Effect of Methylprednisolone on Orthostatic Intolerance and Heart Rate Variability in Hip-arthroplasty Patients
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|ClinicalTrials.gov Identifier: NCT02445898|
Recruitment Status : Completed
First Posted : May 15, 2015
Last Update Posted : January 18, 2017
The study evaluates the pathophysiological effects of a single dose Methylprednisolone administered prior to total hip-arthroplasty (THA) surgery. The investigators examine the effect on orthostatic intolerance, orthostatic hypotension and heart rate variability (HRV) to evaluate the efficacy of Methylprednisolone regarding blood pressure regulation and autonomic responses after THA.
Half of participants will receive intravenous Solu-Medrol 125 mg, while the other half will receive placebo.
The investigators hypothesize that the group receiving Methylprednisolone will be less orthostatic intolerant, experience less orthostatic hypotension and have an improved autonomic response compared to the placebo-group, early after THA.
|Condition or disease||Intervention/treatment||Phase|
|Osteoarthrosis||Drug: Methylprednisolone Drug: Isotonic Sodium Chloride||Phase 2 Phase 3|
The anti-inflammatory effects of glucocorticoids are well known. The beneficial effects in postoperative pain, postoperative nausea and vomiting are well-documented.
Hip-arthroplasty surgery and the inflammatory stress response in general affect the potential of recovery. Early postoperative orthostatic intolerance is common in patients undergoing THA with an incidence of 40%. The mechanism is thought related to an impaired autonomic regulation caused by surgery-induced inflammation. The effect of glucocorticoids on orthostatic intolerance, orthostatic hypotension and HRV after hip-arthroplasty surgery is unknown and calls for further investigation.
The study is to be considered as exploratory. The primary analysis of the primary outcome measure is a comparison of the incidence of orthostatic intolerance from baseline to 6 hours postoperatively between the two groups.
For calculation of sample size the difference in incidence between groups (40% versus 10%) from baseline (before surgery) to 6 hours after THA-surgery, a risk of type I errors 5% and a risk of type II errors 20% (80% power) were used.
The primary analysis is carried out on all included patients (intention-to-treat) with baseline values as covariate. Secondary exploratory per-protocol analysis might be performed. Missing outcomes will be analysed using multiple imputation due to expected strong time trends.
The secondary outcomes measures; Non-invasive blood pressure, systemic vascular resistance, cardiac output, HRV, plasma-hemoglobin, C-reactive protein.
For further details please also view the European Clinical Trials Database (EudraCT) registration:
EudraCT nr.: 2015-000102-19
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||64 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Official Title:||Effect of Preoperative Intravenous High Dose Methylprednisolone on Orthostatic Intolerance and Heart Rate Variability in Patients Scheduled for Total Hip-arthroplasty|
|Study Start Date :||September 2015|
|Actual Primary Completion Date :||January 2017|
|Actual Study Completion Date :||January 2017|
Active Comparator: Methylprednisolone
Preoperative single high dose of Solu-Medrol 125 mg iv.
Comparison of preoperative single high dose of Methylprednisolone 125 mg iv. and isotonic Sodium Chloride (placebo)
Other Name: Solu-Medrol
Placebo Comparator: Isotonic Sodium Chloride
Preoperative single dose of isotonic Sodium Chloride
Drug: Isotonic Sodium Chloride
- Difference in incidence of orthostatic intolerance from baseline to 6 hours after surgery [ Time Frame: 6 hours after surgery ]
- Difference in incidence of orthostatic intolerance from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in non-invasive blood pressure from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in heart rate variability from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in stroke volume and cardiac output from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in systemic vascular resistance from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in pain intensity from baseline to 24 hours after surgery [ Time Frame: 24 hours after surgery ]
- Change in concentration of plasma-hemoglobin from baseline to 48 hours after surgery [ Time Frame: 48 hours after surgery ]
- Change in concentration of C-reactive protein from baseline to 48 hours after surgery [ Time Frame: 48 hours after surgery ]
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02445898
|Copenhagen University Hospital, Bispebjerg|
|Copenhagen NV, Denmark, 2400|
|Principal Investigator:||Viktoria Lindberg-Larsen, MD||Section for Surgical Pathophysiology, Rigshospitalet|