To compare the pain relief from combined intrathecal bupivacaine-morphine with bupivacaine alone in lower limb surgery

ISRCTN ISRCTN31685121
DOI https://doi.org/10.1186/ISRCTN31685121
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number Nil known
Sponsor Platinum Orthopaedic and Spine Clinic
Funder Investigator initiated and funded
Submission date
25/04/2022
Registration date
12/05/2022
Last edited
05/05/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Inadequate pain medication during and after surgery may lead to long term pain after surgery.

This study was designed to ascertain the effect of morphine addition to bupivacaine in the management of postoperative pain in patients undergoing lower limb surgeries at the Tamale Teaching Hospital, Ghana.

Who can participate?
Patients aged 16 – 60 years, undergoing lower limb surgery.

What does the study involve?
Participants will be randomly allocated to receive bupivicane alone or bupivicane plus morphine during surgery. Follow up lasts 72 hours.

What are the possible benefits and risks of participating?
Benefits: There were no immediate benefits for participation in the study. No gifts or money were given in exchange for the information obtained. However, data generated from this study will help policy makers in the Ministry of Health to improve the management of postoperative pain after Orthopaedic and Trauma surgeries.
Risks: Participants were informed that they may experience slight pain during the sample collection process. Should they suffer any injury during the collection process, members of the research team will take full responsibility and cover all expenses pertaining to treatment.

Where is the study run from?
Tamale Teaching Hospital, Ghana.

When is the study starting and how long is it expected to run for?
April 2021 to November 2021

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Sylvanus Kampo, sylvanuskampo@yahoo.com
Fidelis Bayor, bayorfidelis@gmail.com

Contact information

Mr Fidelis Bayor
Scientific

University of Ghana Medical School
Accra
24
Ghana

ORCiD logoORCID ID 0000-0002-2703-8856
Phone +233 249229949
Email bayorfidelis@gmail.com
Dr Sylvanus Kampo
Principal investigator

CK Tedam University of Technology and Applied Sciences
Navrongo
19
Ghana

Phone +233 559355229
Email sylvanuskampo@yahoo.com

Study information

Primary study designInterventional
Study designRandomised comparative controlled trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleAnalgesic efficiency of intrathecal bupivacaine with morphine and bupivacaine alone in lower limb orthopaedic surgery. A comparative study
Study acronymIBM
Study objectivesBupivacaine with morphine induces better postoperative pain relief and improve patient outcomes in lower limb orthopaedic surgery
Ethics approval(s)Approved 30/09/2021, Ethical review board of the Kwame Nkrumah University of Science and Technology (University Post Office, Kumasi, Ghana; +233(0)205453785; chrpe@knust.edu.gh), ref: CHRPE/AP/416/21
Health condition(s) or problem(s) studiedPostoperative pain management in trauma patients
InterventionAfter meeting the inclusion criteria, eligible patients received 15 mg preservative free hyperbaric bupivacaine and 0.2 mg morphine or 15 mg bupivacaine alone. Patients were followed up 72 hrs for postoperative complications and patient outcome.
Each recruited patient was randomly assigned to one of two groups using a computer-generated random number table. Group A (n=30) represented those who received bupivacaine alone and Group B (n=30) represented those who received bupivacaine with morphine.
Intervention typeDrug
PhaseNot Applicable
Drug / device / biological / vaccine name(s)bupivacaine, morphine
Primary outcome measure(s)

1. Vital signs (pulse rate, blood pressure, oxygen saturation, and respiratory rate) of the patient were monitored and recorded for every 5 minutes for the first 30 minutes and then for every 15 minutes during surgery
2. Pain severity was measured every 4 hours for 72 hours immediately after the surgery on a 100-mm VAS, 0 mm = no pain, and 100 mm = intolerable pain.

Key secondary outcome measure(s)

1. The episodes of postoperative nausea and vomiting (PONV) were identified by direct scheduled assessments or by a spontaneous complaint by the patients after the surgery. The incidence of PONV was recorded hourly for the first 4 hours and then 4 hourly for the next 24 hours using a 3 point ordinal scale (0 = none, 1 = nausea, 2 = vomiting). The incidence of PONV was calculated and categorized as early (0 – 4 hours) or delayed (5 – 24hours).
2. The incidence of pruritus was recorded every 4 hours for 48 hours after surgery on a four-point categorical scale as; 0 = no pruritus, 1 = mild, 2 = moderate, 3 = severe pruritus.
3. Overall perioperative satisfaction was evaluated on the day of discharged during an interview as; 4 = excellent, 3 = good, 2 = satisfactory, 1 = poor.

Completion date30/11/2021

Eligibility

Participant type(s)Patient
Age groupAdult
SexAll
Target sample size at registration150
Total final enrolment60
Key inclusion criteria1. Patients undergoing elective lower limb orthopaedic surgery
2. ASA status class I and II
3. Patients between 16 - 60 years of age
4. Patients who were on admission for 72 hours or more postoperatively
Key exclusion criteria1. Pregnant or breastfeeding mothers
2. Patients with polytrauma
3. Glasgow coma scale <15
4. Opioids abusers
5. Expected post-surgical stay <24 hours
6. ASA physical status class III and IV
7. Patients allergic to bupivacaine and/morphine
8. Contraindication to spinal anaesthesia
Date of first enrolment10/09/2021
Date of final enrolment29/11/2021

Locations

Countries of recruitment

  • Ghana

Study participating centre

Tamale Teaching Hospital
Box 1350TL
Tamale
-
Ghana

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
IPD sharing planAvailability of data and materials: The datasets generated and/or analysed during the current study are not publicly available due to patient confidentiality but are available from the corresponding author on reasonable request.
sylvanuskampo@yahoo.com

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

05/05/2022: Trial's existence confirmed by Kwame Nkrumah University of Science and Technology.