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The purpose of this study is to determine whether intravenous lidocaine infusion during a video-assisted chest surgery is effective in reducing the pain involved after the surgery. The hypothesis is that continuous lidocaine infusion during video-assisted thoracoscopic surgery (VATS) reduces morphine consumption and postoperative pain.
Despite newer surgical techniques, many patients still experience moderate to severe postoperative pain after minimally invasive surgeries. Thoracoscopic surgeries are often associated with severe postoperative pain. To relieve the pain, potent narcotics have to be used, which have many side effects. Surgical patients would therefore benefit from an intra-operative analgesic regimen that is safe and effective, has minimal side effects and can reduce their postoperative narcotic requirements. Intravenous lidocaine has been shown previously to relieve cancer pain, chronic pain, and pain after other types of surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lidocaine Infusion | Experimental |
| |
| Placebo | Placebo Comparator | Saline Infusion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lidocaine Infusion | Drug | Infusion of lidocaine 3mg/min or 2mg/min during surgery |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Verbal Rating Scale for pain with deep inspiration | Patients will be questioned about pain intensities with a deep inspiratory breath using the Verbal Rating Scale (0-10) at 8, 16, 24, 36, and 48 hours post-initiaition of patient-controlled analgesia. | Up to 48 hrs post-initiation of patient-controlled analgesia |
| PCA Morphine Consumption | Patient-controlled analgesia machines will be reviewed for the total morphine doses administered at 8, 16, 24, 36, 48 hours post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Number of PCA Morphine Requests | PCA machines will be reviewed for total number of PCA requests at 8, 16, 24, 36, 48 hours post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Verbal Rating Scale for pain at rest | Patients will be questioned about pain intensities at rest using the Verbal Rating Scale (0-10) at 8, 16, 24, 36, 48 hours post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Measure | Description | Time Frame |
|---|---|---|
| Nausea | Patients will be questioned about the side effect of nausea at 8, 16, 24, 36, 48 hrs post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Vomiting |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dennis Ong, MD FRCPC | University of Saskatchewan, Department of Anesthesiology, Perioperative Medicine, and Pain Management | Principal Investigator |
| Brian Taylor, MD | Department of Anesthesiology, Perioperative Medicine, and Pain Management | Study Director |
| Ashraf Salem, MD | Department of Anesthesiology, Perioperative Medicine, and Pain Management | Study Director |
| Mark Slovack, MD | Department of Anesthesiology, Perioperative Medicine, and Pain Management | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Paul's Hospital | Saskatoon | Saskatchewan | S7M 0Z9 | Canada |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Placebo |
| Drug |
Saline Infusion at same rate as experimental arm |
|
Patients will be questioned about the side effect of vomiting at 8, 16, 24, 36, 48 hrs post-initiation of patient-controlled analgesia.
| Up to 48hrs post-initiation of patient-controlled analgesia |
| Pruritus | Patients will be questioned about the side effect of pruritus at 8, 16, 24, 36, 48 hrs post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Constipation | Patients will be questioned about the side effect of constipation at 8, 16, 24, 36, 48 hrs post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |
| Urinary Retention | Patients will be questioned about the side effect of urinary retention at 8, 16, 24, 36, 48 hrs post-initiation of patient-controlled analgesia. | Up to 48hrs post-initiation of patient-controlled analgesia |