Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12617000830392
Ethics application status
Approved
Date submitted
31/05/2017
Date registered
6/06/2017
Date last updated
7/05/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of intraoperative magnesium on the incidence of chronic post surgical pain after thoracotomy
Query!
Scientific title
Effect of intraoperative magnesium on the incidence of chronic post surgical pain after thoracotomy
Query!
Secondary ID [1]
292098
0
None
Query!
Universal Trial Number (UTN)
U1111-1197-1970
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Chronic post-thoracotomy pain
303519
0
Query!
Condition category
Condition code
Surgery
302931
302931
0
0
Query!
Other surgery
Query!
Anaesthesiology
302942
302942
0
0
Query!
Pain management
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
The aim of this study is to investigate the effects of intraoperative systemic magnesium on chronic postsurgical pain in patients undergoing thoracotomy. A bolus dose of 50mg/kg of magnesium (magnesium sulfate) will be administered for 15 minutes immediately after induction and prior to skin incision, followed by infusion at 10mg/kg/hr which will be continued until the patient has been transferred to the Post Anaesthesia Care Unit (PACU).
Query!
Intervention code [1]
298240
0
Treatment: Drugs
Query!
Comparator / control treatment
Patients in the control group will be administered and infused the same volume of isotonic saline.
Query!
Control group
Placebo
Query!
Outcomes
Primary outcome [1]
302323
0
Assess the incidence of chronic post surgical pain at 2 and 6 months post thoracotomy.
This will be done via a telephone call from a pain nurse at 2 and 6 months post thoracotomy. A simple yes/no categorical outcome will be used and patients reporting pain will be asked to present to a chronic pain clinic for further assessment by an anaesthetist. At this visit, a 0-10 point numeric rating scale (NRS) will be used to measure the degree of pain intensity.
Query!
Assessment method [1]
302323
0
Query!
Timepoint [1]
302323
0
2 and 6 months post operation
2 months post operation is the primary endpoint
Query!
Secondary outcome [1]
335490
0
Evaluate the duration of hospital stay
Query!
Assessment method [1]
335490
0
Query!
Timepoint [1]
335490
0
At hospital discharge
Query!
Secondary outcome [2]
335491
0
Evaluate intraoperative opioid requirements (in morphine equivalents) by reviewing the anaesthetic record.
Query!
Assessment method [2]
335491
0
Query!
Timepoint [2]
335491
0
At surgery completion
Query!
Secondary outcome [3]
335492
0
Evaluate opioid/local anaesthetic requirements (converted to morphine and ropivacaine equivalents).
This will be done by evaluating analgesic requirements which will have been documented on standard hospital pain protocol forms.
Query!
Assessment method [3]
335492
0
Query!
Timepoint [3]
335492
0
Opioid/local anaesthetic requirements will be assessed at 24 and 48 hours post surgery
Query!
Secondary outcome [4]
335493
0
Characterise the intensity and type of CPSP. This is a composite secondary outcome. A 0-10 point numeric rating scale (NRS) will be used to measure the degree of pain intensity. Type of CPSP will be assessed using the Neuropathic Pain Questionnaire (NPQ).
Query!
Assessment method [4]
335493
0
Query!
Timepoint [4]
335493
0
2 and 6 months post thoracotomy
Query!
Secondary outcome [5]
335621
0
Evaluate postoperative pain scores. Pain scores will be measured using a 0-10 point numeric rating scale (NRS).
Query!
Assessment method [5]
335621
0
Query!
Timepoint [5]
335621
0
This will be done at 24 and 48 hours post surgery.
Query!
Secondary outcome [6]
335622
0
Health related quality of life
This will be assessed using the Medical Outcome Study 36-Item Short Form (SF-36). This form will be sent to all participants. The SF-36 is a widely used instrument that is standardized and validated. It assesses eight scales: physical functioning, role functioning-physical, bodily pain, general health, energy, social functioning, role functioning-emotional, and mental health.
Query!
Assessment method [6]
335622
0
Query!
Timepoint [6]
335622
0
6 months post thoracotomy
Query!
Eligibility
Key inclusion criteria
18 to 80 years of age, male or female gender, scheduled for elective thoracotomy surgery, ASA physical status class I to III, body mass index <40kg/cm2
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
80
Years
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
Allergy to magnesium sulfate, major hepatic or renal failure, presence of neurologic disease, second or third degree atrioventricular block, pre-existing treatment with magnesium or calcium channel blockers. Patients with chronic neuropathic pain due to any cause will also be excluded from this clinical trial.
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Block randomisation and sealed envelope method
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Recruiting
Query!
Date of first participant enrolment
Anticipated
1/08/2017
Query!
Actual
7/05/2018
Query!
Date of last participant enrolment
Anticipated
1/08/2018
Query!
Actual
Query!
Date of last data collection
Anticipated
14/11/2019
Query!
Actual
Query!
Sample size
Target
200
Query!
Accrual to date
1
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
QLD
Query!
Recruitment hospital [1]
8226
0
The Townsville Hospital - Douglas
Query!
Recruitment postcode(s) [1]
16283
0
4814 - Douglas
Query!
