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Total Hip Arthroplasty (THA)NCT07747142

Comparison Between Opioid-sparing Anesthesia Guided by the CARDEAN® Index and Opioid-free Anesthesia During Total Hip Arthroplasty

A study testing Titrated Opioid Sparing Anesthesia and opioid free anesthesia in people with Total Hip Arthroplasty (THA), run by Pole Sante Oreliance, Polyclinique des Longues Allees at 1 site in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The proposed study compares two anesthesia techniques; the hypothesis being tested is that titrating sufentanil based on the CARDEAN® index (titrated OSA) does not increase post-operative morphine consumption compared to opioid-free anesthesia (OFA). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Total Hip Arthroplasty (THA)
What is being tested?
Titrated Opioid Sparing Anesthesia and opioid free anesthesia
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
140 participants
Where
1 siteFrance
Study dates
15 Sep 2026to 1 Oct 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women
  • Patient aged at least 18 years
  • Signed informed consent
  • American Society of Anesthesiologists (ASA) Class 1 to 3
  • Scheduled total hip arthroplasty under general anesthesia (anterior or lateral approach) with local analgesic infiltration performed by the surgeon at the end of the procedure
  • Affiliated with or a beneficiary of a social security scheme.

Who cannot join

  • ASA Class 4 or 5
  • Emergency hip surgery
  • Indication for an anesthesia technique other than general anesthesia (patient preference, benefit-risk ratio, etc.)
  • Permanent cardiac arrhythmia or permanent cardiac pacing (invalid CARDEAN® index)
  • Resting bradycardia < 50 bpm
  • Second- or third-degree atrioventricular block
Show all 13Show fewer
  • Chronic opioid user
  • Refusal of consent
  • Patient unable to read, write, or understand French
  • Vulnerable patient as defined by Article L1121-6 of the Public Health Code (CSP)
  • Adult patient under guardianship, curatorship, or judicial protection
  • Patient unable to personally provide consent as defined by Article L.1121-8 of the CSP, or an adult under legal protection
  • Pregnant or breastfeeding woman as defined by Article L1121-5 of the CSP

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jean-Yves JY Martinez, Doctor contact

+33 2 38 79 61 85

jyvesmartinez@yahoo.com

France1 site
  • Pole Sante Oreliance, Polyclinique des Longues Allees

    Saran, 45770

    Jean-Yves Martinez, Doctor, +33 2 38 79 61 85, jyvesmartinez@yahoo.com

Other trials in France

About this study

Official title: Comparaison Entre anesthésie Avec épargne Morphinique guidée Par l'Index CARDEAN® et anesthésie Sans Morphinique au Cours Des Arthroplasties Totales de Hanche : étude randomisée

The proposed study compares two anesthesia techniques; the hypothesis being tested is that titrating sufentanil based on the CARDEAN® index (titrated OSA) does not increase post-operative morphine consumption compared to opioid-free anesthesia (OFA). This CARDEAN®-guided titrated anesthesia approach could potentially allow for hospital discharge as early as 24 hours post-operatively and is compatible with ERAS protocols. The primary objective is to demonstrate that sufentanil administration guided by the CARDEAN® index (titrated OSA) does not increase postoperative morphine consumption compared to opioid-free anesthesia (OFA). This is a prospective, single-center, randomized, single-blind, non-inferiority study.

Two groups of 70 patients each (140 patients in total) are compared based on the type of intraoperative analgesia: titrated OSA (Arm 1) versus OFA (Arm 2).

Randomization will be performed at a 1:1 ratio and stratified by surgical approach (anterior or lateral approach).

Being tested
Titrated Opioid Sparing Anesthesia, opioid free anesthesia
Keywords
Cardean, OSA, OFA, anesthesia

What participants receive

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

  • Titrated Opioid Sparing AnesthesiaProcedure or surgery

    Opioid-sparing anesthesia using the CARDEAN® index, which enables specific monitoring of nociception during general anesthesia.

    By adjusting sufentanil administration in real time based on variations in surgical painful stimuli, the CARDEAN® index enables titrated opioid-sparing anesthesia (titrated OSA).

  • opioid free anesthesiaProcedure or surgery

    anesthesia performed without opioid administration

Study groups in NCT07747142
Study groupRoleWhat they receive
Titrated Opioid Sparing AnesthesiaExperimentalNot described
Receives: Procedure: Titrated Opioid Sparing Anesthesia
Opioid Free AnesthesiaActive comparatorNot described
Receives: Procedure: opioid free anesthesia

What is being measured

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

  1. Total dose of morphine required to maintain a pain score ≤ 3 on a numerical scale of 1 to 10 during the first 24 hours (dose expressed as oral morphine equivalent, OME)

    Measured: During the first 24 hours after the start of anesthesia

Secondary outcomes (13)
  1. Stability of heart rate (HR) and mean arterial pressure (MAP)

