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Post Operative PainTRONNCT05879536

The Effect of Intravenous Infusion of Tramadol-ondansetron on Recovery After Caesarean Section.

An observational study of Post Operative Pain and Cesarean Section, run by Hospital Universitario La Fe at 1 site in Spain.

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

It will be a prospective observational cohort study. The investigators will compare post-cesarean section recovery in patients receiving intravenous infusion of tramadol-ondansetron versus epidural catheter with infusion of local anesthetics. Read more about this study

Who is it for?
Ages 18 to 50 years, women onlyHealthy volunteers can take part
Conditions the study is for
Post Operative Pain, Cesarean Section, Tramadol
What is being tested?
Tramadol-ondansetron continuous infusion and Ropivacaine via epidural catheter
Type of treatment
Injection or infusion
How many people
312 participants
Where
1 siteSpain
Study dates
23 May 2023to 1 Oct 2024
Phase
Observational
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 50 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Study population: The target population of this study would correspond to women who underwent a caesarean section (therefore, of childbearing age) in the first 48 hours of their puerperium, who underwent surgery at the HUiP La Fe. Among these, the patients who, following the practice usual clinical presentation in a standard cesarean section at the study center, receive a TRON or an infusion through the epidural catheter with ropivacaine.

Who may be able to join

  • Woman over 18 years old undergoing caesarean section
  • She agrees to participate voluntarily.
  • She is already receiving any of the analgesic strategies studied.

Who cannot join

  • Receiving an analgesic medication other than the one mentioned as "routine multimodal analgesia" (either as regular medication or for acute post-surgical pain)
  • Medical history that determines the baseline data of the scales and data that we collect ( pain or previous disabilities; addiction to drugs, alcohol or drugs; another disease that worsens the quality of life)
  • Medical history that conditions the pharmacological effect (allergy, intolerance or atypical reaction to any of the drugs involved in its treatment or possible cross-reactions )
  • Contraindication for neuraxial techniques (patient refusal, difficulty in understanding or communication, localized infection, increased intracranial pressure, or other medical criteria)
  • Two or more previous caesarean sections
  • Difficulty in understanding or communication
  • Mother care will not be available to the newborn in the postpartum period for any reason

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Hospital Universitario La Fe

    Valencia

Other trials in Spain

About this study

Official title: The Effect of Intravenous Infusion of Tramadol-ondansetron on Recovery After Caesarean Section. A Prospective, Observational and Non-inferiority Study Against Epidural Analgesia.

It will be a prospective observational cohort study. The investigators will compare post-cesarean section recovery in patients receiving intravenous infusion of tramadol-ondansetron versus epidural catheter with infusion of local anesthetics.

Read the detailed description

The primary outcome is to assess the non-inferiority in terms of post-cesarean section recovery of the intravenous perfusion of tramadol + ondansetron compared to the perfusion of local anesthetics through an epidural catheter.

This will be a prospective observational cohort study, with a total N of 312 patients who underwent a cesarean section. 156 who maintain the epidural catheter as the main measure of analgesia for 24 h, and 156 who receive an infusion of tramadol-ondansetron from the end of the cesarean section and for the following 24 h. The following data will be collected at 24 and 48 hours: need for unscheduled pharmacological reinforcement, adverse effects, QoR (Quality of Recovery) score 15, ObsQor-10 (Obstetric Quality of Recovery) score, and Visual Analogue Pain Scale (VAS) every 4 hours for 48 hours. The incidence of chronic pain 90 days after cesarean section will be assessed using the Numerical Pain Rating Scale (NRS).

Being tested
Tramadol-ondansetron continuous infusion, Ropivacaine via epidural catheter
Keywords
tramadol, cesarean section, postcesarean section, Qor-15, ObsQor-10, postcesarean recovery
Medical subject headings
Pain, Postoperative

What participants receive

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

  • Tramadol-ondansetron continuous infusionDrug

    Analgesia strategy determined by routine use according to protocols, without investigator intervention.

  • Ropivacaine via epidural catheterDrug

    Analgesia strategy determined by routine use according to protocols, without investigator intervention.

