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Preoperative Gabapentin for Post-tonsillectomy Pain in Children

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University of Colorado, Denver

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概要

The typical post-operative course for children following surgical removal of their tonsils and adenoids can be challenging, especially for pain control. First line medications for pain include intravenous and enteral narcotics, acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) or N-methyl-D-aspartate (NMDA) antagonists but their effects appear to be short-lived. Gabapentin has been shown in adult studies to tone down the body's response to pain and decreases opioid use post-operatively. The purpose of this study is to see if a single preoperative dose will reduce post-operative pain scores and the amount of analgesic used.

説明

This is a randomized, double blind, placebo-controlled trial to study the effect of a preoperative oral dose of gabapentin on postoperative analgesic requirements and subjective pain levels in children undergoing tonsillectomy with adenoidectomy. Investigators will also look for a limited set of genotypic variations to explain any difference between individuals or groups in their response to the medication. Additionally, investigators will document potential adverse effects including excessive sedation, respiratory issues, surgical bleeding and emergence agitation/delirium.

Investigators hypothesize that gabapentin will reduce opioid analgesic requirements and pain scores up to 36 hours post adenotonsillectomy without increased adverse effects such as emergence delirium, respiratory complications or bleeding. The clinical effect may depend on the individual's pharmacogenetic profile to look for a specific set of genetic polymorphisms that relate to the metabolism and effect of the study drug, gabapentin, and opioid analgesic pain medications.

日付

最終確認済み: 04/30/2016
最初に提出された: 10/11/2012
提出された推定登録数: 10/11/2012
最初の投稿: 10/15/2012
最終更新が送信されました: 05/19/2016
最終更新日: 05/22/2016
実際の研究開始日: 07/31/2012
一次完了予定日: 11/30/2015
研究完了予定日: 11/30/2015

状態または病気

Post Operative Pain Management in Children With Tonsillectomy/Adenoidectomy

介入/治療

Drug: Gabapentin

Drug: liquid placebo

段階

-

アームグループ

介入/治療
Active Comparator: Gabapentin
gabapentin, 20 mg/kg, single dose, 60 min prior to surgery
Drug: Gabapentin
The active comparator, Gabapentin, is a structural analog of g-aminobutyric acid which has anticonvulsant properties. This study is a prospective randomized double-blinded trial examining the effectiveness of a single dose of liquid Gabapentin given 60 minutes prior to surgery for pain management in pediatric tonsillectomy/adenoidectomy pediatric patients.
Placebo Comparator: liquid placebo
subjects randomized to the liquid placebo arm will receive a single dose elixir of 0.4 mL/kg given 60 min prior to surgery
Drug: liquid placebo
Subjects randomized to the liquid placebo will receive an identical appearing liquid placebo of 0.4mL/kg.

適格基準

研究の対象となる年齢 5 Years に 5 Years
研究に適格な性別All
健康なボランティアを受け入れるはい
基準

Inclusion Criteria:

- scheduled for outpatient tonsillectomy and adenoidectomy

- < 60 Kg, between 5th and 95th percentile for weight

- ability to self-report pain

- complete pain diary with assistance from parent or guardian

Exclusion Criteria:

- require pre-anesthesia medication for anxiety

- require interpreter for verbal or written communication

- Obstructive sleep apnea significant enough to not qualify for outpatient surgery per surgeon

- ongoing oxygen dependence, pulmonary hypertension

- elevated risk of regurgitation

- history of seizures

- currently taking psychoactive medications or having a psychiatric condition requiring medications

- chronic pain disorders requiring medications

- renal disease

- developmental or cognitive disabilities

- history of adverse reactions to components of liquid gabapentin or placebo

結果

主な結果の測定

1. Total oral analgesia consumption [36 hours]

Total oral analgesic requirement (mL of hydrocodone/acetaminophen elixir) during the first 36 hours post operatively

二次的な結果の測定

1. Self-report pain score [36 hours]

Self-report pain scores at rest and with swallowing using Bieri Faces Scale-Revised.

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