Influence of Anesthetic Technique on Acute and Chronic Neuropathic Pain

Veterans Affairs (VA) Pittsburgh Healthcare System

Status and phase: Completed; Phase 4

Conditions: Hernia; Chronic Pain; Acute Pain; Anesthesia, Intravenous; Anesthesia, Intratracheal

Treatments: Drug: Ketamine; Drug: Sevoflurane; Drug: Propofol; Drug: Remifentanil

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02527083

PRO00000878

Details and patient eligibility

About

Research suggests that the type of anesthesia used for surgery may affect intraoperative stress hormone levels. There is also data to support that an increased level of stress hormones leads to increased pain after surgery. The primary aim of this study is to determine the effect of anesthesia type on long term pain after hernia surgery. In this study, patients undergoing inguinal hernia repair will be randomized to an anesthetic group, either Total Intravenous Anesthesia (TIVA) maintained with propofol or Balanced Inhaled Anesthesia (BIA) maintained with sevoflurane. This will allow us to look at any differences in short and long-term pain after hernia repair depending on type of anesthesia received.

Enrollment: 10 patients

Sex: Male

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All male patients undergoing herniorrhaphy surgery that requires general anesthesia.

Exclusion criteria

• Subjects unable to communicate directly with the investigators, due to being non-English speaking, loss of hearing, or incompetence.
• A history of malignant hyperthermia, pseudocholinesterase deficiency, or other disease that prevents anesthetic randomization.
• Pain-related disorders such as fibromyalgia or other chronic pain syndromes.
• Emergency surgery.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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10 participants in 3 patient groups

BIA

Active Comparator group

Description:

Balanced Inhalational Anesthesia (consisting of a sevoflurane inhaled anesthestic only)

Treatment:

Drug: Remifentanil

Drug: Sevoflurane

TIVA-K

Active Comparator group

Description:

Total intravenous anesthetic with ketamine

Treatment:

Drug: Propofol

Drug: Ketamine

TIVA-R

Active Comparator group

Description:

Total intravenous anesthetic with remifentanil

Treatment:

Drug: Remifentanil

Drug: Propofol