Study groups in NCT05879536
Study groupRoleWhat they receive
TRON (Tramadol-Ondansetron)Women who receive an infusion of tramadol-ondansetron from the end of the cesarean section and for the following 24 h. The infusion (TRON) is composed of 300 mg of tramadol and 12 mg of ondansetron dissolved in 250 ml of 0.9% saline, which is routinely programmed at 11 ml/h until the content is exhausted (approximately 23 hours).
Receives: Drug: Tramadol-ondansetron continuous infusion
AL-EPI (Local anesthetics via epidural)Women who maintain the epidural catheter as the main measure of analgesia for 24 h. The epidural catheter after caesarean section is programmed with a 0.2% ropivacaine PCA (Patient controlled analgesia) pump at 7 ml/h with 7 ml on-demand boluses, with block every 20 min.
Receives: Drug: Ropivacaine via epidural catheter

What is being measured

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

  1. Post-surgical recovery

    QoR-15 score at 24 hours after cesarean section

    Measured: Day 1

Secondary outcomes (7)
  1. Analgesia for acute pain

    Pain score evolution on the sequential Visual Analogue Scale at 24 hours, measured every 4 hours.

    Measured: Day 1

  2. Adverse effects

    Presence or absence of the next adverse effects: Pruritus; tremors; urinary retention or need for a bladder catheter; Constipation or abdominal distension; limitation of mobility; delayed initiation of breastfeeding if desired (due to analgesia); need for blood extraction for control analysis.

    Measured: Day 1

  3. Quality of recovery using ObsQoR10 - Spanish version

    ObsQor-10 score at 24 hours.

    Measured: Day 1

  4. Post-surgical recovery

    QoR-15 score at 48 hours after cesarean section

    Measured: Day 2

  5. Adverse effects

    Presence or absence of the next adverse effects: Pruritus; tremors; urinary retention or need for a bladder catheter; Constipation or abdominal distension; limitation of mobility; delayed initiation of breastfeeding if desired (due to analgesia); need for blood extraction for control analysis.

    Measured: Day 2

  6. Analgesia for acute pain

    Pain score evolution on the sequential Visual Analogue Scale at 48 hours, measured every 4 hours.

    Measured: Day 2

  7. Chronic Pain

    Chronic pain measured by numerical rating scale at 90 days of TRON versus AL-EPI.

    Measured: Day 90

Timeline

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

  1. First posted30 May 2023
  2. Study start23 May 2023
  3. Primary completion1 Oct 2024
  4. Study completion1 Oct 2024

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
312 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05879536
Sponsor's protocol ID
TRON
Acronym
TRON
Status last verified
Feb 2025
First submitted
4 Apr 2023
Last updated
21 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Myles PS, Boney O, Botti M, Cyna AM, Gan TJ, Jensen MP, Kehlet H, Kurz A, De Oliveira GS Jr, Peyton P, Sessler DI, Tramer MR, Wu CL; StEP-COMPAC Group; Myles P, Grocott M, Biccard B, Blazeby J, Boney O, Chan M, Diouf E, Fleisher L, Kalkman C, Kurz A, Moonesinghe R, Wijeysundera D. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: patient comfort. Br J Anaesth. 2018 Apr;120(4):705-711. doi: 10.1016/j.bja.2017.12.037. Epub 2018 Feb 2.

    PubMed 29576111
  • Moonesinghe SR, Jackson AIR, Boney O, Stevenson N, Chan MTV, Cook TM, Lane-Fall M, Kalkman C, Neuman MD, Nilsson U, Shulman M, Myles PS; Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine initiative: patient-centred outcomes. Br J Anaesth. 2019 Nov;123(5):664-670. doi: 10.1016/j.bja.2019.07.020. Epub 2019 Sep 5.

    PubMed 31493848
  • Boney O, Moonesinghe SR, Myles PS, Grocott MPW; StEP-COMPAC group. Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC): a modified Delphi process to develop a core outcome set for trials in perioperative care and anaesthesia. Br J Anaesth. 2022 Jan;128(1):174-185. doi: 10.1016/j.bja.2021.09.027. Epub 2021 Nov 2.

    PubMed 34740438
  • Ma J, Martin R, Chan B, Gofeld M, Geary MP, Laffey JG, Abdallah FW. Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation after Regional Anesthesia and Analgesia Interventions. Anesthesiology. 2018 Mar;128(3):598-608. doi: 10.1097/ALN.0000000000001979.

