Aortic Valve Replacement
Conditions
Keywords
pain treatment, intensive care, cardiology, medical device
Brief summary
The objective of this study is to evaluate a new medical device in the management of pain. The principle of this new treatment is based on the emission of electromagnetic radiation in millimeter band. This new modality of pain management is evaluated in a perioperative management in patients undergoing surgery for aortic valve replacement. The hypothesis is that the use of this medical device in perioperative would reduce the consumption of postoperative morphine with an identical quality of analgesia. The decline in morphine consumption would allow a decrease in opioid adverse effects.
Interventions
Treatment sessions with the medical device (no-marked EC): 2 sessions before surgery and 4 or 5 sessions until 48 hours after surgery. Each treatment sessions takes 45 minutes. Each session is spaced by 12 +/-3 hours.
Sponsors
Study design
Eligibility
Inclusion criteria
* candidate for an aortic valve replacement with extra-corporal flow. * wrist size between 14.5 and 18.5 centimeters (for the experimental group) * patient affiliated to social security * signature of the informed consent (for the experimental group)
Exclusion criteria
for the control group : * patient with diabetes * patient with an evolutive cancer * patient with cardiac assistance * patient under the influence of opioid in the 48 hours before the surgery * patient deprived of liberty by judicial or administrative decision * patient subject to legal protection or unable to express his consent (guardianship or curators)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative consumption of morphine auto-administered in the experimental group in the first 48 hours : descriptive analysis | 48 hours | The morphine cumulative consumption administered by auto-analgesia in the experimental group at 24 and 48 hours after the surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Determine the number of patients required to demonstrate a 30% decrease in morphine consumption within the first 48h following aortic valve replacement surgery in a population treated with Electronic-Pain-Killer compared to conventional pain management | 48 hours | Cumulative morphine consumption in milligrams, administered by auto-analgesia, at 48 hours post-operatively in the experimental and control groups. |
| Troponin's peak characterization in the first 48 hours postoperatively. | 48 hours | The troponin is assessed in ng/ml in the two groups from the end of the surgery until 48 hours postoperatively |
| The Pain characterization: Echelle Numérique Standard; standard digital scale | 48 hours | The patient pain is evaluated using the ENS (Echelle Numérique Standard; standard digital scale, score between 0 to 10) for both groups. |
| The hospitalization length in the intensive care unit | 48 hours | For the two groups, the hospitalization length in the intensive care unit is assessed in hours. |
| Characterization of analgesic drugs | 48 hours | The analgesic drugs are characterized by their class, dose and number of dose taken in the two groups since they are in the intensive care unit. |
| Number of postoperative nausea or vomiting events (number of PONV) in the experimental group | 48 hours | In the experimental group, the number of PONV events requiring a treatment is assessed. |
| Cumulative consumption of morphine auto-administered in the control group in the first 48 hours : descriptive analysis | 48 hours | The morphine cumulative consumption administered by auto-analgesia in the control group at 24 and 48 hours after the surgery |
| Adverse effect from the medical device | 48 hours | The number of adverse effects from the medical device is assessed from the first session with the medical device to the follow-up visit. |
| Description of the medical device use | 48 hours | Log files of the medical device are extracted. The length of each session, the start and end session times, each stopping is analysed. |
| Medical device acceptability : score | 48 hours | This score has been specifically created for the electronic pain killer medical device. Each item range from 0 (the worst) to 10 (the best). |
| Medical device acceptability : descriptive analysis | 48 hours | Open questions will be asked in a questionnaire without scale. A descriptive analysis will be done with the answers. |
| Use Error evaluation : System Usability Scale (SUS) | 48 hours | The System Usability Scale (SUS) contains 10 questions that are rated on a scale from 1 to 5. The participant's scores for each question are converted to a new number, added together and then multiplied by 2.5 to convert the original scores of 0-40 to 0-100. Jeff Sauro established the average score of SUS is 68. The score can go from 0 (worst) to 100 (best). |
| Subgroup analysis excluding patients who have had Nefopam administration | 48 hours | To avoid a potential bias confusion, patients taking Nefopam drug are excluded from the analyses and all the previous outcome are assessed again. |
| Delirium events in the experimental group | 48 hours | The number of delirium events is assessed using the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit) scale in the experimental group. |
Countries
France