Funding & Sponsors
Funding source category [1]
296629
0
Government body
Query!
Name [1]
296629
0
Queensland Health
Query!
Address [1]
296629
0
Townsville Hospital
100 Angus Smith Drive
Douglas 4814
QLD
Query!
Country [1]
296629
0
Australia
Query!
Primary sponsor type
Individual
Query!
Name
Antimony Mar
Query!
Address
Townsville Hospital
100 Angus Smith Drive
Douglas 4814
QLD
Query!
Country
Australia
Query!
Secondary sponsor category [1]
295592
0
None
Query!
Name [1]
295592
0
None
Query!
Address [1]
295592
0
None
Query!
Country [1]
295592
0
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
297861
0
Townsville Hospital
Query!
Ethics committee address [1]
297861
0
Query!
Ethics committee country [1]
297861
0
Australia
Query!
Date submitted for ethics approval [1]
297861
0
26/05/2017
Query!
Approval date [1]
297861
0
21/09/2017
Query!
Ethics approval number [1]
297861
0
Query!
Summary
Brief summary
Chronic post surgical pain (CPSP) is a recognised and adverse outcome of many surgical procedures. It was first reported by Macrae and Davis and is defined as “pain persisting for at least two months duration following a surgical procedure”. Other causes for the pain and the possibility that the pain is from a pre-existing condition should be excluded before classifying the pain as CPSP. The prevalence of CPSP varies depending on the operation with higher rates observed after major thoracic surgery. In fact, patients undergoing thoracotomy have one of the greatest incidences of CPSP among all surgical procedures. The etiology of chronic post-thoracotomy pain is not understood fully. It is thought to result from potential intercostal nerve damage. As there is also a component of neuropathic pain, rather than inflammatory or nociceptive pain, central sensitisation is likely involved. Central sensitisation relies on N-methyl-D-aspartate (NMDA) receptor activation by excitatory neurotransmitters, such as glutamate and aspartate. Studies have shown that NMDA receptor antagonists, such as ketamine, can decrease CPSP. In theory, magnesium, which is a physiologic antagonist of NMDA receptors, should prevent central sensitisation and therefore reduce the incidence of CPSP. The aim of this study is to investigate the effects of intraoperative systemic magnesium on chronic postsurgical pain in patients undergoing thoracotomy. We propose to perform a single centre, prospective, double-blind, placebo-controlled study over the period of one year. Our hypothesis is that intra-operative systemic administration of magnesium will reduce the incidence of CPSP in patients undergoing thoracotomy. On the morning of surgery, block randomisation and sealed envelope method will be used to assign patients to one of the two groups: magnesium group or control group. The anaesthetist, surgeon, patient and those assessing outcomes will be blinded to the group assignment. A bolus dose of 50mg/kg of magnesium (magnesium sulfate) will be administered for 15 minutes immediately after induction and prior to skin incision, followed by infusion at 10mg/kg/hr. Patients in the control group will be administered the same volume of isotonic saline. Patients will be assessed on postoperative day 1 and 2 by a pain team (includes anaesthetist and pain nurse). A 0-10 point numeric rating scale (NRS) will be used to measure the degree of pain intensity. Higher scores indicate a higher degree of pain. Postoperative opioid consumption (24 hours and 48 hours) will also be recorded by converting to the equivalent dose of intravenous morphine. Patients will be assessed at 2 and 6 months post surgery. This will be done via a telephone call from a pain nurse. Patients reporting pain will be asked to present to a chronic pain clinic for assessment by an anaesthetist. All patients will be asked to complete a Medical Outcome Study 36-Item Short Form to assess health related quality of life.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Attachments [1]
2665
2665
0
0
/AnzctrAttachments/373060-SSA_17_QTHS_149_1 Approval.pdf
(Supplementary information)
Query!
Query!
Attachments [2]
2666
2666
0
0
/AnzctrAttachments/373060-HREC17QTHS102_4 AM01.pdf
(Ethics approval)
Query!
Query!
Contacts
Principal investigator
Name
75298
0
Dr Christopher Butler
Query!
Address
75298
0
Townsville Hospital
100 Angus Smith Drive
Douglas 4814
QLD
Query!
Country
75298
0
Australia
Query!
Phone
75298
0
+61744331111
Query!
Fax
75298
0
Query!
Email
75298
0
[email protected]
Query!
Contact person for public queries
Name
75299
0
Antimony Mar
Query!
Address
75299
0
Townsville Hospital
100 Angus Smith Drive
Douglas 4814
QLD
Query!
Country
75299
0
Australia
Query!
Phone
75299
0
+61744331111
Query!
Fax
75299
0
Query!
Email
75299
0
[email protected]
Query!
Contact person for scientific queries
Name
75300
0
Antimony Mar
Query!
Address
75300
0
Townsville Hospital
100 Angus Smith Drive
Douglas 4814
QLD
Query!
Country
75300
0
Australia
Query!
Phone
75300
0
+61744331111
Query!
Fax
75300
0
Query!
Email
75300
0
[email protected]
Query!
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.
Download to PDF