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Phase 1: Pain ManagementPhase 1/2NCT02654860

Dose-finding Study of Intrathecal Paracetamol Administered Immediately Before Spinal Anaesthesia

A Phase 1/2 study testing Paracetamol 3% and Hyperbaric Bupivacaine HCl 0.5% in people with Phase 1: Pain Management and Phase 2: Pain Management, run by Sintetica SA at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Two-part study of intrathecal paracetamol administered immediately before spinal anaesthesia in patients scheduled for hip replacement surgery Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Paracetamol 3% and Hyperbaric Bupivacaine HCl 0.5%
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
69 participants
Where
1 siteSwitzerland
Study dates
Nov 2016to Feb 2019
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Informed consent: signed written informed consent before inclusion in the study
  • Sex, age and surgery: male/female 18-80 years (inclusive) old patients, scheduled for hip replacement surgery, with anticipated need for post-operative narcotic analgesia, adequate i.v. access and anticipated hospital stay > 48 hours.
  • Body Mass Index (BMI): 18 - 34 kg/m2 inclusive
  • ASA physical status: I-III
  • Full comprehension: ability to comprehend the full nature and purpose of the study, including possible risks and side effects; ability to co-operate with the investigator and to comply with the requirements of the entire study
  • Inclusion criteria - Phase 1 only : Age: 18-70 (inclusive) old patients
  • Inclusion criteria - Phase 2 only : Age: 18-80 (inclusive) old patients Hospital stay: Patients with anticipated hospital stay > 48 hours

Who cannot join

  • Physical findings: clinically significant abnormal physical findings which could interfere with the objectives of the study. Contraindications to spinal anaesthesia. History of neuromuscular diseases to the lower extremities
  • ASA physical status: IV-V
  • Further anaesthesia: patients expected to require further anaesthesia
  • Pain assessment: anticipated to be unable to make a reliable self-report of pain intensity
  • Allergy: ascertained or presumptive hypersensitivity to the active principles (paracetamol and/or amide type anaesthetics) and/or formulations' ingredients or related drugs, opioids, non-steroidal anti-inflammatory drugs; history of anaphylaxis to drugs or allergic reactions in general, which the investigator considers could affect the outcome of the study
  • Diseases: significant history of renal, hepatic, gastrointestinal, cardiovascular, respiratory, skin, haematological, endocrine or neurological diseases that may interfere with the aim of the study; ascertained psychiatric and neurological diseases, sepsis, blood coagulation disorders, severe cardiopulmonary disease, thyroid disease, diabetes, other neuropathies, history or evidence of asthma or heart failure. History of severe head trauma that required hospitalisation, intracranial surgery or stroke within the previous 30 days, or any history of intracerebral arteriovenous malformation, cerebral aneurism or CNS mass lesion.
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  • Liver function: Impaired liver function (transaminases > twice upper limit)
  • Renal function: Renal dysfunction (creatinine > 2.0 mg/dL)
  • Investigative drug studies: participation in the evaluation of any investigational product for 3 months before this study, calculated from the first day of the month following the last visit of the previous study
  • Drug, alcohol: history of drug or alcohol abuse. Pre-existing dependence on narcotics or known tolerance to opioids
  • Pregnancy and lactation: positive pregnancy test at screening (if applicable), pregnant or lactating women [The pregnancy test will be performed to all fertile women and to all women up to 55 years old, if not in proven menopause (available laboratory test confirming menopause or surgically sterilised)]
  • Chronic pain syndromes: patients with chronic pain syndromes (taking opioids, anticonvulsant agents or chronic analgesic therapy).
  • Medications: medication known to interfere with the extent of spinal blocks for 2 weeks before the start of the study. Paracetamol formulations, other than the investigational product, for 1 week before the start of the study and during the study. Hormonal contraceptives for females are allowed.
  • Phase 2 only - Exclusion criteria Pain assessment: anticipated to be unable to make a reliable self-report of pain intensity

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • Claudio Camponovo

    Gravesano, Lugano, CH-6929

Other trials in Switzerland

About this study

Official title: Two-part Study of Intrathecal Paracetamol Administered Immediately Before Spinal Anaesthesia in Patients Scheduled for Hip Replacement Surgery

