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Trial registered on ANZCTR
Registration number
ACTRN12620001131943
Ethics application status
Approved
Date submitted
7/08/2020
Date registered
30/10/2020
Date last updated
4/08/2023
Date data sharing statement initially provided
30/10/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of methadone as pain relief in day-surgery patients undergoing a laparascopic gynaecological procedure
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Scientific title
Investigating the post-operative opioid use of patients who received intraoperative methadone compared with those who received conventional potent opioids during laparoscopic gynaecological surgery - a double blind randomised controlled trial.
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Secondary ID [1]
301968
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Nil known
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Universal Trial Number (UTN)
U1111-1256-5554
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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:
Pain management
318527
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Gynaecological laparoscopic surgery
318945
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Condition category
Condition code
Anaesthesiology
316531
316531
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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
intervention drug: Methadone (0.15mg/kg, up to 10mgs) as compared to standard care using morphine or fentanyl during laparoscopic procedure. this will be a single intra-operative dose administered via intravenous infusion. methadone will be administered at the time of incision closure.
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Intervention code [1]
318256
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Treatment: Drugs
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Comparator / control treatment
methadone will be compared to standard care pain management procedures - intraoperative fentanyl (200microgram single dose intraoperatively through intravenous infusion)
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary outcome
Opioid dose (in morphine equivalents) administered in the PACU
Assessed via recorded opioid use in PACU
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Assessment method [1]
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Timepoint [1]
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- Opioid dose (in morphine equivalents) consumed in PACU
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Secondary outcome [1]
385367
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- Opioid dose (in morphine equivalents) administered prior to discharge from hospital
will be assessed from participant medical records
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Assessment method [1]
385367
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Timepoint [1]
385367
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- Pain scores on arrival in PACU, every 15 min for the first hour, hourly for the next 4h, and prior to discharge.
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Secondary outcome [2]
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- Pain scores on arrival in PACU, every 15 min for the first hour, hourly for the next 4 h, and prior to discharge
will be assessed by research team present in PACU
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Assessment method [2]
387488
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Timepoint [2]
387488
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every 15 min for the first hour, hourly for the next 4 h, and prior to discharge
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Secondary outcome [3]
387489
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- Respiratory complications in PACU (e.g. respiratory depression, oxygen desaturation)
Will be assessed by research team present in PACU
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Assessment method [3]
387489
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Timepoint [3]
387489
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Throughout time in PACU
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Secondary outcome [4]
387490
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Rate of admission to hospital for analgesia
will be assessed from participant medical records,
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Assessment method [4]
387490
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Timepoint [4]
387490
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whether patient represents to hospital for pain complaints within 1 week post-procedure
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Secondary outcome [5]
387491
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- Opioid dose (in morphine equivalents) consumed after discharge, at one week
will be assessed by phone follow up at one week post-discharge
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Assessment method [5]
387491
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Timepoint [5]
387491
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one week post-discharge
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Eligibility
Key inclusion criteria
- Adults undergoing general surgery laparoscopy as well as gynaecology laparoscopy at Albury and Wodonga Hospitals
- Planned same-day discharge
- Able to speak and read English
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Minimum age
18
Years
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Maximum age
78
Years
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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
- Morbid obesity
- Obstructive sleep apnoea, treated with CPAP, or diagnosed but untreated
- Significant renal or liver dysfunction
- Pregnant or breastfeeding women
- Preoperative opioid dependence
- Known or suspected allergy to methadone
- Anaesthetist wish to avoid methadone administration for any reason
- Undergoing laparoscopic bowel resection or laparoscopic nephrectomy
- Undergoing emergency laparoscopic operations (e.g. appendicectomy, ectopic pregnancy)
- Patients with long QT syndrome, and any on whom a preop ECG reveals a long QT interval
- Anyone already on an SSRI (serotonin syndrome risk)
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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)
central randomisation by phone/fax/computer
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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 (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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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
utilising local hospital records and previous studies, the power of the study and sample size was estimated
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
9/12/2020
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Actual
13/01/2021
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Date of last participant enrolment
Anticipated
2/02/2022
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Actual
11/05/2022
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Date of last data collection
Anticipated
9/02/2022
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Actual
18/05/2022