    • Number of heart rate episodes deviating by ±20% for more than 15 seconds from the baseline heart rate, relative to the duration of the procedure
    • Number of mean arterial pressure (MAP) values deviating by ±20% from the baseline MAP, relative to the duration of the procedure
    • Number of boluses and total doses of cardiotropic and vasoactive drugs: atropine, norepinephrine, nicardipine

    Measured: During intervention

  2. Speed of emergence from anesthesia in the post-anesthesia care unit (PACU)

    Measured: Time interval between the end of the procedure and extubation

  3. Postoperative pain control

    Maximum pain score on a 0-10 numerical rating scale (NRS max) in the PACU

    Measured: During awakening, at day 1 and day 2 after surgery

  4. Adverse effects of postoperative opioids

    Number of hypoxia episodes in the PACU (hypoxia defined as SpO2 ≤ 94% on room air)

    Measured: During the awakening

  5. Discharge from the hospital is possible as early as 24 hours post-procedure for patients deemed eligible for early discharge (determined by the surgeon prior to the intervention).

    Measured: Until 24 hours after surgery

  6. Patient satisfaction: satisfaction questionnaire (completed on the day of discharge) regarding the management of any pain.

    Measured: At discharge (between 24 and 48 hours after surgery)

  7. Maximum pain score on a 0-10 numerical rating scale (NRS max) at rest and during movement

    Measured: On postoperative days 1 and 2

  8. IV morphine dose received in the PACU, expressed in MME

    Measured: during the awakening

  9. Morphine dose received in the surgical ward, expressed in MME, at 6, 12, 18, 24, 36, and 48 hours post-surgery (H0 = start of surgery)

    Measured: Every 6 hours until 48 hours after surgery

  10. Number of patients not receiving morphine in the PACU

    Measured: during the awakening, 24 hours after surgery, 48 hours after surgery

  11. Presence of postoperative nausea and/or vomiting (PONV)

    Measured: Until up to 48 hours after surgery

  12. Acute urinary retention (defined by the presence of a bladder volume > 600 ml requiring urinary catheterization)

    Measured: Until up to 48 hours after surgery

  13. Postoperative confusional state: preoperative cognitive test (Mini-Cog) and screening for postoperative confusional state (Confusion Assessment Method, CAM)

    Measured: After surgery just before discharge (between 24 and 48 hours after surgery)

Timeline

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

  1. First posted5 Aug 2026
  2. Study start15 Sep 2026 (estimated)
  3. Primary completion1 Oct 2027 (estimated)
  4. Study completion1 Oct 2027 (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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
140 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07747142
Sponsor's protocol ID
ID-RCB-2026-A00810-51
Status last verified
Jul 2026
First submitted
22 Jul 2026
Last updated
5 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Pedersen C, Vilhelmsen FJ, Laigaard J, Mathiesen O, Karlsen APH. Opioid consumption and non-opioid multimodal analgesic treatment in pain management trials after hip and knee arthroplasties: A meta-epidemiological study. Acta Anaesthesiol Scand. 2023 May;67(5):613-620. doi: 10.1111/aas.14213. Epub 2023 Feb 21.

    PubMed 36759566
  • Laigaard J, Pedersen C, Ronsbo TN, Mathiesen O, Karlsen APH. Minimal clinically important differences in randomised clinical trials on pain management after total hip and knee arthroplasty: a systematic review. Br J Anaesth. 2021 May;126(5):1029-1037. doi: 10.1016/j.bja.2021.01.021. Epub 2021 Mar 5.

    PubMed 33678402
  • Wey PF, Loheas D, Lamblin A, Riche B, Rabilloud M, Escarment J, Puidupin M, Quintin L, Martinez JY, Cividjian A. A beat-by-beat cardiovascular index, CARDEAN, to titrate opioid administration in the setting of orthopaedic surgery: a prospective randomized trial. J Clin Monit Comput. 2021 Dec;35(6):1311-1324. doi: 10.1007/s10877-020-00597-6. Epub 2020 Oct 6.

    PubMed 33025323
  • Papaioannou V, Chouvarda I, Gaertner E, Benyamina M, Ferry A, Maurel V, Soussi S, Blet A, Chaouat M, Plaud B, Mebazaa A, Legrand M; PRONOBURN Group. Heart rate variability and cardiac baroreflex inhibition-derived index predicts pain perception in burn patients. Burns. 2016 Nov;42(7):1445-1454. doi: 10.1016/j.burns.2016.04.017. Epub 2016 May 8.

    PubMed 27170468
  • Rossi M, Cividjian A, Fevre MC, Oddoux ME, Carcey J, Halle C, Frost M, Gardellin M, Payen JF, Quintin L. A beat-by-beat, on-line, cardiovascular index, CARDEAN, to assess circulatory responses to surgery: a randomized clinical trial during spine surgery. J Clin Monit Comput. 2012 Dec;26(6):441-9. doi: 10.1007/s10877-012-9372-y. Epub 2012 Jun 10.

