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Trial registered on ANZCTR
Registration number
ACTRN12610000454077
Ethics application status
Approved
Date submitted
27/05/2010
Date registered
3/06/2010
Date last updated
3/06/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
The relationship between the numeric rating scale, as a subjective measure of postoperative pain, and the plasma levels of catecholamines
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Scientific title
The relationship between the numeric rating scale, as a subjective measure of postoperative pain, and the plasma levels of catecholamines in patients undergoing non-emergency minor surgery
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Secondary ID [1]
251881
0
none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
acute postoperative pain
257478
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Condition category
Condition code
Anaesthesiology
257629
257629
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0
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Pain management
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Assessment of acute pain on a numeric rating scale (NRS 0-10, categories: 0= no pain, 1-3 = mild, 4-5 = moderate, >6 = severe pain) every 5 minutes during a patients stay in the recovery room (as long as this might take) in the recovery room. In addition, monitoring of blood pressure, respiration rate and heart rate, as well as recording and calculation of Electrocardiogram-based parameters of heart rate variability.
At up to 5 time points (admission to the recovery room, discharge from the recovery room + whenever a patient "transits" down a pain category, e.g. from severe to moderate pain, or when a patient "transits" up to any level above "no pain" [no further samples after first "transit up"]) 5 ml blood will be sampled from an intravenous (iv) line sited during the anaesthetic to measure the plasma levels of adrenaline and noradrenaline.
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Intervention code [1]
256574
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Not applicable
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Comparator / control treatment
nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
258540
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Correlation between acute postoperative pain and stress hormone plasma levels
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Assessment method [1]
258540
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Timepoint [1]
258540
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during the stay of a patient in the recovery room (2-5 blood samples, see above)
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Secondary outcome [1]
264379
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Correlation between pain, hormone levels and parameters of heart rate variability, blood pressure and heart rate
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Assessment method [1]
264379
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Timepoint [1]
264379
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hormone levels: 2-5 time points, see above
other parameters: approx. 5 minutely during recovery room stay
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Eligibility
Key inclusion criteria
age > 18, non-emergency minor surgery
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
age < 18, incapacity to consent, pacemaker, any drugs known or suspected to interact with sympathetic tone or haemodynamic parameters (e.g. ketamine, clonidine), chronic drug or alcohol abuse, continuous intravenous opioid infusion
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
85
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
257070
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Self funded/Unfunded
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Name [1]
257070
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Address [1]
257070
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Country [1]
257070
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Primary sponsor type
Individual
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Name
Thomas Ledowski
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Address
Dept. of Anaesthesia, Royal Perth Hospital, Wellington St., Perth WA 6000
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Country
Australia
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Secondary sponsor category [1]
256328
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None
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Name [1]
256328
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Address [1]
256328
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Country [1]
256328
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Other collaborator category [1]
1307
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Individual
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Name [1]
1307
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Vimal Kapoor
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Address [1]
1307
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University of Western Australia Pharmacology, M Block QEII Medical Centre, Hospital Ave, Nedlands 6009, WA
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Country [1]
1307
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
259093
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Royal Perth Hospital
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Ethics committee address [1]
259093
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Ethics Committee of the Royal Perth Hospital, Kirkman House Level 4, Wellington St., Perth WA 6000
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Ethics committee country [1]
259093
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Australia
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Date submitted for ethics approval [1]
259093
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Approval date [1]
259093
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15/01/2010
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Ethics approval number [1]
259093
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EC 2008/057
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Summary
Brief summary
It is commonly believed that acute postoperative pain can lead to an impaired outcome by means of stress hormone provoked physiological changes (e.g. hyperglycaemia, altered immune response, increased myocardial oxygen consumption). However, it has not yet been investigated whether or not pain that is often measured by means of subjective pain scales (e.g. numeric rating scale, NRS) actually correlates with changes in the plasma level of stress hormones. Aim of this study is to investigate the relationship between the subjective NRS score (0-10; 0= no pain, 10 = worst pain) and the plasma levels of adrenaline and noradrenaline. Furthermore, the correlation between these parameters and other non-invasive measures of pain (heart rate [HR], blood pressure [BP], respiration rate [RR], heart rate variability [HRV]) will be investigated. For this purpose, 85 patients scheduled for non-emergency plastic surgery will be included in the trial. On arrival in the recovery room, 4 ml blood will be taken from a cannula sited during the anaesthetic into the cubital fossa to measure plasma levels of catecholamines. Simultaneously, HR, BP and RR will be recorded as part of the recovery room protocol and the patient will be asked to rate their pain on the NRS. In addition, data from the connected electrocardiogram will be downloaded onto a laptop PC to calculate parameters of HRV by means of the MEMCALC method: total power, low frequency, high frequency, the low: high frequency ratio and a non-linear approach, ultra-short entropy. These HRV parameters are purely mathematical calculations (hence “no touch” technique) and have previously shown correlations with the sympatho-vagal balance. At the time of discharge from the recovery unit, above mentioned procedure will be repeated. In between these 2 time points, the procedure may be repeated up to 3 times if a patient “moves” from one pain category into another (4 categories defined: no [NRS 0], mild [NRS 1-3], moderate [NRS 4-5] and severe [NRS 6-10] pain). To identify changes in pain perception, patients are frequently (approx. 5 minutely) asked to rate their pain on the NRS. This is a standard procedure in the Royal Perth Hospital recovery room. Hence, a minimum of 2 and a maximum of 5 blood samples (=20ml) may be taken of a subject. The study period ends with discharge of a patient from the recovery room.
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Trial website
none
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Trial related presentations / publications
none
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Public notes
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Contacts
Principal investigator
Name
31233
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Address
31233
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Country
31233
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Phone
31233
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Fax
31233
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Email
31233
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Contact person for public queries
Name
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Prof. Thomas Ledowski
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Address
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Dept. of Anaesthesia, Royal Perth Hospital, Wellington St., Perth WA 6000
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Country
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Australia
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Phone
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0061 8 9224 1037
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Fax
14480
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0061 8 9224 1111
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Email
14480
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[email protected]
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Contact person for scientific queries
Name
5408
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Prof. Thomas Ledowski
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Address
5408
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Dept. of Anaesthesia, Royal Perth Hospital, Wellington St., Perth WA 6000
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Country
5408
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Australia
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Phone
5408
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0061 8 9224 1037
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Fax
5408
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Email
5408
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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