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Sample size
Target
70
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Accrual to date
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Final
69
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
17206
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Albury Wodonga Health - Albury campus - Albury
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Recruitment hospital [2]
17207
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Albury Wodonga Health - Wodonga campus - Wodonga
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Recruitment postcode(s) [1]
30914
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2640 - Albury
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Recruitment postcode(s) [2]
30915
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3690 - Wodonga
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Funding & Sponsors
Funding source category [1]
306660
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Self funded/Unfunded
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Name [1]
306660
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Address [1]
306660
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Country [1]
306660
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Primary sponsor type
University
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Name
University of New South Wales
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Address
Street Address
559 East Street,
Albury,
NSW, 2640
Mailing Address
PO Box 3004,
Albury,
NSW, 2640
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Country
Australia
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Secondary sponsor category [1]
307208
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None
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Name [1]
307208
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Address [1]
307208
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Country [1]
307208
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306590
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The Albury Wodonga Health Human Research Ethics Committee
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Ethics committee address [1]
306590
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559 East Street, Albury, NSW, 2640
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Ethics committee country [1]
306590
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Australia
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Date submitted for ethics approval [1]
306590
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12/08/2020
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Approval date [1]
306590
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13/10/2020
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Ethics approval number [1]
306590
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66418
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Summary
Brief summary
Methadone is an opioid medication used as a pain reliever medication and as a way of reducing withdrawal symptoms for those patients addicted to opioids. It is in the same class of drugs as codeine, oxycodone, morphine and fentanyl. These drugs are commonly employed to manage acute pain, such as that inflicted by surgery. Due to opioids having significant side effects alongside addictive properties, reducing the dose of such potent drugs is important, especially to avoid patients becoming dependent on them. Such adverse effects range from nausea, constipation and sedation to respiratory suppression, overdose and death. Laparoscopic surgery is a minimally invasive, moderately painful procedure commonly employed in general and gynaecological cases. Such procedures, especially gynaecological surgeries can be notoriously difficult to manage post-operative pain where no ideal analgesic regimen has been established. Conventionally, potent opioids like fentanyl and morphine are employed during surgery with patients frequently requiring opioids in both the PACU, and after discharge. This carries substantial risks and adverse effects. Methadone may offer an appealing alternative to current strategies. If the amount of post-operative opioid required can be reduced, not only will patients benefit in terms of greater comfort and fewer dose-related opioid adverse effects, but recent concerns about overprescribing of discharge opioids may be alleviated Hypothesis This study hypothesises that intraoperative methadone use will reduce PACU opioid consumption. As a result, we also predict that we will be able to reduce opioid dose (in morphine equivalents) consumed after discharge, at one week.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Kyle Green
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Address
104390
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University of New South Wales, 559 East St, East Albury NSW 2640
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Country
104390
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Australia
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Phone
104390
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+61 400639923
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Fax
104390
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Email
104390
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[email protected]
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Contact person for public queries
Name
104391
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Kyle Green
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Address
104391
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University of New South Wales
559 East Street,
Albury,
NSW, 2640
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Country
104391
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Australia
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Phone
104391
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+61 400639923
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Fax
104391
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Email
104391
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[email protected]
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Contact person for scientific queries
Name
104392
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Luke Baitch
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Address
104392
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Albury Wodonga Health
559 East Street,
Albury,
NSW, 2640
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Country
104392
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Australia
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Phone
104392
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+61 408586318
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Fax
104392
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Email
104392
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
The consent obtained for patients in this trial has precluded data sharing of individual patient data. Aggregate data will be available for use in further investigation.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
19033
Study protocol
[email protected]
19034
Informed consent form
[email protected]
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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