Study to Evaluate the Efficacy of a Polyamine-deficient Diet for Treating Postoperative Pain After Abdominal Surgery
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Polyamine Deficient Diet.
- Кому может быть актуально
- Состояния в реестре: Digestive System Surgical Procedures. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Франция
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
Не всё понятно в терминах? Прочитайте наш гид для пациентов →
Официальное название
A Prospective Randomized Multicenter Study to Evaluate the Efficacy of a Polyamine-deficient Diet for the Treatment of Postoperative Pain After Abdominal Surgery.
Обзор
The aim of this study is to evaluate if a polyamine deficient diet started 7 days prior to a major abdominal surgery (eventration cure and digestive continuity) and followed 7 days post-surgery reduces the area under the curve of the numerical pain rating scale in the 72 hours post-surgery.
Подробное описание
Morphine derivatives are known to be a major cause of postoperative ileus and also operative hyperalgesia. Operative hyperalgesia corresponds to an increase in morphine needs postoperatively which is proportional to the morphine dose necessary during the surgery. This effect is due to two mechanisms: opioids tolerance and induced hypersensitivity.
N-methyl-D-aspartate receptors (R-NMDA) play a key role in this induced hypersensitivity. Polyamines, organic compounds with several amines functions, are known R-NMDA agonists. They increase the phosphorylation of the tyrosine group within the NR2B subunit responsible for the inflammatory hyperalgesia.
Limiting the binding of polyamines to the R-NMDA seems an easy, safe and efficient way to limit the hypersensitivity induced post-operatively.
Most of the polyamines in the human body come from food. One study listed food regarding their polyamines content and allowed to check the safety of a polyamine deficient diet. Such a well-followed diet would allow to reduce by 20 the polyamines quantity present in the body.
The aim of this study is to evaluate whether a deficient polyamine diet introduced 7 days before and continued up to 7 days after an abdominal surgery requiring the use of morphine post-operatively reduces the post-operative pain, the consumption of analgesics (morphine) post-operatively and improve the recovery ability. Abdominals surgeries concerned will be the eventration cure and digestive continuity.
The medico-economic impact will be observed during this study.
Вмешательства
- Другое Polyamine Deficient Diet
Diet low in polyamines: the estimated calculated dose is 20 times lower that in an usual diet
Первичные конечные точки
- To show a 20% decrease of the area under the curve for the numerical pain rating scale in the 72 hours post-operative in the polyamine deficient diet group [Срок оценки: 72 hours post-surgery]
Вторичные конечные точки (10)
- Change in the analgesics consumption post-operatively [Срок оценки: 15 days post-surgery]
- Change in the main dimension of pain [Срок оценки: 6 months post-surgery]
- Change of the recovery time of the gas transit [Срок оценки: 6 months post-surgery]
- Change of duration of urinary catheterization [Срок оценки: 6 months post-surgery]
- Change in the delay before the first postoperative lift [Срок оценки: 6 months post-surgery]
- Change in length of hospitalisation stay and sick leave [Срок оценки: 6 months post-surgery]
- Change in neuropathic pain: Neuropathic pain scale (DN4) [Срок оценки: 6 months post-surgery]
- Change in global health status [Срок оценки: 1 month before surgery, 1 month and 6 months post-surgery]
- Change of the recovery ability [Срок оценки: 1 month before surgery, 1 month and 6 months post-surgery]
- Change in the quality of life [Срок оценки: 1 month before surgery, 1 month and 6 months post-surgery]
Критерии участия
Критерии включения
- Adult (>18 years)
- Indication for a " major " abdominal surgery as second surgical procedure : cure of eventration and restoration of digestive continuity
- Intended Use of a Patient Controlled Morphine Pump (PCA) postoperatively or taking oral opioids
- Possible follow-up during 7 months (post-operative consultation at 1 month and 6 months only if postoperative pain or complications)
- Written informed consent form obtained from the patient
- Affiliated to the social security
Критерии исключения
- Pregnant women
- Minor, adult under guardianship or benefiting from a legal protection
- Oncological surgery
- Surgery not painful (cholecystectomy, hernia, thyroidectomy, bariatric surgery)
- Drug addicts patients, or under opiate dependency
- Chronic pain patients (pain over 3 months)
- Patients in nursing home or convalescence home (diet non possible in institution)
- Planned hospitalisation before the intervention (during the 7 days before the surgery)
- Severe undernutrition defined by the HAS criteria (weight loss > 10% in 1 month and/or > 15% in 6 months, albumin at inclusion <15g/l)
- Patient refusing the possibility to change his eating habits
- Oral feeding impossible preoperatively
- Patient not able to express himself on their pain (silent, …)
- Decompensated psychiatric pathologies (severe depression syndrome,…)
- Patient unable to understand the protocol and/or to give his informed consent
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Простое слепое
- Основная цель
- Лечение
Центры проведения
Франция · 4 центра
- CHRU Brest La Cavale Blanche — Brest
- Hôpital Louis Mourier from Ap-HP — Colombes
- CHD Vendée — La Roche-sur-Yon
- CHU Nantes Hôtel Dieu — Nantes
Идентификаторы
NCT: NCT04219956 · RC19_0023