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Is buprenorphine patch more effective than standard oral medication in the management of post-tonsillectomy pain: a study on how people cope with the pain following the removal of tonsils
ISRCTN ISRCTN59862351
ClinicalTrials.gov identifier
Public title Is buprenorphine patch more effective than standard oral medication in the management of post-tonsillectomy pain: a study on how people cope with the pain following the removal of tonsils
Scientific title PATCH Trial: Post-tonsillectomy Analgesia with buprenorphine Transdermal patCH: a prospective, randomised, phase IV, open label clinical trial to study the therapeutic use of buprenorphine 20 mg (Transtec®) matrix transdermal patch in the management of post-tonsillectomy pain in adults
Acronym PATCH Trial
Serial number at source Puranik 07/03/23
Study hypothesis To establish whether post-tonsillectomy analgesia using a transdermal patch has benefits over currently used oral analgesia, by comparatively measuring the clinical efficacy, the effective and perceived pain control, and the rate at which complications and adverse effects occur.
Ethics approval Ethics approval received from North East Wales Research Ethics Committee (REC) on the 31st January 2008 (ref: 07/WNo03/23). Medicines and Healthcare products Regulatory Agency (MHRA) approval received on the 21st December 2007.
Study design Randomised controlled trial
Countries of recruitment United Kingdom
Disease/condition/study domain Post-tonsillectomy pain
Participants - inclusion criteria Patients undergoing tonsillectomy, who meet the following criteria:
1. Aged 18 to 50 years old, either sex
2. American Society of Anaesthesiologists (ASA) grade I and II: healthy patient, mild systemic disease with no functional limitation (e.g., well controlled hypertension [HTA])
Participants - exclusion criteria 1. Age less than 18 or over 50 years
2. ASA grade III - severe systemic disease with definite functional limitation (e.g., unstable angina)
3. Any condition in which the respiratory centre and function are severely impaired or may become so
4. Asthmatic and allergic to non-steroidal anti-inflammatory drugs (NSAIDS)
5. Hypotension
6. Pregnancy and lactation
7. Recent head injury
8. Known hypersensitivity towards the active substance buprenorphine or to any of the excipients
9. Opioid-dependent patients, or patients in narcotic withdrawal treatment
9. Patients who are receiving monoamine oxidase (MAO) inhibitors or have taken them within the last two weeks
10. Patients suffering from myasthenia gravis
11. Patients suffering from delirium tremens or acute alcohol intoxication
12. Convulsive disorders
Anticipated start date 15/11/2007
Anticipated end date 30/10/2009
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details provided in the interventions field to request a patient information sheet
Target number of participants 150 in each arm, 300 in total
Interventions Arm A (interventional): will receive a 12 day supply of buprenorphine 20 mg (35 mg/h) (Transtec®) matrix transdermal patches (a total of four patches). Patients are required to replace the transdermal patch every three days.

Arm B (control): will receive a 12-day supply of codeine phosphate 30 mg/ paracetamol 500 mg (30/500/Solpadol®). Patients are required to take two tablets every four hours (p.r.n).

Total duration of treatment is 12 days. Final assessment and all data collected at day 10 (outpatient clinic), for both arms, no other follow-up.

Please use the following contact details to request a patient information sheet:
Dr. Rossela O. Stoicescu
Clinical Governance Officer (R&D Manager/Ethics Co-ordinator)
North Wales Clinical School - Clinical Academic Office
North West Wales NHS Trust
Ysbyty Gwynedd
Bangor, Gwynedd
LL57 2PW
Primary outcome measure(s) 1. Clinical efficacy: the buprenorphine : creatinine ratio
2. Perceived pain: measurements on the Visual Analogue Scale (VAS)
3. Coping strategies: the compounded prevalent strategy

All outcomes will be measured at day 10 of the intervention.
Secondary outcome measure(s) 1. Use (dose/frequency) of rescue medication
2. Readmission rate
3. Post-operative haemorrhage rate

All outcomes will be measured at day 10 of the intervention.
Sources of funding North West Wales NHS Trust (UK) - Pathology Research Fund
Trial website
Publications
Contact name Mr  Viswanath  Puranik
  Address North West Wales NHS Trust
ENT Department
Ysbyty Gwynedd
  City/town Bangor
  Zip/Postcode LL57 2PW
  Country United Kingdom
Sponsor North West Wales NHS Trust (UK)
  Address c/o Dr. P. Birch
Ysbyty Gwynedd
  City/town Bangor
  Zip/Postcode LL57 2PW
  Country United Kingdom
  Sponsor website: http://www.northwestwales.org/
Date applied 24/10/2007
Last edited 16/04/2008
Date ISRCTN assigned 16/04/2008
News
28 Sept 2007: 2007 Update of NHS Trusts Clinical Trials Register now available online
Aug 2007: Searches on ISRCTN register can now be bookmarked
Jul 2007: Patient information material field added to the ISRCTN Register
May 2007: WHO launches the International Clinical Trials Registry Search Portal
3 Apr 2007: Q&As regarding trial registration in the UK
4 Dec 2006: Trials taking place in the UK collated in 'Gateway'

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