Comprehensive Study of Post-surgical Pain After Pectus or Spine Surgery

NCT04031716 | Active Not Recruiting

• 1 other identifier: 2017-5817
• Study Type: interventional
• Target: 600
• Locations: 1 country
• Sites: 1

Brief Summary

This will be a prospective study to determine the association between specific genotypes, epigenetics, behavioral, social and biological factors, with the phenotypes, defined by pain perception, postoperative pain, analgesic effects, side effects to perioperative analgesics, chronic postoperative pain, and gene expression in patients following pectus excavatum repair.

Conditions

Pain, Postoperative; Excavatum, Pectus; Scoliosis Idiopathic

Keywords

Meditation; Pectus Excavatum; Scoliosis

Outcome Measures

Primary Outcomes (7)

• Pain score trajectory

  Pain scores will be collected preoperatively through 1 year postoperatively

  1 year

• Changes in self-reported psychosocial scores (including anxiety, pain, coping, physical limitation, etc.)

  Psychosocial measures will be collected preoperatively through 1 year postoperatively

  1 year

• Changes in heart rate variability

  Heart rate variability will be assessed preoperatively and postoperatively

  8 weeks

• Changes in mean amplitude values for lower, upper, and entire alpha frequency bands by group (intervention/no intervention) and time (pre-surgery/post-surgery)

  Brain activity will be assessed preoperatively and postoperatively

  8 weeks

• Changes in evoked response potentials (ERPs) during meditation and experimental pain tasks

  Brain activity will be assessed preoperatively and postoperatively

  8 weeks

• Changes in sleep efficiency/duration (actigraphy) and self-reported sleep quality

  Sleep efficiency and quality will be assessed preoperatively and postoperatively

  8 weeks

• Incidence of side-effect measures

  Incidences of respiratory depression, sedation, postoperative nausea and vomiting will be collected during the recovery phase

  72 hours postoperatively

Secondary Outcomes (1)

• Changes in pressure pain threshold, conditioned pain modulation, tactile discrimination, and temporal summation index

  8 weeks

Study Arms (2)

Control

NO INTERVENTION

Participants in the control group will receive present standard of care, which includes an assessment of participant/family needs by integrative care after surgery, as well as standard holistic health care by a licensed/certified holistic health specialist. They will not receive the MUSETM focused-attention meditation training or intervention protocol.

Meditation

EXPERIMENTAL

Participants randomized to receive focused-attention meditation training will attend a preoperative training session, provided by a licensed/certified Holistic Health Specialist. The content will include an age appropriate explanation of focused-attention meditation, using breath as the focus; set-up and utilization of the MUSETM headband; and experiential practices. The goal of the intervention is to increase mindfulness (i.e., moment-to-moment, non-judgmental and non-reactive awareness of sensations, emotions, and thoughts), provide self-regulation strategies, and promote healthy and adaptive responses to stress.

Behavioral: Meditation

Interventions

Meditation BEHAVIORAL

Participants assigned to the Meditation intervention will receive focused attention meditation training preoperatively, and encouraged to meditate for 20 minutes per day before surgery. In the postoperative inpatient period, the participants will be offered standard holistic health care, reinforcement of meditation training, and encouragement to practice at least 20 minutes of guided focused-attention meditation with breath as their focus, utilizing the MUSETM headband for bio-feedback, every day during their hospital stay. They will be asked to continue using the MUSETM neurofeedback-assisted meditation after hospital discharge, until their visit to repeat pain testing, at which time they will return the MUSETM headband.

Meditation

Eligibility Criteria

• Age: 8 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Children aged 8 years of age through adulthood
• Diagnosis of pectus excavatum or adolescent idiopathic scoliosis
• Scheduled for endoscopic pectus excavatum repair or spine fusion

You may not qualify if:

• History of or active renal or liver disease
• Major surgery requiring opioids in the last 5 years
• Severe respiratory problems (such as obstructive sleep apnea, cystic fibrosis, pulmonary fibrosis, or pneumonia within the last month)
• Cardiac conditions including, but not limited to, cyanotic heart disease, hypoplastic left ventricle, arrhythmia, hypertension with ongoing treatment, Kawasaki disease, or cardiomyopathies. Participants with asymptomatic valvular lesions or defects may be included
• History of seizures currently treated on medication (participants off medication and seizure free for greater than one year may be included)
• Taking no more than two concomitant medications known to induce or inhibit CYP2D6 activity, including paroxetine, fluoxetine, cimetidine, and duloxetine
• Needing postoperative ventilation or intraoperative cardiac bypass standby
• BMI \>35
• Pregnant or breastfeeding females
• Non-English speaking
• Definite developmental delay

Sponsors & Collaborators

• Children's Hospital Medical Center, Cincinnati: lead

Study Sites (1)

Cincinnati Childrens Hospital Medical Center

Cincinnati, Ohio, 45229, United States

Location

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MeSH Terms

Conditions

Pain, Postoperative; Funnel Chest; Scoliosis

Interventions

Meditation

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Bone Diseases, Developmental; Bone Diseases; Musculoskeletal Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Spinal Curvatures; Spinal Diseases

Intervention Hierarchy (Ancestors)

Mind-Body Therapies; Complementary Therapies; Therapeutics; Spiritual Therapies; Relaxation Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Vidya Chidambaran, MD

  Children's Hospital Medical Center, Cincinnati

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: All participants will receive standard perioperative care, anesthetic management, and postoperative pain management per institutional standardized practices. Participants will be randomized into either the Meditation or Control Groups, as deemed appropriate.

Study Record Dates

• First Submitted: September 20, 2018
• First Posted: July 24, 2019
• Study Start: July 6, 2018
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: June 13, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will share

Locations

US (1)