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| Name | Class |
|---|---|
| Jinhua Central Hospital | OTHER |
| Minda Hospital of Hubei Minzu University | UNKNOWN |
| Taihe Hospital of Traditional Chinese Medicine | UNKNOWN |
| Qujing first people's Hospital |
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The goal of this clinical trial is to learn if the administration of oxycodone for preventive analgesia works to reduce the chronification of acute postoperative pain in adult participants undergoing major abdominal surgery. The main question it aims to answer is:
• Does administration of oxycodone before surgical incision reduce the occurrence of chronic pain or relieve the chronic pain symptoms 3 months after the operation? Researchers will compare oxycodone + parecoxib sodium to placebo + parecoxib sodium combinations to see if oxycodone works to reduce the chronification of acute postoperative pain.
Participants will:
Preventive analgesia encompasses a range of analgesic strategies designed to mitigate hyperalgesia and allodynia induced by noxious stimuli by preventing peripheral and intraoperative sensitization to pain. It constitutes a fundamental component of multimodal analgesia. Nonsteroidal anti-inflammatory drugs (NSAIDs) are presently the most frequently employed agents for preventive analgesia, demonstrating efficacy in reducing the incidence of acute postoperative pain and chronic post-surgical pain. However, the management of acute postoperative pain and chronic post-surgical pain remains suboptimal. κ-opioid receptors are regarded as the primary receptors involved in the transmission of visceral pain, and κ-receptor agonists have been shown to effectively inhibit this transmission. Administering κ-receptor agonists via intravenous infusion either before the conclusion of surgery or postoperatively can substantially mitigate pain during the recovery period. This indicates that κ-receptor agonists possess potential as preventive analgesics. However, there is currently a paucity of high-quality clinical evidence supporting their use in preventive analgesia. Oxycodone functions as a dual agonist of μ-opioid and κ-opioid receptors and is extensively utilized in postoperative analgesia and anesthesia induction. Its safety and efficacy in pain management have been thoroughly validated. Theoretically, the concurrent administration of oxycodone and NSAIDs, which mitigate pain signal transmission through distinct mechanisms, could result in an additive preventive analgesic effect. However, there is currently a paucity of high-quality clinical evidence supporting this hypothesis. Consequently, this study seeks to investigate the effects of the combined administration of oxycodone and NSAIDs as preventive analgesia on the transition of acute postoperative pain to chronic pain in patients undergoing major abdominal surgery. The findings aim to contribute clinical evidence and theoretical insights to enhance perioperative pain management strategies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| OP group | Experimental | Participants in this group will receive oxycodone and parecoxib sodium before surgical incision. |
|
| PP group | Placebo Comparator | Participants in this group will receive a placebo and parecoxib sodium before surgical incision. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| oxycodone and parecoxib sodium combinations | Drug | Participants will receive 0.1ml/kg oxycodone (1mg/ml) and 2 ml parecoxib sodium (20 mg/ml) combinations after the anesthesia induction but before the surgical incision. Oxycodone is administered 5 minutes after parecoxib sodium administration. |
| Measure | Description | Time Frame |
|---|---|---|
| Visceral pain scores in the surgical area at 90 days postoperatively. | The pain scores will be assessed by the Numeric Rating Scale (NRS) and Brief Pain Inventory Scale-Short form (BPI-9). The NRS evaluates pain intensity on a 0-10 scale and the scores are grouped as no (NRS 0), mild (NRS 1-4), moderate (NRS 5-7), or severe pain (NRS 8-10). The BPI-9 is a 9-item questionnaire and each item is scored from 0 = no pain to 10 = worst pain. The BPI-9 is used to assess various aspects of pain severity and pain interference. | 90 days after the surgery |
| The incidence of moderate to severe visceral pain at 90 days postoperatively. | The incidence will be calculated as the ratio of the number of participants with moderate to severe visceral pain to the number of participants allocated to each group at 90 days after the surgery . | 90 days after the surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Somatic pain scores in the surgical area at 48 hours postoperatively; | The pain scores will be assessed by the NRS and BPI-9 scales as described above. | 48 hours after the surgery |
| Visceral pain scores in the surgical area at 48 hours postoperatively; |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Luo Ailin | Contact | 86-027-83665480 | alluo@hust.edu.cn | |
| Li Shiyong | Contact |
| Name | Affiliation | Role |
|---|---|---|
| Luo Ailin | Department of Anesthesiology of Tongji hospital | Principal Investigator |
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| UNKNOWN |
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| Placebo and parecoxib sodium combinations | Drug | Participants will receive 0.1ml/kg placebo (0.9% saline) and 2 ml parecoxib sodium (20 mg/ml) combinations after the anesthesia induction but before the surgical incision. Placebo is administered 5 minutes after parecoxib sodium administration. |
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The pain scores will be assessed by the NRS and BPI-9 scales as described above. |
| 48 hours after the surgery |
| Incidence of moderate to severe visceral pain at 48 hours postoperatively; | The incidence will be calculated as the ratio of the number of participants with moderate to severe visceral pain to the number of participants allocated to each group at 48 hours after the surgery. | 48 hours after the surgery |
| Incidence of moderate to severe visceral pain in the surgical area at 30 days postoperatively; | The incidence will be calculated as the ratio of the number of participants with moderate to severe visceral pain to the number of participants allocated to each group at 30 days after the surgery. | 30 days after the surgery |
| Incidence of moderate to severe somatic pain in the surgical area at 30 days postoperatively; | The incidence will be calculated as the ratio of the number of participants with moderate to severe somatic pain to the number of participants allocated to each group at 30 days after the surgery. | 30 days after the surgery |
| Incidence of moderate to severe somatic pain in the surgical area at 90 days postoperatively. | The incidence will be calculated as the ratio of the number of participants with moderate to severe somatic pain to the number of participants allocated to each group at 90 days after the surgery. | 90 days after the surgery |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D010098 | Oxycodone |
| ID | Term |
|---|---|
| D003061 | Codeine |
| D009022 | Morphine Derivatives |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
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