remote organ injury caused by ischemia reperfusion, (2) the interaction of different antinociceptive modalities on ischemia reperfusion injury.

Conditions

End Stage Liver Disease; Lung Cancer

Keywords

reactive oxygen species; ischemia reperfusion injury

Outcome Measures

Primary Outcomes (1)

• lung injury score

  four days

Study Arms (4)

PCA with morphine in liver transplant

Intravenous patient controlled analgesia with morphine was used for postoperative pain control in liver transplant recipients.

Drug: Patient controlled analgesia

PCA with ketorolac in liver transplant

Patient controlled analgesia with morphine and ketorolac was used for postoperative pain control in liver transplant and thoracic surgery patients.

Drug: Patient controlled analgesia

Intravenous PCA in thoracic surgery

Intravenous patient controlled analgesia was used for postoperative pain control in thoracic surgery patients.

Drug: Patient controlled analgesia

PCEA in thoracic surgery

Patient controlled epidural analgesia was used for postoperative pain control in thoracic surgery patients.

Drug: Patient controlled analgesia

Interventions

Patient controlled analgesia DRUG

1. PCA with morphine in liver transplant: Intravenous patient controlled analgesia with morphine was used for postoperative pain control in liver transplant recipients. 2. PCA with morphine and ketorolac: Patient controlled analgesia with morphine and ketorolac was used for postoperative pain control in liver transplant and thoracic surgery patients. 3. Intravenous PCA in thoracic surgery Intravenous patient controlled analgesia was used for postoperative pain control in thoracic surgery patients. 4. PCEA in thoracic surgery Patient controlled epidural analgesia was used for postoperative pain control in thoracic surgery patients.

Also known as: morphine, ketorolac, marcaine

Intravenous PCA in thoracic surgery; PCA with ketorolac in liver transplant; PCA with morphine in liver transplant; PCEA in thoracic surgery

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

End stage liver disease Lung cancer

You may qualify if:

• End stage liver disease patients scheduled for liver transplantation in National Taiwan University Hospital
• Lung cancer patients scheduled for thoracic surgery in National Taiwan University Hospital

You may not qualify if:

• preoperative pulmonary dysfunction

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

Department of Anesthesiology, NTUH, Taipei, Taiwan

Taipei, Taiwan

Location

Related Publications (1)

• Lin TF, Yeh YC, Lin FS, Wang YP, Lin CJ, Sun WZ, Fan SZ. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth. 2009 Jan;102(1):117-22. doi: 10.1093/bja/aen320. Epub 2008 Nov 5.

  PMID: 18987053 BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

plasma

MeSH Terms

Conditions

End Stage Liver Disease; Lung Neoplasms; Reperfusion Injury

Interventions

Analgesia, Patient-Controlled; Morphine; Ketorolac; Bupivacaine

Condition Hierarchy (Ancestors)

Liver Failure; Hepatic Insufficiency; Liver Diseases; Digestive System Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Vascular Diseases; Cardiovascular Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Analgesia; Anesthesia and Analgesia; Morphine Derivatives; Morphinans; Opiate Alkaloids; Alkaloids; Heterocyclic Compounds; Heterocyclic Compounds, Bridged-Ring; Heterocyclic Compounds, 4 or More Rings; Heterocyclic Compounds, Fused-Ring; Phenanthrenes; Polycyclic Aromatic Hydrocarbons; Polycyclic Compounds; Indomethacin; Indoles; Heterocyclic Compounds, 2-Ring; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Officials

• Kuang Cheng Chan, M.D.

  Department of Anesthesiology, NTUH, Taipei, Taiwan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 27, 2013
• First Posted: August 30, 2013
• Study Start: January 1, 2011
• Primary Completion: July 1, 2015
• Study Completion: July 1, 2015
• Last Updated: July 23, 2015

Record last verified: 2015-07

Locations

TW (1)