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SurgeryPhase 4NCT04043624

The Study of Perioperative Intravenous Infusion of Lidocaine on Postoperative Analgesia in Patients Undergoing Single-port Thoracoscopic

A Phase 4 study testing Lidocaine and Saline in people with Surgery, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to evaluate the effect of intravenous lidocaine infusion on pain and opioid dosage in patients undergoing single-port thoracoscopic surgery,and to evaluate the effects of perioperative catecholamine levels, extubation time, incidence of nausea and vomiting, patient satisfaction and… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Surgery
What is being tested?
Lidocaine and Saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
1 siteChina
Study dates
1 Aug 2019to 31 Dec 2020
Phase
Phase 4
Are there results?
None posted in the registry

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 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients undergoing single-port thoracoscopic with a left double lumen bronchial catheter
  • Age ≧ 18 years old, ≦70 years old
  • Temperature, white blood cells, and hemoglobin were normal before surgery
  • Patient informed consent

Who cannot join

  • Patients with a history of surgery within six months
  • Patients with dysfunction of heart, liver, kidney, lung, pancreas or other important organs
  • American Society of Anesthesiologists (ASA) physical Status classes ≧ Ⅲ
  • Allergic to lidocaine
  • Bradycardia (heart rate < 60 beats/min) or atrioventricular block
  • Mental disorder
  • Patients requiring a right double lumen bronchial catheter

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • The Second Affiliated Hospital Zhejiang University School of Medicine

    Hangzhou, Zhejiang, 310009

    Jin Ma, 86+18867539602, 1241370980@qq.com

    Recruiting

Other trials in China

About this study

The purpose of this study is to evaluate the effect of intravenous lidocaine infusion on pain and opioid dosage in patients undergoing single-port thoracoscopic surgery,and to evaluate the effects of perioperative catecholamine levels, extubation time, incidence of nausea and vomiting, patient satisfaction and hospital stay.

Read the detailed description

The World Congress on Pain identified pain as the "fifth leading indicator of human life" after breathing, pulse, body temperature and blood pressure. Postoperative pain is an acute nociceptive pain caused by surgical trauma and is a complex stress response in the body, especially in 72 hours after surgery. Pain after thoracic surgery is a more severe type of surgery in various types of surgery.

Acute pain at the early stage of operation is not only an external signal of body injury, but also an independent factor inducing stress response and systemic inflammatory response syndrome (SIRS). Pain stimulus can also cause excessive release of catecholamine, damage of vascular endothelial cells and neutrophil aggregation, which can induce cytokine "waterfall" secretion. Stress, pain and inflammation induce and interact with each other, which seriously affects the early recovery of patients after operation. Timely and effective post-operative analgesia can not only alleviate patients'pain, but also avoid a series of stress reactions. It provides favorable conditions for the stability of patients' physiological function and recovery of their body after operation.

Although multimodal analgesia has largely replaced monotherapy with opioids, they are still the most commonly used drugs for postoperative pain. Lidocaine is an amide local anesthetic which when used intravenously demonstrates significant analgesic, anti-hyperalgesic and anti-inflammatory properties .

Intravenous infusion of lidocaine has a good effect on fibromyalgia, chronic neuropathic pain, opioid tolerance and other chronic pain, and can reduce postoperative acute pain. In the 1960s, Barlett et al. first published a study on the use of lidocaine intravenous infusion for postoperative analgesia.Since then, more and more researchers have begun to explore the use of lidocaine in the treatment of postoperative acute pain.In 2007, Kaba et al. selected patients who underwent colectomy as an experimental subject, and intravenously injected lidocaine during the perioperative period. The results showed that the pain of the experimental group was effectively relieved and the use of opioids was reduced. In 2008, Lauwick et al. used laparoscopic cholecystectomy as the experimental subject. The results showed that the dose of opioid analgesia in the lidocaine group was significantly lower than that in the control group, and the postoperative pain was effectively improved. In 2009, Yardeni et al. selected patients undergoing total hysterectomy as experimental subjects and intravenously injected lidocaine during the perioperative period. The results confirmed that the hemodynamics of the experimental group was more stable, the average dosage of anesthetics was reduced, and the pain was significantly improved.However, to date, there is no strong evidence for the effect of perioperative intravenous infusion of lidocaine in single-port thoracoscopic surgery, so we designed this study.

