Efficacy of intravenous paracetamol and mannitol in managing chronic post-thoracotomy pain in patients with lung cancer: Study protocol for a single center prospective randomized double-blind controlled trial

Xing Lu, Junhui Zhou, Xi Li, Jie Gao, Siqing Liu, Wei Zhong, Gaoyuan Xi, Yingchun Guo, Hongdang Xu
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Abstract

Chronic post-thoracotomy pain is a common complication that affects 20% to 60% of patients who undergo surgery for lung cancer. The persistent pain affects quality of life and satisfaction with surgery. Intravenous paracetamol and mannitol, known to have analgesic and antipyretic properties, may help relieve moderate-to-severe post-operative pain. This trial aims to assess their effectiveness and safety in managing chronic post-thoracotomy pain in patients with lung cancer. This prospective double-blind randomized controlled clinical trial will be conducted at a single center. A total of 856 patients who will undergo thoracoscopic radical surgery for lung cancer will be enrolled and randomly assigned to test (intravenous paracetamol and mannitol) and control (intravenous normal saline) groups in a 1:1 ratio (428 patients in each group). Efficacy will be evaluated in terms of the incidence of chronic post-thoracotomy pain at 3 months (primary outcome). Secondary outcomes will include the dosage of propofol and remifentanil, numerical rating scale pain scores, number of times the patient-controlled intravenous analgesia button is pressed, occurrence of post-operative nausea and vomiting and respiratory depression, time to first flatus and ambulation after surgery, length of hospital stay, surgeon and patient satisfaction, and incidence of chronic post-thoracotomy pain at 6 and 12 months after surgery. Quality of daily life will be evaluated at 3, 6, and 12 months after surgery. Intention-to-treat analysis will also be conducted. The research protocol has been reviewed and approved by the Medical Thesis Committee of Henan Provincial Chest Hospital and Chest Hospital of Zhengzhou University on April 29, 2023 (reference: [2023] approval number: [04-06]). The results of this trial will be communicated to the participants and subsequently submitted for publication in peer-reviewed journals for wider dissemination. The study has been registered in the Chinese Clinical Trial Registry on June 27, 2023 (registration number: ChiCTR2300072869, available at https://www.chictr.org.cn/). The protocol version number is Version 1.1, dated August 20, 2023.
静脉注射扑热息痛和甘露醇治疗肺癌患者胸廓切开术后慢性疼痛的疗效:单中心前瞻性随机双盲对照试验研究方案
胸廓切开术后慢性疼痛是一种常见的并发症,20% 到 60% 的肺癌手术患者都会出现这种症状。持续疼痛会影响生活质量和手术满意度。静脉注射扑热息痛和甘露醇具有镇痛和解热作用,可帮助缓解中度至重度术后疼痛。本试验旨在评估这两种药物治疗肺癌患者胸廓切开术后慢性疼痛的有效性和安全性。这项前瞻性双盲随机对照临床试验将在一个中心进行。共有 856 名患者将接受胸腔镜肺癌根治术,他们将按 1:1 的比例随机分配到试验组(静脉注射扑热息痛和甘露醇)和对照组(静脉注射生理盐水)(每组 428 名患者)。疗效将根据 3 个月后胸廓切开术后慢性疼痛的发生率进行评估(主要结果)。次要结果将包括异丙酚和瑞芬太尼的用量、疼痛数字评分量表评分、按下患者控制静脉镇痛按钮的次数、术后恶心呕吐和呼吸抑制的发生率、术后首次排便和下床活动的时间、住院时间、外科医生和患者的满意度以及术后 6 个月和 12 个月时胸廓切开术后慢性疼痛的发生率。日常生活质量将在术后 3、6 和 12 个月进行评估。此外,还将进行意向治疗分析。研究方案已于 2023 年 4 月 29 日通过河南省胸科医院和郑州大学附属胸科医院医学论文委员会的审查和批准(参考文献:[2023] 批准号:[04-06])。本试验的结果将告知参与者,随后将在同行评审期刊上发表,以进行更广泛的传播。该研究已于 2023 年 6 月 27 日在中国临床试验注册中心注册(注册号:ChiCTR2300072869):ChiCTR2300072869,网址:https://www.chictr.org.cn/)。方案版本号为 1.1 版,日期为 2023 年 8 月 20 日。
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