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Trial registered on ANZCTR
Registration number
ACTRN12615000765527
Ethics application status
Not yet submitted
Date submitted
23/06/2015
Date registered
23/07/2015
Date last updated
23/07/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
For patients with moderate to severe endometriosis undergoing surgical intervention will the use of methadone and bupivacaine compared to fentanyl alone improve the development of post-operative pain and quality of life
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Scientific title
Prospective double blind randomised controlled trial of the long-term follow-up of pain post laparoscopic surgery for moderate to severe endometriosis, comparison of standard anaesthesia versus pro-active aggressive intra-operative analgesic intervention, with blinding of surgeon and patient – Pilot Study.
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Secondary ID [1]
286961
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Nil
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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:
Chronic Pain
295418
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Endometriosis
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Condition category
Condition code
Anaesthesiology
295674
295674
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0
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Pain management
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Reproductive Health and Childbirth
295675
295675
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0
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Other reproductive health and childbirth disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
IV methadone 0.2mg/kg (after induction of anaesthesia) and 200mL levobupivocaine 0.625% intraperitoneal (at completion of surgical case)
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Intervention code [1]
292166
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Treatment: Drugs
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Comparator / control treatment
IV fentanyl 5mcg/kg (after induction of anaesthesia) + placebo (200ml saline) intraperitoneal (at completion of surgical case)
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Control group
Active
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Outcomes
Primary outcome [1]
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VAS pain scores
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Assessment method [1]
295378
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Timepoint [1]
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6 months post operatively
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Primary outcome [2]
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QOL scores using SF-12 and EQ-5D Quality of Life Scores
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Assessment method [2]
295508
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Timepoint [2]
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6 months post operatively
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Secondary outcome [1]
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VAS pain scores
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Assessment method [1]
315473
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Timepoint [1]
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Day 1, 6 weeks, 12 months
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Secondary outcome [2]
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Quality of Life Scores using SF-12 and EQ-5D Scores
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Assessment method [2]
315728
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Timepoint [2]
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6 weeks and 12 months post operatively
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Secondary outcome [3]
315729
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Post-operative analgesia requirements - data linkage to medication chart for 24 hours post operative, patient self reported use of regular medications at 6 weeks, 6 months and 12 months.
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Assessment method [3]
315729
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Timepoint [3]
315729
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24 hours post-operatively
6 weeks
6 months
12 months
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Secondary outcome [4]
315730
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Post operative sedation using Ramsay sedation score
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Assessment method [4]
315730
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Timepoint [4]
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In recovery - assessed at 10 minute intervals post-operatively for thirty minutes
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Secondary outcome [5]
315731
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Post operative nausea & vomiting (anti-emetic use) - data linkage with patient medication chart
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Assessment method [5]
315731
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Timepoint [5]
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Day 1
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Secondary outcome [6]
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Discharge time - length of hospital stay assessed from day of surgery until hospital discharge
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Assessment method [6]
315732
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Timepoint [6]
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At discharge
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Eligibility
Key inclusion criteria
Women aged 18-40 who complain of regular significant dysmenorrhea and / or pelvic pain that has persisted for more than 1 year AND
Who have undergone a staging laparoscopy according to the AFS endometriosis score by a gynaecologist and are documented to have an American Fertility Society Score of 2 or 3. AND
Planned surgery for treatment of endometriosis
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Allergy or sensitivity to methadone or bupivacaine OR
Contraindication to use of opioids OR
Surgical procedure other than laparoscopic treatment of endometriosis, check of tubal patency and minor hysteroscopic procedure OR
Active or relapsing pelvic inflammatory disease OR
Poor communication of written and spoken English for informed consent purposes
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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)
Participants will be recruited at the endoscopy clinic at King Edward Memorial Hospital. Consent and information sheets will be provided in the clinic. Patient will undergo formal informed consent when reviewed by the medical staff.
Participants will be randomly allocated to the treatment groups by computer generator.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomisation in blocks will be performed at the time of surgery and concealment will be achieved by a sealed envelope technique
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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 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
All patients who undergo randomisation will be included in the analysis. As this is a pilot study, a sample size has not been calculated. All eligible patients will be recruited for a one-year period.
Statistical analysis of the data will be performed with GraphPad (GraphPad Software, San Diego CA). A two sided, paired t test will be used to compare continuous variables. The Fisher’s exact test will be used to analyze proportions. There will not be an interim analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2015
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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
20
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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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King Edward Memorial Hospital - Subiaco
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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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King Edward Memorial Hospital
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Address [1]
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374 Bagot Road
Subiaco, WA 6008
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Country [1]
291516
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Australia
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Primary sponsor type
Individual
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Name
Professor Roger Hart
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Address
University of Western Australia
School of Women’s and Infant’s Health
35 Stirling Highway
CRAWLEY, WA, 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
290284
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Address [1]
290284
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Country [1]
290284
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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WNHS HREC
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Ethics committee address [1]
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Level 1, Children's Clinical Research Facility (CCRF) Princess Margaret Hospital GPO Box D184 Perth WA 6840
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
293059
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30/06/2015
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Approval date [1]
293059
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Ethics approval number [1]
293059
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Summary
Brief summary
This is a double blinded prospective randomised trial to investigate the effect of methadone and bupivacaine on the development of chronic pelvic pain in women undergoing surgical management of endometriosis. Chronic pelvic pain is common in women with endometriosis, and can develop despite surgical treatment of the disease. Endometriosis causes pain in a variety of mechanisms including direct compression/infiltration of nerves by the lesions, inflammation, and damage to pelvic nerves during surgery and may lead to changes in the central nervous system which propagate chronic pain. The objective of this trial is to prove that active management of intra-operative analgesia with intravenous methadone and intraperitoneal bupivacaine, for women with long-standing pain from moderate to severe endometriosis leads to long-term benefit in terms of pain experience and quality of life. Patients will be recruited from the endoscopy clinic at King Edward Memorial Hospital. They will be eligible if they have an American Fertility Society Score of 2 or 3 on previous laparoscopy and are planned for laparoscopic treatment on endometriosis. At recruitment patients will undergo a visual analogue scale (VAS) assessment for pain and will complete a quality of life (QOL) assessment. Patients will be randomised to either the standard analgesia group (IV fentanyl 5mcg/kg + placebo (200ml saline) intraperitoneal) or the intervention group (IV methadone 0.2mg/kg and 200mL levobupivocaine 0.625% intraperitoneal). Repeat pain scores will be recorded on day 1, and repeat pain scores and QOL scores at 6 weeks, 6 months and 12 months post-operatively.
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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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Prof Roger Hart
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Address
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University of Western Australia
King Edward Memorial Hospital
374 Bagot Road
Subiaco, WA 6008
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Country
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Australia
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Phone
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+61893402222
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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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Jade Acton
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Address
58299
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King Edward Memorial Hospital
374 Bagot Road
Subiaco, WA 6008
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Country
58299
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Australia
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Phone
58299
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+61893402222
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Fax
58299
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Email
58299
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[email protected]
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Contact person for scientific queries
Name
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Jade Acton
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Address
58300
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King Edward Memorial Hospital
374 Bagot Road
Subiaco, WA 6008
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Country
58300
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Australia
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Phone
58300
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+61893402222
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Fax
58300
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Email
58300
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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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