Perioperative Inflammation and Cyclooxygenase 2 (COX-2)

Surgery initiates a complex cascade of events involving the release of chemical compounds from nerve endings and damaged tissue which leads to an inflammatory and pain response. The purpose of this investigation is to measure various chemical mediators in the blood and cerebrospinal fluid, and to test the hypothesis that they will be decreased in patients treated with a COX-2 inhibitor...

Date First Received: July 18, 2005

Last Updated: September 25, 2008

Verified by: University of Washington, September 2008

Clinical Trial Phase: Phase 4 | Start Date: November 2002

Overall Status: Completed

Estimated Enrollment: 30

Brief Summary

Official Title: “Preoperative Valdecoxib: CNS Penetration and Effects on Biochemical Markers of Pain and Sensitization”

Condition Keyword(s):

Intervention(s):

Surgery initiates a complex cascade of events involving the release of chemical compounds from nerve endings and damaged tissue which leads to an inflammatory and pain response. The purpose of this investigation is to measure various chemical mediators in the blood and cerebrospinal fluid, and to test the hypothesis that they will be decreased in patients treated with a COX-2 inhibitor.

Study Type: Interventional

Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Pharmacokinetics/Dynamics Study

Detailed Clinical Trial Description

Surgery initiates a complex cascade of events involving the release of nociceptive compounds from nerve endings and damaged tissue which leads to an inflammatory and hyperalgesic response. COX-2 inhibitors are often used for treating pain. This is a double-blind randomized study in surgical patients receiving a spinal drain for surgical purposes. The hypothesis is that valdecoxib will reach therapeutic concentrations in CSF, and will decrease plasma and CSF concentrations of inflammatory mediators. Subjects will receive valdecoxib 40 mg or placebo approximately 1 hr prior to surgery. Serial blood and CSF samples will be obtained. Valdecoxib and cytokine concentrations will be measured.

Intervention(s) in this Clinical Trial

  • Drug: valdecoxib

Outcome Measures for this Clinical Trial

Primary Measures

  • Cerebrospinal fluid (CSF) valdecoxib concentration

Secondary Measures

  • Plasma valdecoxib concentration
  • CSF/plasma valdecoxib concentration ratio
  • CSF and plasma cytokine concentrations
  • Postoperative opioid consumption
  • Pain visual analogue scale (VAS) scores

Criteria for Participation in this Clinical Trial

Inclusion Criteria:

  • Patients undergoing surgery requiring lumbar drain placement

Exclusion Criteria:

  • Contraindication to COX-2 inhibitor (renal or hepatic insufficiency)
  • Known adverse reaction to nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Use of NSAID or COX-2 within 7 days prior to surgery

Gender Eligibility for this Clinical Trial: Both

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: 80 Years

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Clinical Trial Sponsor Information

Lead Sponsor: University of Washington

Overall Clinical Trial Officials and Contacts

Evan Kharasch, MD PhD Principal Investigator Washington University School of Medicine  

Additional Information

Information obtained from ClinicalTrials.gov on July 02, 2009

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00122096

Study ID Number: EDK001

ClinicalTrials.gov Identifier: NCT00122096

Health Authority: United States: Institutional Review Board

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