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Trial registered on ANZCTR
Registration number
ACTRN12616000919415
Ethics application status
Approved
Date submitted
3/04/2016
Date registered
11/07/2016
Date last updated
16/06/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Use of Patient Controlled Analgesics in the management of pain in Orthognathic Surgery – A randomised controlled trial pilot study
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Scientific title
Use of Patient Controlled Analgesics in the management of pain in Orthognathic Surgery – A randomised controlled trial pilot study
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Secondary ID [1]
288920
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None
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Universal Trial Number (UTN)
U1111-1181-3681
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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:
Post surgery pain management
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Condition category
Condition code
Anaesthesiology
298400
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Following orthognathic surgery (corrective jaw surgery), patients are randomised into control group and exposure group.
The exposure group will be administered a Patient Controlled Analgesics (PCA) on top of their regular pain relief.
The patients in the PCA group will follow the PCA protocol of 100microgram of fentanyl per delivery with a lock out time of 5 minutes. The patient will be given a push button which is connected to the PCA machine. At each press of the button, the machine will deliver 100micrograms of fentanyl. with a lock out time of 5 minutes. This means that patient will receive 12 doses of 100 micrograms of fentanyl per hour. There are no limits on the dosing per day.
The regular pain medications will be Paracetamol 1g every 6 hours, Ibuprofen 400mg every 6 hours or Celebrex 100mg every 12 hours. These medications will be given as tablets.
The PCA and oral pain relief will be administered until patient is discharged
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Intervention code [1]
294383
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Treatment: Drugs
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Comparator / control treatment
Following orthognathic surgery (corrective jaw surgery), patients are randomised into control group and exposure group.
The control group will only receive oral pain relief administered orally by the nursing staff.
This includes Paracetamol 1gram every 6 hourly, Ibuprofen 400mg every 8 hourly or Celebrex 100mg every 12 hours, Tramadol immediate release 100mg every 6 hours (with maximum of 400mg per 24hr) as required (PRN), and Oxynorm 5mg every 4 hours as requried (PRN).
These medications will be given until discharge. These patients will be discharged on Paracetamol 1g every 6 hours for 7 days, Ibuprofen 400mg every 8 hours for 7 days and oxynorm 5mg every 4 hours for 3 days.
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Control group
Active
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Outcomes
Primary outcome [1]
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Length of hospital stay from the day of surgery to discharge from hospital.
This outcome is assessed by the way of review of medical records
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Assessment method [1]
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Timepoint [1]
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The outcome is assessed after the patient is discharge from the hospital
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Primary outcome [2]
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Visual analogue pain score
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Assessment method [2]
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Timepoint [2]
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Pain score is measured from 8am the day after surgery and is measured every hour until patient is discharged
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Secondary outcome [1]
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Health economics - the cost of hospital stay for each patient, cost of using patient controlled analgesias. This will involve the review of medical records on how many days patient has stayed post surgery and the amount of patient controlled analgesics used during the post operative period.
The analysis required for the health economics will involve cost-minimization analysis, cost–benefit analysis and cost-effectiveness analysis
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Assessment method [1]
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Timepoint [1]
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Assessed after the patient is discharged
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Eligibility
Key inclusion criteria
Sample group will be ASA 1 or 2 patients who have no significant prior medical problems (including any cardiac history, respiratory disease, chronic pain issues or on any regular pain relief for chronic pain or arthritic pains) and are having Orthognathic surgery will be recruited for this study. All ages and genders are included. They will be fully informed and given the option to agree or deny participation into the study and will be consented for this study.
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Minimum age
16
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?
