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Antiemetic Prophylaxis for Postdischarge Nausea and Vomiting After Hip Arthroscopy (PDNV)

Primary Purpose

Nausea and Vomiting, Postoperative

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Ondansetron
Placebo
Sponsored by
Hospital for Special Surgery, New York
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nausea and Vomiting, Postoperative

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • All patients of Dr. Coleman or Dr. Kelly ages 18 to 65 undergoing arthroscopic hip surgery
  • Planned use of neuraxial anesthesia
  • Ability to follow study protocol
  • Willing to complete daily diary and be interviewed daily for three days after discharge

Exclusion Criteria:

  • Patients younger than 18 years old and older than 65
  • Patients unable to undergo a spinal or epidural anesthetic
  • Having nausea or vomiting within 24 hours of the surgery
  • Receiving drugs with anti-emetic properties within 24 hours of the surgery (e.g Zofran, Compazine, Phenergan, Reglan)
  • Chronic opioid use (defined as daily or almost daily use of opioids for >3 months)
  • Hypersensitivity and/or allergy to ondansetron
  • Intraoperative use of any volatile anesthetic
  • Contraindication to a short course of NSAIDs (renal failure, intolerance)
  • Allergy or intolerance to Vicodin

Sites / Locations

  • Hospital for Special Surgery

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Study Group

Control Group

Arm Description

The study group will receive intraoperative IV ondansetron and also postoperative oral ondansetron tablets (8 mg each day for two days).

The control group will receive IV ondansetron intraoperatively and then oral placebo tablets (for 2 days).

Outcomes

Primary Outcome Measures

Incidence of Nausea
Percentage of participants with nausea

Secondary Outcome Measures

Severity of Nausea
Percentage of participants reporting moderate or severe nausea in the first 24 hours
Impact of Nausea and Vomiting on Quality of Life
Percentage of participants whose quality of life was impacted by nausea and vomiting

Full Information

First Posted
April 7, 2009
Last Updated
January 28, 2013
Sponsor
Hospital for Special Surgery, New York
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1. Study Identification

Unique Protocol Identification Number
NCT00878228
Brief Title
Antiemetic Prophylaxis for Postdischarge Nausea and Vomiting After Hip Arthroscopy
Acronym
PDNV
Official Title
Antiemetic Prophylaxis for Postdischarge Nausea and Vomiting After Hip Arthroscopy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
April 2009 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
February 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hospital for Special Surgery, New York

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The study is a randomized placebo controlled trial to determine whether repeated postoperative prophylactic ondansetron ("Zofran") administration will prevent postoperative and/or postdischarge nausea and vomiting in patients undergoing ambulatory hip arthroscopy. Ondansetron will be administered in the intra- and post-operative period. These individuals will be followed on postoperative days 1, 2, and 3. It is hypothesized that the incidence of postdischarge nausea and vomiting (PDNV) will be significantly decreased by postoperative prophylactic administration of multiple doses of ondansetron (Zofran).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nausea and Vomiting, Postoperative

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
98 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study Group
Arm Type
Experimental
Arm Description
The study group will receive intraoperative IV ondansetron and also postoperative oral ondansetron tablets (8 mg each day for two days).
Arm Title
Control Group
Arm Type
Placebo Comparator
Arm Description
The control group will receive IV ondansetron intraoperatively and then oral placebo tablets (for 2 days).
Intervention Type
Drug
Intervention Name(s)
Ondansetron
Other Intervention Name(s)
Zofran
Intervention Description
The study group will receive 4 mg of IV ondansetron perioperatively and also postoperative oral ondansetron tablets (8 mg each day for two days). The tablets will be concealed in generic capsules prepared by the pharmacy at the Hospital for Special Surgery to make the ondansetron tablets indistinguishable from the placebos.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The control group will receive IV ondansetron intraoperatively and then oral placebo tablets (for 2 days). These placebo tablets will contain lactose and be indistinguishable from the study medication.
Primary Outcome Measure Information:
Title
Incidence of Nausea
Description
Percentage of participants with nausea
Time Frame
Postdischarge Day 1
Secondary Outcome Measure Information:
Title
Severity of Nausea
Description
Percentage of participants reporting moderate or severe nausea in the first 24 hours
Time Frame
Postdischarge Day 1
Title
Impact of Nausea and Vomiting on Quality of Life
Description
Percentage of participants whose quality of life was impacted by nausea and vomiting
Time Frame
Postdischarge Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All patients of Dr. Coleman or Dr. Kelly ages 18 to 65 undergoing arthroscopic hip surgery Planned use of neuraxial anesthesia Ability to follow study protocol Willing to complete daily diary and be interviewed daily for three days after discharge Exclusion Criteria: Patients younger than 18 years old and older than 65 Patients unable to undergo a spinal or epidural anesthetic Having nausea or vomiting within 24 hours of the surgery Receiving drugs with anti-emetic properties within 24 hours of the surgery (e.g Zofran, Compazine, Phenergan, Reglan) Chronic opioid use (defined as daily or almost daily use of opioids for >3 months) Hypersensitivity and/or allergy to ondansetron Intraoperative use of any volatile anesthetic Contraindication to a short course of NSAIDs (renal failure, intolerance) Allergy or intolerance to Vicodin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jacques YaDeau, MD, PhD
Organizational Affiliation
Hosptial for Special Surgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital for Special Surgery
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
9257427
Citation
Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J. Effect of postchemotherapy nausea and vomiting on health-related quality of life. The Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. Support Care Cancer. 1997 Jul;5(4):307-13. doi: 10.1007/s005200050078.
Results Reference
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PubMed Identifier
18633020
Citation
Pan PH, Lee SC, Harris LC. Antiemetic prophylaxis for postdischarge nausea and vomiting and impact on functional quality of living during recovery in patients with high emetic risks: a prospective, randomized, double-blind comparison of two prophylactic antiemetic regimens. Anesth Analg. 2008 Aug;107(2):429-38. doi: 10.1213/ane.0b013e318172f992.
Results Reference
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PubMed Identifier
18042859
Citation
Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kranke P, Myles P, Philip BK, Samsa G, Sessler DI, Temo J, Tramer MR, Vander Kolk C, Watcha M; Society for Ambulatory Anesthesia. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007 Dec;105(6):1615-28, table of contents. doi: 10.1213/01.ane.0000295230.55439.f4.
Results Reference
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PubMed Identifier
15190136
Citation
Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N; IMPACT Investigators. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004 Jun 10;350(24):2441-51. doi: 10.1056/NEJMoa032196.
Results Reference
background
PubMed Identifier
18633023
Citation
White PF, O'Hara JF, Roberson CR, Wender RH, Candiotti KA; POST-OP Study Group. The impact of current antiemetic practices on patient outcomes: a prospective study on high-risk patients. Anesth Analg. 2008 Aug;107(2):452-8. doi: 10.1213/ane.0b013e31817b842c.
Results Reference
background
PubMed Identifier
18633024
Citation
White PF, Sacan O, Nuangchamnong N, Sun T, Eng MR. The relationship between patient risk factors and early versus late postoperative emetic symptoms. Anesth Analg. 2008 Aug;107(2):459-63. doi: 10.1213/ane.0b013e31817aa6e4.
Results Reference
background
PubMed Identifier
12198050
Citation
Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesth Analg. 2002 Sep;95(3):627-34, table of contents. doi: 10.1097/00000539-200209000-00025.
Results Reference
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Links:
URL
http://www.hss.edu
Description
This is the link to the Hospital for Special Surgery home website.

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Antiemetic Prophylaxis for Postdischarge Nausea and Vomiting After Hip Arthroscopy

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