Two-part study of intrathecal paracetamol administered immediately before spinal anaesthesia in patients scheduled for hip replacement surgery

Read the detailed description

This is a prospective, single centre, two-part, three doses study. Part 1 is a Phase I, three cohorts, dose-ascending, open-label, safety study. Part 2 is a Phase II, randomised, parallel-group, double-blind, placebo-controlled, exploratory efficacy and safety study The objective of the study is to investigate the efficacy and safety of a single intrathecal injection of paracetamol, administered at 3 doses to 3 active treatment groups, as compared to placebo solution, for post-operative analgesia of hip replacement surgery performed under spinal anaesthesia. Patients scheduled for hip replacement surgery will be randomised into 4 treatment groups (15 patients per group) to receive either one of the 3 single doses of paracetamol 3% (D1: 60 mg, D2: 90 mg, D3: 120 mg) or placebo solution (P: saline solution) by intrathecal (IT) injection. Immediately after paracetamol or placebo IT administration, all patients will receive a single IT dose of Hyperbaric Bupivacaine HCl 0.5% (12.5 mg for ≤ 160 cm-tall patients and 15 mg for > 160 cm-tall patients). The time interval between paracetamol IT and bupivacaine IT administrations should not exceed 2 min.

The study will include a screening phase (Visit 1, Days -21/1), a treatment phase (paracetamol IT administration, anaesthesia and surgical procedure: Visit 2, Day 1) and a follow-up phase including an observation period (Visit 3, from Day 1 after surgery until discharge, a final visit (at discharge) and a follow-up (day 6±1). Pain at rest will be assessed at screening and on visit 2 at baseline (0 h), 1, 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45 and 48 h after anaesthetic IT injection and at discharge, using a 0-100 mm VAS.

Being tested
Paracetamol 3%, Placebo injection containing Saline solution 0.9%, Hyperbaric Bupivacaine HCl 0.5%

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Paracetamol 3%Drug

    Investigate the efficacy and safety of a single intrathecal injection of paracetamol,for post-operative analgesia of hip replacement surgery

  • Placebo injection containing Saline solution 0.9%Drug

    Injection containing sterile solution of Saline Solution 0.9 %. Study part 2 will be placebo-controlled. Each patient will be allocated to a treatment arm (one of the three paracetamol doses or placebo) according to a computer-generated randomisation list.

  • Hyperbaric Bupivacaine HCl 0.5%Drug

    NIMP, spinal anaesthetic before the surgical procedure

Study groups in NCT02654860
Study groupRoleWhat they receive
60 mg Paracetamol 3% (2 mL)Experimental60 mg Paracetamol 3%. Solution for injection, single administration by Intrathecal route.
Receives: Drug: Paracetamol 3%; Drug: Hyperbaric Bupivacaine HCl 0.5%
90 mg Paracetamol 3% (3 mL)Experimental90 mg Paracetamol 3%. Solution for injection, single administration by Intrathecal route.
Receives: Drug: Paracetamol 3%; Drug: Hyperbaric Bupivacaine HCl 0.5%
120 mg Paracetamol 3% (4mL)Experimental120 mg Paracetamol 3%. Solution for injection, single administration by Intrathecal route.
Receives: Drug: Paracetamol 3%; Drug: Hyperbaric Bupivacaine HCl 0.5%
Phase II Only: Saline solution 0.9%Placebo comparatorPlacebo, 0.9%. Solution for injection , single administration by route Intrathecal (2 mL, 3 mL and 4 mL) Study part 2 will be placebo-controlled. Each patient will be allocated to a treatment arm (one of the three paracetamol doses or placebo) according to a computer-generated randomisation list.
Receives: Drug: Placebo injection containing Saline solution 0.9%; Drug: Hyperbaric Bupivacaine HCl 0.5%

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1: Number of Participants With Adverse Events Related, Not Related and Serious Events Related to Paracetamol

    Phase 1: Number of participants with treatment evaluation and confirmation of the safety of the three doses of paracetamol 3% solution administered in the total number of patients enrolled

