Non-opioid Analgesia for Fast-track Surgery

• Status: Completed
• Trial end date: 2010-08-01
• Target enrollment: 0
• Participant gender: All

Summary

In this randomized observer-blinded trial the analgesic efficacy of intravenous esmolol, as alternative to intraoperative opioids, is tested in patients undergoing laparoscopic prostatectomy and upper gastrointestinal surgery (such as Nissen fundoplication). The purpose of this study is to determine whether intravenous esmolol improves postoperative analgesia and accelerate the surgical recovery. We hypothesize that patients receiving intravenous esmolol will consume less analgesic in the postoperative period, will have less opioid-related side effects and will recover their functional status faster then patients receiving intravenous esmolol.

Patients will be stratified according to the type of surgical procedure in 2 arms: 40 patients with prostate cancer and undergoing elective laparoscopic prostatectomy, and 40 patients with gastro-esophageal reflux undergoing upper gastrointestinal surgery (Nissen funduplication) will be enrolled.

Patients will receive total intravenous anesthesia with propofol and esmolol (Esmolol group, n=20 in each arm) or propofol and remifentanil (Remifentanil Group, n=20 in each arm).

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: McGill University Health Center; McGill University Health Centre/Research Institute of the McGill University Health Centre
• Treatments: Esmolol; Remifentanil

Criteria

Inclusion Criteria:

1. Patients with prostate cancer undergoing laparoscopic prostatectomy

2. Patients with gastro-esophageal reflux undergoing upper abdominal surgery (Nissen funduplication)

Exclusion Criteria:

1. Age <18 yr or > 85 yr

2. ASA physical status 3 and greater

3. History of hepatic failure (Child & Pug A-C)

4. Renal failure (creatinine outside the normal range)

5. Cardiac failure (NYHA I-IV)

6. Organ transplant

7. Diabetes mellitus type 1 and 2

8. Morbid obesity (BMI > 40)

9. Chronic use of opioids and beta-blockers

10. Severe mental impairment

11. History of allergic reactions to all the medications used in the study or inability to understand pain assessment.

12. Asthma or Reactive airway disease

13. Patient with known or suspected peritoneal adhesion

14. Pregnancy