Conditions
Surgery
Being tested
Lidocaine, Saline
Keywords
single-port thoracoscopic surgery, lidocaine, postoperative pain, opioid
Medical subject headings
Pain, Postoperative

What participants receive

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

  • LidocaineDrug

    regimen of lidocaine administration of 1.5 mg/kg, IV bolus, followed by continuous infusion at 2 mg/kg/h

  • SalineDrug

    IV bolus of saline, followed by continuous infusion of saline

Study groups in NCT04043624
Study groupRoleWhat they receive
Lidocaine groupExperimentalFirst group (lidocaine group) will include those who receive a intraoperative lidocaine infusion.Induction bolus dose of 1.5 mg/kg body weight ( 30 minutes before incision)followed by a continous lidocaine infusion of 2mg/kg/h,until 1 hours after skin closure.
Receives: Drug: Lidocaine
Saline groupPlacebo comparatorThe second group(saline group) will include those who receive a intraoperative placebo.The same dosage of saline was given according to the same method of administration in the lidocaine group.
Receives: Drug: Saline

What is being measured

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

  1. Postoperative pain score

    Using Visual Analogue Scales

    Measured: Immediately postoperation

  2. Postoperative pain score

    Using Visual Analogue Scales

    Measured: 1 hour postoperation

  3. Postoperative pain score

    Using Visual Analogue Scales

    Measured: 4 hours postoperation

  4. Postoperative pain score

    Using Visual Analogue Scales

    Measured: 8 hours postoperation

  5. Postoperative pain score

    Using Visual Analogue Scales

    Measured: 24 hours postoperation

  6. Postoperative pain score

    Using Visual Analogue Scales

    Measured: 48 hours postoperation

Secondary outcomes (27)
  1. Opioid requirement

    The dosage of opioids was recorded

    Measured: Immediately postoperation

  2. Opioid requirement

    The dosage of opioids was recorded

    Measured: 1 hour postoperation

  3. Opioid requirement

    The dosage of opioids was recorded

    Measured: 4 hours postoperation

  4. Opioid requirement

    The dosage of opioids was recorded

    Measured: 8 hours postoperation

  5. Opioid requirement

    The dosage of opioids was recorded

    Measured: 24 hours postoperation

  6. Opioid requirement

    The dosage of opioids was recorded

    Measured: 48 hours postoperation

  7. Pressing times of PCIA postoperation

    The pressing times of PCIA within 48 hours postoperation was recorded

    Measured: 48 hours postoperation

  8. Occurrence of nausea and/or vomiting

    The occurrence of nausea and vomiting within 48 hours postoperation was recorded

    Measured: 48 hours postoperation

  9. Blood level of adrenaline

    Perioperative blood level of adrenaline was recorded

    Measured: before induction

  10. Blood level of adrenaline

    Perioperative blood level of adrenaline was recorded

    Measured: after incision

  11. Blood level of adrenaline

    Perioperative blood level of adrenaline was recorded

    Measured: immediately after extubation

  12. Blood level of norepinephrine

    Perioperative blood level of norepinephrine was recorded

    Measured: before induction

  13. Blood level of norepinephrine

    Perioperative blood level of norepinephrine was recorded

    Measured: after incision

  14. Blood level of norepinephrine

    Perioperative blood level of norepinephrine was recorded

    Measured: immediately after extubation

  15. Blood level of adrenocortical

    Perioperative blood level of adrenocortical was recorded

    Measured: before induction

  16. Blood level of adrenocortical

    Perioperative blood level of adrenocortical was recorded

    Measured: after incision

  17. Blood level of adrenocortical

    Perioperative blood level of adrenocortical was recorded

    Measured: immediately after extubation

  18. Blood level of TNF-alpha

    Perioperative blood level of TNF-alpha was recorded

    Measured: before induction

  19. Blood level of TNF-alpha

    Perioperative blood level of TNF-alpha was recorded

    Measured: after incision

  20. Blood level of TNF-alpha

    Perioperative blood level of TNF-alpha was recorded

    Measured: immediately after extubation

  21. Blood level of IL-6

    Perioperative blood level of IL-6 was recorded

    Measured: before induction

  22. Blood level of IL-6

    Perioperative blood level of IL-6 was recorded

    Measured: after incision

  23. Blood level of IL-6

    Perioperative blood level of IL-6 was recorded

    Measured: immediately after extubation

  24. Blood level of IL-10

    Perioperative blood level of IL-10 was recorded

    Measured: before induction

  25. Blood level of IL-10

    Perioperative blood level of IL-10 was recorded

    Measured: after incision

  26. Blood level of IL-10

    Perioperative blood level of IL-10 was recorded

    Measured: immediately after extubation

  27. Duration of hospital stay

    length of hospital stay (in days)

