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Postoperative Stress Response in Patients Following Fast Track vs Conventional Protocol After Hepatectomy or Pancreatectomy


2012-04


2015-03


2015-07


231

Study Overview

Postoperative Stress Response in Patients Following Fast Track vs Conventional Protocol After Hepatectomy or Pancreatectomy

A prospective randomized clinical study, with cross-sectional comparisons and correlations was conducted from May 2012 to July 2015 with a sample of 231 patients who have undergone hepatectomy or pancreatectomy, randomized into 2 groups. In group A was applied postoperatively the protocol Fast-track, while in group B the conventional postoperative care. Demographic and clinical data were collected. In 170 patients, Neuropeptide Y (NPY), Adrenocorticotropic hormone (ACTH)/Cortisol plasma levels were measured by ELISA method: a) at the day of patient's admission, b) the operation day, c) the 3rd postoperative day or prior to discharge.

Pain levels were assessed by Puntillo scale (behavioral observation scale) which has ranges; 0-1 "no pain", 2-4 ⊬hing" 5-7 "moderate pain" 8-10 and "severe pain". Patient stress levels were evaluated by: a) scale I.C.U.E.S.S. which evaluated environmental stress during their stay in hospital and takes values; 40-80 "no environmental stress" 81-120 "mild to moderate environmental stress," 121-160 " Moderate to severe environmental stress ", b) three questions of self- experienced feelings (with a score of 0 = None and 10 = Completely) like "How sad you feel right now?" "How stress do you feel right now?" "How optimist do you feel right now about the future?" The data collected in three phases: a) the day of hospitalization, b) the day of surgery, and c) the third postoperative day or before discharge. Depression levels were evaluated with Zung scale (Zung self-rating depression scale), which assesses depression levels with a score 25-49 for "normal level mood," 50-59 for "mild depression", 60-69 for "moderate depression" and 70 + for "severe depression".

  • Hepatic Cancer
  • Cancer of Pancreas
  • PROCEDURE: fast track protocol
  • 87

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2015-08-10  

N/A  

2015-08-14  

2015-08-14  

N/A  

2015-08-17  

2015-08-17  

N/A  

2015-08  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Supportive Care


Allocation:
Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
ACTIVE_COMPARATOR: fast track protocol

Oral fluids intake (0.5 lt) 6 hours after operation Mobilization 4 hours after operation Check discharge criteria the 4th-6th postoperative day

PROCEDURE: fast track protocol

  • Evaluation of postoperative stress
NO_INTERVENTION: conventional protocol

Oral intake after bowel mobilization Mobilization after the 1st postoperative day Check discharge criteria the 7th-15th postoperative day

Primary Outcome MeasuresMeasure DescriptionTime Frame
Analyzing Neuropeptide Y, Cortisol and Adrenocorticotropic hormones levels in blood samplesAnalyzing Neuropeptide Y, Cortisol and Adrenocorticotropic hormones levels in blood samples in patients after hepatectomy or pancreatectomy. These measures will occured in three phases a. the day of hospitalzation, b. the day of surgery c. the day of discharge.Participants will be followed for the duration of hospital stay, an expected average of 15 days
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Evaluating postoporative stress between the two protocols with scalesEvaluating postoporative stress with scales, such as Zung scale the day of hospitalization, ICUESS scale the 3rd postoperative day, Puntillo scale the day of surgery and three self-experienced questions how sad are you feeling, how stressed are you feeling and how optimistic are you feeling in three phases:a. the day of hospitalzation, b. the day of surgery c. the day of discharge.Participants will be followed for the duration of hospital stay, an expected average of 15 days
Evaluating postoperative pain between the two protocols with scaleEvaluating postoperative pain between the two protocols with scale such as Puntillo scale the day of surgeryParticipants will be followed for the duration of hospital stay, an expected average of 15 days

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
30 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • patients with American Society of Anesthesiologists (ASA) PHYSICAL STATUS CLASSIFICATION SYSTEM I-III
  • age 30-82 years,
  • with normal level of consciousness and communication

  • Exclusion Criteria:

  • the presence of chronic pain,
  • kidney disease, neuropathy,
  • systemic as well as chronic treatment with analgesics

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

  • Saint Savvas Anticancer Hospital

  • STUDY_DIRECTOR: Evangelos A Konstantinou, RN, PhD, National and Kapodistrian University of Athens

Publications

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

No publications available