Yes
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Key exclusion criteria
ASA 3, ASA 4, ASA 5
Chronic pain
Fibromyalgia
Syndromic
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software from https://www.sealedenvelope.com
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data will be analysed with Intention to treat analysis
This is a pilot study, therefore will fulfil ethics approval requirement of involving 40 patients in the trial.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
23/04/2015
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Date of last participant enrolment
Anticipated
1/08/2017
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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
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Royal Perth Hospital - Perth
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Recruitment hospital [2]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
13018
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6000 - Perth
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Recruitment postcode(s) [2]
13019
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6150 - Murdoch
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Royal Perth Hospital
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Address [1]
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197 Wellington St
Perth 6000
Western Australia
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Perth Hospital
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Address
197 Wellington St
Perth 6000
Western Australia
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Fiona Stanley Hospital
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Address [1]
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Department of Oral and Maxillofacial Surgery
Fiona Stanley Hospital
102-118 Murdoch Drive
Murdoch 6150
Western Australia
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Country [1]
292799
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Government of Western Australia Department of Health South Metropolitan Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Research and Governance and Ethics Office Fremantle Hospital PO Box 480 Fremantle, WA, 6959
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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01/10/2013
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Approval date [1]
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16/10/2013
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Ethics approval number [1]
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13/88
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Summary
Brief summary
The aim of this project is to show whether if there is a difference in the length of hospital stay and effect on health economics for patients who are using ‘patient controlled analgesics’ (PCA) compared to those patients who are on conventional oral or intravenous pain relief administered by nurse. The significance of this project is that, if there is a difference between the two groups, PCA and conventional pain relief group, this can help improve the cost of service to the patient. Reduced length of hospital stay means earlier discharge for the patients to their own environment for recovery and prevents nosocomial infections, this will also free up hospital bed for other patients and reduce the cost of administering PCA. The research question is whether there is a difference in the length of hospital stay for patients who are using PCA compared to conventional analgesics after orthognathic jaw surgery. Our hypothesis is that, those patients who are on PCA will have prolonged hospital stay compared to those who are on conventional oral or intravenous analgesics.
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Trial website
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Trial related presentations / publications
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Public notes
Orthognathic surgery (jaw corrective surgery) is carried out for patients who have jaw (maxilla and/or mandible) size/length/width or relationship discrepancy or masticatory function problem or obstructive sleep apnoea. These patients require orthodontic treatment combined with Orthognathic surgery that could involve one jaw or both jaws. In most cases post operative pain is controlled with routine regular simple analgesics orally. However there are cases where patient would be prescribed with ‘patient controlled analgesics’, that are self-administered morphine or fentanyl via a pump, controlled by patient with a lockout time. Clinical observations showed that when patients are prescribed the PCA, it increased the length of hospital stay due to prolonged immobility and side effects from the use of PCA medication such as nausea, vomiting and decreased sensorium and also the use of indwelling catheter which also delays the discharge of patient from the hospital. This project is to compare the length of hospital stay for patients using PCA versus conventional analgesics and the effectiveness of pain control during the recovery period, side effects and impact on health economics for those patients who are on PCA versus those on conventional analgesics (oral or iv administered by nurse). The oral analgesics will be of same action and class as the intravenous pain relief given in the PCA pump, therefore the practice of pain relief remains the same but via a different route of administration.
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Attachments [1]
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/AnzctrAttachments/370417-Pain flowchart 4.3.jpg
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Contacts
Principal investigator
Name
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Dr Frank Chang
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Address
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Department of Oral and Maxillofacial Surgery
Fiona Stanley Hospital
102-118 Murdoch Drive
Murdoch 6150
Western Australia
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Country
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Australia
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Phone
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+61405981551
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Frank Chang
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Address
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Department of Oral and Maxillofacial Surgery
Fiona Stanley Hospital
102-118 Murdoch Drive
Murdoch 6150
Western Australia
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Country
64727
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Australia
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Phone
64727
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+61405981551
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Frank Chang
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Address
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Department of Oral and Maxillofacial Surgery
Fiona Stanley Hospital
102-118 Murdoch Drive
Murdoch 6150
Western Australia
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Country
64728
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Australia
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Phone
64728
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+61405981551
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Fax
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Email
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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
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
RESULTS: Randomization resulted in approximately ...
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Study results article
Yes
Chang FS, Burrows SA, Gebauer DP. Patient-Controll...
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370417-(Uploaded-09-05-2020-19-42-04)-Journal results publication.pdf
Documents added automatically
No additional documents have been identified.
Download to PDF