Guanfacine for PONV and Pain After Sinus Surgery

Vanderbilt University Medical Center

Status

Completed

Conditions

Postoperative Nausea and Vomiting

Pain, Postoperative

Treatments

Drug: Guanfacine

Drug: Placebo

Study type

Interventional

Funder types

Other

Identifiers

NCT02882854

160282

Details and patient eligibility

About

Postoperative nausea and vomiting (PONV) and pain are the most common causes of Post Anesthesia Care Unit (PACU) discharge delay, with untreated PONV occurring in 20-30% of post-surgical patients. The effect of guanfacine (GF) administration on pain and nausea scores will be assessed with two groups. One group will receive 1 mg of GF to take orally and the other group will receive a similar appearing placebo (containing no drug) to take orally.

Full description

Pain after surgery is commonly treated with narcotics which can potentiate PONV, further delaying PACU discharge. In multiple studies, alpha-2 agonists such as clonidine and dexmedetomidine reduce both the incidence of PONV and post-op pain, as well as requirements for postoperative analgesics. These actions are mediated via central alpha-2A receptors (A2AR). Of the A2AR agonists, guanfacine, though a weak antihypertensive agent, has the highest selectivity for the A2AR, but to date is untested for its potential to treat either PONV or post-operative pain.

Enrollment

84 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

VUMC patients undergoing sinus surgery in MCE OR

Exclusion criteria

Inability to read and freely consent
Patients who take alpha-2 agonists routinely (guanfacine, clonidine, tizanidine)
Patients undergoing sinus surgery planned for greater than 3 hours
Patients with significant pre-existing pain, on chronic pain (opioid, methadone) therapy, severe fibromyalgia or other pre-existing pain condition in any body part
Patients with preoperative nausea/vomiting at baseline.
Pregnant or lactating women