MEOPA to Improve Physical Therapy Results After Multilevel Surgery (KINOPA)

• ClinicalTrials.gov Identifier: NCT00632528
• Recruitment Status: Completed
• First Posted: March 10, 2008
• Last Update Posted: January 10, 2012
• Sponsor: Assistance Publique - Hôpitaux de Paris
• Information provided by (Responsible Party): Assistance Publique - Hôpitaux de Paris

Study Description

Brief Summary:

Children with cerebral palsy commonly undergo "multilevel surgery", meaning several lower limb combined procedures performed during the same surgical intervention. The aim of this type of surgery is to correct all deformities together in order to restore near to normal anatomy and muscular function. It is very important to be able to obtain good range of motion after surgery, in order to consolidate surgical results. During the first days after the operation, children are sore and it may be difficult to realize adequate physical therapy. In order to palliate this situation, MEOPA gaz is used during REHAB sessions. Good results have been obtained so far but no study is available to demonstrate these results. The goal of our research is to prove that there is a benefit in using MEOPA postoperatively in these patients.

Condition or disease	Intervention/treatment	Phase
Cerebral Palsy; Spastic Diplegia; Quadriplegia; Hemiplegia	Drug: MEOPA; Drug: Medicinal air	Phase 3

Detailed Description:

The study is a randomized, single blinded, controlled clinical trial. It consist of two groups of patients: one group will receive MEOPA (FDA approval-"AMM" in France, 2003) and the other will receive medical air.

Results, in terms of articular range of motion, will be compared between groups after five sessions of REHAB. The following items will be evaluated: degree of pain, measured by a pain scale; joint ROM; number of sessions to obtain the desired results; parents, patients and caregivers satisfaction.

Patients aging from 6 to 20 years will be included if they meet selection criteria. Inclusions are confirmed before the first session starts. At this time, informed consent is to be signed by patients or parents and the Clinical Epidemiology Unit will assign a study number to the patient.

All patients get morphine therapy before the REHAB session; a new dose is administrated 10 minutes later if pain is higher than 4/10; ten minutes later, if pain is still over 4/10, MEOPA (or medical air) will be administrated. If this is not enough to diminish pain, the session will be interrupted. Five physical therapy sessions are provided after surgery, during inpatient time.

Knee ROM will be measured by goniometry and will be the measure of reference to evaluate the influence of MEOPA. Two types of pain scale will be used: analogical scale from 1 to 10 and faces scale (FPS-R) for small children.

For security reasons, the person who administrates de gaz will be informed of the nature of the product (MEOPA or medical air), the bottle will be masked and the therapist won't know what kind of product is being administrated.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 64 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: Evaluation of the Efficacy of "MEOPA" Used to Obtain Better ROM Immediately After Multilevel Surgery in Children With Spastic Diplegia, Quadriplegia or Hemiplegia.
• Study Start Date: March 2008
• Actual Primary Completion Date: March 2011
• Actual Study Completion Date: March 2011

Arms and Interventions

Arm	Intervention/treatment
Experimental: 1; Administration of MEOPA gaz during postoperative physical therapy	Drug: MEOPA; Administration of MEOPA gaz during postoperative physical therapy
Placebo Comparator: 2; Administration of medical air during postoperative physical therapy	Drug: Medicinal air; Administration of medical air during postoperative physical therapy

Outcome Measures

Primary Outcome Measures :

1. Knee range of motion [ Time Frame: at 7 days ]

Secondary Outcome Measures :

1. Improvement of function after surgery [ Time Frame: at 7 days ]

Eligibility Criteria

• Ages Eligible for Study: 6 Years to 20 Years (Child, Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Multilevel surgery
• Spastic cerebral palsy

Exclusion Criteria:

• Patient not being able to walk

Contacts and Locations

Locations

France

Robert Debré University Hospital

Paris, France, 75019

Sponsors and Collaborators

Assistance Publique - Hôpitaux de Paris

Investigators

• Principal Investigator: Ana PRESEDO, MD; Assistance Publique - Hôpitaux de Paris

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Delafontaine A, Presedo A, Mohamed D, Lopes D, Wood C, Alberti C. Equimolar mixture of nitroux oxyde and oxygen during post-operative physiotherapy in patients with cerebral palsy: A randomized, double-blind, placebo-controlled study. Eur J Pain. 2017 Nov;21(10):1657-1667. doi: 10.1002/ejp.1071. Epub 2017 Jul 20.

• Responsible Party: Assistance Publique - Hôpitaux de Paris
• ClinicalTrials.gov Identifier: NCT00632528 History of Changes
• Other Study ID Numbers: P061007; CRC 06 013 ( Other Identifier: CRC )
• First Posted: March 10, 2008
• Last Update Posted: January 10, 2012
• Last Verified: February 2008

Keywords provided by Assistance Publique - Hôpitaux de Paris:

MEOPA; spasticity; multilevel surgery; cerebral palsy; children

Additional relevant MeSH terms:

Muscle Spasticity; Cerebral Palsy; Hemiplegia; Quadriplegia; Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Muscular Diseases; Musculoskeletal Diseases; Muscle Hypertonia; Neuromuscular Manifestations; Neurologic Manifestations; Signs and Symptoms; Paralysis