Confirmatory Study of HFVI Guided Analgesic Administration in Surgical Subjects

NCT04049656 | Completed FDA Device

• 2 other identifiers: OCR2716220192697
• Study Type: interventional
• Target: 5
• Locations: 1 country
• Sites: 1

Brief Summary

The current study is intended to be a prospective clinical performance validation study designed to confirm the clinical utility of HFVI-guided fentanyl administration during sevoflurane anesthesia. The overall objective of this study is to confirm the safety and efficacy of HFVI-guided analgesic administration in comparison to standard clinical practice. The primary efficacy endpoint will be the amount of postoperative pain reported in the PACU, as measured using a nurse administered Numerical Rating Scale (NRS) pain score.

Conditions

Analgesia

Keywords

Sevoflurane-Fentanyl Anesthesia

Outcome Measures

Primary Outcomes (1)

• Change in Numerical Pain Scores (NPS)

  The change in numerical pain scores reported during the first hour (scores at 15, 30, 45, and 60 minutes) of recovery. The NPS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of pain, with 0 being 'no pain' and 10 being 'the worst pain.' Subjects and clinical pain assessors will remain blinded to treatment group assignment.

  15 minutes; 30 minutes; 45 minutes; 60 minutes

Secondary Outcomes (3)

• Percentage of patients minimal pain (NPS < 3) during recovery

  Hour 1

• Number of opioid analgesics administered in the operating room (OR) and post-anesthesia care unit (PACU).

  Hour 1

• Incidence of postoperative nausea and vomiting (PONV) in the PACU

  Hour 1

Study Arms (2)

HFVI intervention group

EXPERIMENTAL

Subjects in the HFVI intervention group will be monitored in the same manner as the control group, but the HFVI monitor display will also be available to the anesthesia provider in real time. Bolus doses of 25ug or 50 ug of fentanyl will be recommended to be administered when the HFVI values begin to decrease below 50, and as needed based on the judgment of the clinician responsible for the case. All anesthetic medications that are given, patient events, and vital sign recordings will be included in the anesthetic record and data collection forms.

Device: HFVI

Standard of Care Group

NO INTERVENTION

Subjects receiving a balanced maintenance anesthetic consisting primarily of a sevoflurane hypnotic (titrated to a BIS range of 40-60) and fentanyl analgesia. Subjects randomized to the control group (Standard Practice) will have analgesia administered as needed according to standard clinical monitoring and practice requirements based on the judgment of the clinician responsible for the case. The HFVI monitor will be applied, but the display will be masked in this control group population.

Interventions

HFVI DEVICE

Subjects in the HFVI intervention group will be monitored in the same manner as the control group, but the HFVI monitor display will also be available to the anesthesia provider in real time. Bolus doses of 25ug or 50 ug of fentanyl will be recommended to be administered when the HFVI values begin to decrease below 50, and as needed based on the judgment of the clinician responsible for the case. All anesthetic medications that are given, patient events, and vital sign recordings will be included in the anesthetic record and data collection forms.

HFVI intervention group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Able to provide informed consent
• American Society of Anesthesiologist Physical Status 1 or 2
• Body Mass Index range of 19-35 kg.m-2.
• Planned spinal or open abdominal surgery expected to last 1-3 hours utilizing a balanced sevoflurane-fentanyl general anesthetic

You may not qualify if:

• Subjects are unable or unwilling to give informed consent.
• Emergency surgery
• Women who are currently pregnant or not using a medically acceptable means of birth control
• Cardiac morbidity, including non-regular sinus cardiac rhythm or implanted cardiac pacemaker
• Concurrent medications with a major effect upon the sinus node including prescribed antimuscarinic agents, α2-adrenergic agonists, β1-adrenergic antagonists, and antiarrhythmic agents
• Expected duration of surgery less than 1 hour (60 minutes) or greater than 3 hours (180 minutes)
• Pre-operative chronic opioid use or chronic pain, equivalent to requiring oxycodone 20mg per oral, per day for more than 6 weeks
• Allergy or intolerance to any of the anticipated study medications, such as history of malignant hyperthermia during anesthesia
• Planned use of neuraxial anesthesia
• Clinically significant abnormality or clinically significant unstable medical condition, as indicated by medical history, physical examination, ECG results, or clinical laboratory testing, that in the Investigator's judgment might pose a potential safety risk to the subject or limit interpretation of the trial results, e.g., any uncontrolled thyroid disorders, hepatic, cardiac, pulmonary and renal malfunctioning.

Sponsors & Collaborators

• University of Florida: lead
• Mdoloris Medical Systems: collaborator

Study Sites (1)

UF Health Jacksonville

Jacksonville, Florida, 32209, United States

Location

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Jay W Johansen, MD, PhD

  University of Florida

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Masking Details: Investigators administering anesthesia will be informed as to whether or not HFVI information will be unmasked to help guide analgesic administration. However, subjects who participate in the trial and the PACU assessors of pain levels will be blinded to study group assignment.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: A Prospective, Randomized, PACU Blinded, Clinical Utility Study to Confirm the Safety and Efficacy of HFVI-Guided Analgesic Administration in Surgical Subjects Receiving Balanced Sevoflurane-Fentanyl Anesthesia

Study Record Dates

• First Submitted: August 6, 2019
• First Posted: August 8, 2019
• Study Start: October 8, 2020
• Primary Completion: January 9, 2024
• Study Completion: January 9, 2024
• Last Updated: January 11, 2024

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)