    Measured: In the first 24 hours, in the first 48 hours and at day 7±1

  2. Phase 2: Pain Intensity

    Phase 2: Pain intensity at rest evaluated as VAS scores ( 0-100 mm visual analogue scale : 0 is the absence pain and 100 is the maximum pain sensation)

    Measured: baseline (0 h), 1, 6, 9, 12, 15, 24, and 48 h after anaesthetic IT injection and at discharge

Secondary outcomes (12)
  1. Phase 2: Morphine

    Phase 2: Total morphine use

    Measured: At 24 and 48 h after anaesthetic IT injection and entire study period, up to 7 days

  2. Phase 2: Time to First Morphine Use

    Phase 2: Time to first morphine use (minutes)

    Measured: Postoperative, up to 48 hours after end of surgery

  3. Phase 2: Number of Participants With Need for Supplemental Analgesia

    Phase 2: Need for supplementary analgesia, other than the planned morphine PCA

    Measured: Postoperative, up to 48 hours after end of surgery

  4. Phase 2: Morphine-related Adverse Events

    Percentage of subjects experiencing during the study the morphine-related adverse events pre-specified in the protocol

    Measured: up to 24 hours after surgery, up to 48 hours

  5. Phase 2: Time to Readiness for Surgery

    Time period from completion of spinal injection (time 0 h) to achievement of sensory and motor block adequate for surgery.

    Measured: Intraoperative

  6. Phase 2:Maximum Level of Sensory Block

    Sensorial block will be verified by bilateral Pinprick test using a 20-G hypodermic needle and will be recorded. Pinprick sensation will be scored as being present (score 1) or absent (score 0). Onset of sensory block is defined as an absent touch sensation (score 0)

    Measured: Intraoperative

  7. Phase 2: Time to Sensory Block

    Time to maximum level of sensory block

    Measured: Intraoperative

  8. Phase 2: Time to Regression of Spinal Block

    Time period from spinal injection (time 0 h) to the time when the Bromage score returns to 0 and sensitive perception returns to S1. Bromage scale:

    I - Free movement of legs and feet II - Just able to flex knees with free movement of feet III - Unable to flex knees, but with free movement of feet IV - Unable to move legs or feet

    Measured: from readiness for surgery,then every 10 min until the maximum level is reached (two consecutive observations with the same level of sensory block) and then every 30 min until regression of spinal block

  9. Phase 2: Vital Signs

    Systolic and Diastolic Blood Pressure (mmHg)

    Measured: at screening, at baseline (before the spinal injection) and at end of the study (Day 6).

  10. Phase2: Concomitant Medications

    record the concomitant medications intaked during the study

    Measured: at screening, at baseline until the end of the study (Day 6)

  11. Phase 2: SpO2

    Oxygen saturation is the fraction of oxygen-saturated hemoglobin relative to total hemoglobin (unsaturated + saturated) in the blood.

    Measured: at screening, at baseline (before the spinal injection) and at the end of the study (day 6)

  12. Phase 2: ECG

    Electrocardiography is the process of producing an electrocardiogram (ECG), it is a graph of voltage versus time of the electrical activity of the heart using electrodes placed on the skin.

    Measured: screening, baseline and end of study (Day 6±1)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jan 2016 (estimated)
  2. Study startNov 2016
  3. Primary completionFeb 2019
  4. Study completionFeb 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
4 arms for Phase II only
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
69 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02654860
Sponsor's protocol ID
PAR.3/02-2015
Status last verified
Jul 2021
First submitted
23 Dec 2015
Last updated
27 Oct 2021
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Paracetamol 3% and Hyperbaric Bupivacaine HCl 0.5% in people with Phase 1: Pain Management and Phase 2: Pain Management, run by Sintetica SA at 1 site in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Jun 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1: Number of Participants With Adverse Events Related, Not Related and Serious Events Related to Paracetamol (time frame: In the first 24 hours, in the first 48 hours and at day 7±1). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2021; AzTrials last refreshed its copy on 6 Nov 2026.

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