Remifentanil versus fentanyl during cardiac surgery on the incidence of chronic thoracic pain (REFLECT): study protocol for a randomized controlled trial
Autor: | Eric P.A. van Dongen, Dick Tibboel, Sabine J.G.M. Ahlers, Catherijne A. J. Knibbe, Sjoerd de Hoogd, Albert Dahan |
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Přispěvatelé: | Pediatric Surgery |
Rok vydání: | 2014 |
Předmět: |
Employment
Pain Threshold Chest Pain medicine.medical_specialty Time Factors Analgesic Remifentanil Medicine (miscellaneous) Chronic pain Chest pain Drug Administration Schedule law.invention Fentanyl Postoperative pain Study Protocol SDG 3 - Good Health and Well-being Clinical Protocols Piperidines Randomized controlled trial law Surveys and Questionnaires Threshold of pain medicine Humans Single-Blind Method Thermosensing Pharmacology (medical) Prospective Studies Cardiac Surgical Procedures Infusions Intravenous Netherlands Pain Measurement Pain Postoperative business.industry Perioperative medicine.disease Sternotomy Surgery Analgesics Opioid Treatment Outcome Research Design Anesthesia Quality of Life medicine.symptom business medicine.drug |
Zdroj: | Trials Trials, 15 Trials, 15. BioMed Central Ltd. Trials, 15, 466 |
ISSN: | 1745-6215 |
Popis: | BACKGROUND: Chronic thoracic pain after cardiac surgery is prevalent (11 to 56%) and may affect patients' physical and mental health status. Despite its favorable pharmacokinetic and pharmacodynamic properties, high doses of remifentanil administered during surgery are reported to cause acute postoperative pain and increased requirements for analgesics. Recently, an association between remifentanil use and the incidence of chronic thoracic pain in the long term was also reported. Our objective is to investigate the influence of the intraoperative remifentanil on chronic postoperative pain in a prospective randomized controlled trial.METHODS/DESIGN: In this prospective, randomized, single-blind clinical trial, all patients (N = 126) between 18 and 85 years undergoing cardiac surgery via sternotomy receive a continuous infusion of propofol together with intermittent intravenous fentanyl at predetermined times perioperatively. Patients are randomized to receive either an additional continuous infusion of remifentanil (0.15 μg(-1)kgIBW(-1) min(-1)) or additional fentanyl (200 to 500 μg) as needed during surgery.The primary end point is the prevalence of chronic thoracic pain 12 months after surgery. Secondary end points include acute postoperative pain; postoperative analgesic use; chronic thoracic pain 3 and 6 months after surgery; quality of life (SF-12) at 3, 6 and 12 months after surgery; work productivity; and use of health care. In addition, thermal detection and pain thresholds are measured preoperatively, 3 days after surgery and 12 months after surgery using quantitative sensory testing (QST). Finally, the influence of several genetic variances on the different outcomes will be measured.DISCUSSION: Chronic thoracic pain is prevalent after cardiac surgery, and research is needed to minimize the risk of chronic persistent postoperative pain, which is an invalidating, long-term complication of surgery. The objective of this trial is to determine the influence of perioperative remifentanil on long-term pain outcomes for cardiac patients in a prospective randomized trial. The results may be used to optimize perioperative analgesia techniques and, thereby, improve quality of life after cardiac surgery.TRIAL REGISTRATION: Clinicaltrials.gov NCT02031016 on 13 December 2013. |
Databáze: | OpenAIRE |
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