    PubMed 29135475
  • Delfino E, Netto R, Zanon D. Pain control after cesarean delivery: a new proposal for a continuous locoregional technique. Int J Obstet Anesth. 2021 Nov;48:103196. doi: 10.1016/j.ijoa.2021.103196. Epub 2021 Jun 23. No abstract available.

    PubMed 34243070
  • Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.

    PubMed 26580836
  • Vercauteren M, Vereecken K, La Malfa M, Coppejans H, Adriaensen H. Cost-effectiveness of analgesia after Caesarean section. A comparison of intrathecal morphine and epidural PCA. Acta Anaesthesiol Scand. 2002 Jan;46(1):85-9. doi: 10.1034/j.1399-6576.2002.460115.x.

    PubMed 11903078
  • Chi X, Li M, Mei W, Liao M. Comparison of patient-controlled intravenous analgesia with sufentanil versus tramadol in post-cesarean section pain management and lactation after general anesthesia - a prospective, randomized, double-blind, controlled study. J Pain Res. 2017 Jul 3;10:1521-1527. doi: 10.2147/JPR.S137799. eCollection 2017.

    PubMed 28740418
  • Duan G, Bao X, Yang G, Peng J, Wu Z, Zhao P, Zuo Z, Li H. Patient-controlled intravenous tramadol versus patient-controlled intravenous hydromorphone for analgesia after secondary cesarean delivery: a randomized controlled trial to compare analgesic, anti-anxiety and anti-depression effects. J Pain Res. 2018 Dec 18;12:49-59. doi: 10.2147/JPR.S184782. eCollection 2019.

    PubMed 30588079
  • Siddik-Sayyid S, Aouad-Maroun M, Sleiman D, Sfeir M, Baraka A. Epidural tramadol for postoperative pain after Cesarean section. Can J Anaesth. 1999 Aug;46(8):731-5. doi: 10.1007/BF03013907.

    PubMed 10451131
  • Nnacheta TE, Onyekwulu FA, Amucheazi AO. Prevention of postanesthetic shivering under subarachnoid block for cesarean section: A randomized, controlled study comparing tramadol versus ondansetron. Niger J Clin Pract. 2020 May;23(5):619-625. doi: 10.4103/njcp.njcp_641_18.

    PubMed 32367867
  • Jayaraj A, Balachander H, Kuppusamy SK, Arusamy S, Rai Y, Siddiqui N. Comparison of meperidine, tramadol and fentanyl for post-spinal shivering prevention during cesarean delivery: A double-blind randomized controlled trial. J Obstet Gynaecol Res. 2019 Nov;45(11):2202-2208. doi: 10.1111/jog.14106. Epub 2019 Sep 4.

    PubMed 31486253
  • Sammour RN, Ohel G, Cohen M, Gonen R. Oral naproxen versus oral tramadol for analgesia after cesarean delivery. Int J Gynaecol Obstet. 2011 May;113(2):144-7. doi: 10.1016/j.ijgo.2010.11.024.

    PubMed 21435642
  • Sahmeddini MA, Azemati S, Motlagh EM. Local Infiltration of Tramadol versus Bupivacaine for Post Cesarean Section Pain Control: A Double-Blind Randomized Study. Iran J Med Sci. 2017 May;42(3):235-241.

    PubMed 28533571
  • Mitra S, Khandelwal P, Sehgal A. Diclofenac-tramadol vs. diclofenac-acetaminophen combinations for pain relief after caesarean section. Acta Anaesthesiol Scand. 2012 Jul;56(6):706-11. doi: 10.1111/j.1399-6576.2012.02663.x. Epub 2012 Mar 5.

    PubMed 22385415

Questions about this trial

What is this clinical trial studying?

An observational study of Post Operative Pain and Cesarean Section, run by Hospital Universitario La Fe at 1 site in Spain.

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 3 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: finished, as of the sponsor's last update on 21 Feb 2025. 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 Spain. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Post-surgical recovery (time frame: Day 1). 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 NCT05879536, which also lists 28 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 21 Feb 2025.

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