    Measured: from day of surgery until day of discharge from hospital

Timeline

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

  1. First posted2 Aug 2019
  2. Study start1 Aug 2019 (estimated)
  3. Primary completion31 Dec 2019 (estimated)
  4. Study completion31 Dec 2020 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04043624
Sponsor's protocol ID
2019-084
Status last verified
Jul 2019
First submitted
19 Jul 2019
Last updated
2 Aug 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, Schmelz M, Hering W. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesth Analg. 2004 Apr;98(4):1050-1055. doi: 10.1213/01.ANE.0000104582.71710.EE.

    PubMed 15041597
  • Schafranski MD, Malucelli T, Machado F, Takeshi H, Kaiber F, Schmidt C, Harth F. Intravenous lidocaine for fibromyalgia syndrome: an open trial. Clin Rheumatol. 2009 Jul;28(7):853-5. doi: 10.1007/s10067-009-1137-8. Epub 2009 Mar 5.

    PubMed 19263182
  • Challapalli V, Tremont-Lukats IW, McNicol ED, Lau J, Carr DB. Systemic administration of local anesthetic agents to relieve neuropathic pain. Cochrane Database Syst Rev. 2005 Oct 19;2005(4):CD003345. doi: 10.1002/14651858.CD003345.pub2.

    PubMed 16235318
  • Buchanan DD, J MacIvor F. A role for intravenous lidocaine in severe cancer-related neuropathic pain at the end-of-life. Support Care Cancer. 2010 Jul;18(7):899-901. doi: 10.1007/s00520-010-0864-3. Epub 2010 Apr 29.

    PubMed 20429016
  • Sharma S, Rajagopal MR, Palat G, Singh C, Haji AG, Jain D. A phase II pilot study to evaluate use of intravenous lidocaine for opioid-refractory pain in cancer patients. J Pain Symptom Manage. 2009 Jan;37(1):85-93. doi: 10.1016/j.jpainsymman.2007.12.023. Epub 2008 Jul 2.

    PubMed 18599258
  • Lauwick S, Kim DJ, Michelagnoli G, Mistraletti G, Feldman L, Fried G, Carli F. Intraoperative infusion of lidocaine reduces postoperative fentanyl requirements in patients undergoing laparoscopic cholecystectomy. Can J Anaesth. 2008 Nov;55(11):754-60. doi: 10.1007/BF03016348.

    PubMed 19138915
  • Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, Lamy ML, Joris JL. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007 Jan;106(1):11-8; discussion 5-6. doi: 10.1097/00000542-200701000-00007.

    PubMed 17197840
  • Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesth Analg. 2009 Nov;109(5):1464-9. doi: 10.1213/ANE.0b013e3181bab1bd.

    PubMed 19843784
  • Eriksson AS, Sinclair R, Cassuto J, Thomsen P. Influence of lidocaine on leukocyte function in the surgical wound. Anesthesiology. 1992 Jul;77(1):74-8. doi: 10.1097/00000542-199207000-00011.

    PubMed 1610012
  • Feng G, Liu S, Wang GL, Liu GJ. Lidocaine attenuates lipopolysaccharide-induced acute lung injury through inhibiting NF-kappaB activation. Pharmacology. 2008;81(1):32-40. doi: 10.1159/000107792. Epub 2007 Sep 4.

    PubMed 17785997

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Lidocaine and Saline in people with Surgery, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

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 4 inclusion and 7 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: status not confirmed, as of the sponsor's last update on 2 Aug 2019. 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 China. 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 phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Jin Ma (86+18867539602, 1241370980@qq.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative pain score (time frame: Immediately postoperation). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04043624, which also lists 10 linked publications.

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 2 Aug 2019.

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