    PubMed 22684738
  • Martinez JY, Wey PF, Lions C, Cividjian A, Rabilloud M, Bissery A, Bourdon L, Puidupin M, Escarment J, Quintin L. A beat-by-beat cardiovascular index, CARDEAN: a prospective randomized assessment of its utility for the reduction of movement during colonoscopy. Anesth Analg. 2010 Mar 1;110(3):765-72. doi: 10.1213/ANE.0b013e3181cc9ebe.

    PubMed 20185655
  • Cividjian A, Martinez JY, Combourieu E, Precloux P, Beraud AM, Rochette Y, Cler M, Bourdon L, Escarment J, Quintin L. Beat-by-beat cardiovascular index to predict unexpected intraoperative movement in anesthetized unparalyzed patients: a retrospective analysis. J Clin Monit Comput. 2007 Apr;21(2):91-101. doi: 10.1007/s10877-006-9061-9. Epub 2006 Dec 22.

    PubMed 17186401
  • Ao Y, Ma J, Zheng X, Zeng J, Wei K. Opioid-Sparing Anesthesia Versus Opioid-Free Anesthesia for the Prevention of Postoperative Nausea and Vomiting after Laparoscopic Bariatric Surgery: A Systematic Review and Network Meta-Analysis. Anesth Analg. 2025 Feb 1;140(2):385-396. doi: 10.1213/ANE.0000000000006942. Epub 2024 Apr 5.

    PubMed 38578868
  • Collange V, Berruet JB, Aubrun F, Poiblanc M, Olagne E, Golliet Mercier N, Parent S, Noel P, Devillez S, Perrou M, Ramadan J, Coeckelenbergh S, Joosten A. Opioid free versus opioid sparing strategies for multimodal antinociception during laparoscopic colectomy: a randomised controlled trial. Anaesth Crit Care Pain Med. 2024 Dec;43(6):101436. doi: 10.1016/j.accpm.2024.101436. Epub 2024 Oct 9.

    PubMed 39393528
  • Salome A, Harkouk H, Fletcher D, Martinez V. Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2021 May 12;10(10):2069. doi: 10.3390/jcm10102069.

    PubMed 34065937
  • Urvoy B, Aveline C, Belot N, Catier C, Beloeil H. Opioid-free anaesthesia for anterior total hip replacement under general anaesthesia: the Observational Prospective Study of Opiate-free Anesthesia for Anterior Total Hip Replacement trial. Br J Anaesth. 2021 Apr;126(4):e136-e139. doi: 10.1016/j.bja.2021.01.001. Epub 2021 Feb 3. No abstract available.

    PubMed 33549323
  • Beloeil H, Garot M, Lebuffe G, Gerbaud A, Bila J, Cuvillon P, Dubout E, Oger S, Nadaud J, Becret A, Coullier N, Lecoeur S, Fayon J, Godet T, Mazerolles M, Atallah F, Sigaut S, Choinier PM, Asehnoune K, Roquilly A, Chanques G, Esvan M, Futier E, Laviolle B; POFA Study Group; SFAR Research Network. Balanced Opioid-free Anesthesia with Dexmedetomidine versus Balanced Anesthesia with Remifentanil for Major or Intermediate Noncardiac Surgery. Anesthesiology. 2021 Apr 1;134(4):541-551. doi: 10.1097/ALN.0000000000003725.

    PubMed 33630043
  • Chassery C, Atthar V, Marty P, Vuillaume C, Casalprim J, Basset B, De Lussy A, Naudin C, Joshi GP, Rontes O. Opioid-free versus opioid-sparing anaesthesia in ambulatory total hip arthroplasty: a randomised controlled trial. Br J Anaesth. 2024 Feb;132(2):352-358. doi: 10.1016/j.bja.2023.10.031. Epub 2023 Dec 2.

    PubMed 38044236
  • Albrecht E, Grape S, Frauenknecht J, Kilchoer L, Kirkham KR. Low- versus high-dose intraoperative opioids: A systematic review with meta-analyses and trial sequential analyses. Acta Anaesthesiol Scand. 2020 Jan;64(1):6-22. doi: 10.1111/aas.13470. Epub 2019 Oct 7.

    PubMed 31506922
  • Colvin LA, Bull F, Hales TG. Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia. Lancet. 2019 Apr 13;393(10180):1558-1568. doi: 10.1016/S0140-6736(19)30430-1.

    PubMed 30983591

Questions about this trial

What is this clinical trial studying?

A study testing Titrated Opioid Sparing Anesthesia and opioid free anesthesia in people with Total Hip Arthroplasty (THA), run by Pole Sante Oreliance, Polyclinique des Longues Allees at 1 site in France.

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 6 inclusion and 13 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: opening soon, as of the sponsor's last update on 5 Aug 2026. 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 France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jean-Yves JY Martinez, Doctor (+33 2 38 79 61 85, jyvesmartinez@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total dose of morphine required to maintain a pain score ≤ 3 on a numerical scale of 1 to 10 during the first 24 hours (dose expressed as oral morphine equivalent, OME) (time frame: During the first 24 hours after the start of anesthesia). 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 NCT07747142, which also lists 15 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 5 Aug 2026.

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Clinical Trial NCT07747142 | AzTrials