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Trial registered on ANZCTR
Registration number
ACTRN12606000148572
Ethics application status
Approved
Date submitted
14/04/2006
Date registered
1/05/2006
Date last updated
1/05/2006
Type of registration
Prospectively registered
Titles & IDs
Public title
Epidural Versus Intrathecal Analgesia in Abdominal Surgery - the EVITA study
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Scientific title
A randomised trial to compare pain relief after major open abdominal surgery in patients receiving either epidural or intrathecal analgesia
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Universal Trial Number (UTN)
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Trial acronym
EVITA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pain relief and recovery after surgical resection of the stomach, small bowel or colon.
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Condition category
Condition code
Oral and Gastrointestinal
1197
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Other surgery
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Oral and Gastrointestinal
1198
1198
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
continous infusion analgesia for postoperative pain for 3 days by intrathecal infusion of a solution containing midazolam 0.1mg/ml, morphine 10mcg/ml and bupivacaine 0.gmg/ml at 1-2 ml/hour.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
continous infusion analgesia for postoperative pain for 3 days by standard epidural technique (bupivacaine 1.25mg/l + fentanyl 2mcg/ml at 6-14 ml/hour).
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain scores on coughing on the verbal analog pain scale
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Assessment method [1]
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Timepoint [1]
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On day 2 after surgery
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Secondary outcome [1]
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1. Incidence and frequency of side effects (nausea, vomiting, itch, motor block, sedation, hypotension).
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Assessment method [1]
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Timepoint [1]
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Postoperative days 1 to 3.
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Secondary outcome [2]
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2. Use of and type of co-analgesics
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Assessment method [2]
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Timepoint [2]
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Postoperative days 1 to 3.
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Secondary outcome [3]
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3. Number of rescue top ups
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Assessment method [3]
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Timepoint [3]
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Postoperative days 1 to 3.
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Eligibility
Key inclusion criteria
1. Elective open colorectal, gastric or small bowel resection surgery. 2. patient willing to have a neuraxial catheter placed as part of the anaesthetic technique.
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Minimum age
50
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Use of prescribed opoids or sedatives, postoperative ventilation.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Double blinding. Sealed envelope method.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer generated random sequence
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Individual
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Name
Dr Michael Duncan
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Address
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Country
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Secondary sponsor category [1]
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None
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Name [1]
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n/a
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Southern Health Ethics committee-Wentworth Area Health Service Ethics committee
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
Patients undergoing major abdominal surgery require intensive postoperative pain relief for many days. Good pain relief improves recovery and poor pain relief hinders recovery. The conventional choices of pain relief are powerful intravenous drugs or an epidural infusion of local anaesthetic with some morphine like drug (opioid) added. Despite extensive experience with these two techniques it remain unclear in which patients the epidural technique is indicated. In Southern Health and selected other hospitals in Australia a third technique has been in use for 15 years – a continous spinal infusion of pain relieving drugs using a spinal catheter (the ‘intrathecal technique’) . A recent quality assurance audit at Monash medical centre showed that the intrathecal technique was superior to the other two techniques. Patients receiving this had better pain relief than alternative techniques. Unfortunately this work was an unblinded audit comparing 3 groups of patients among whom major differences existed in surgical length, type of surgery and age. This limits what can be concluded from the results. In the proposed project the intention is to recruit patients aged over 50 that are scheduled for gut surgery into a study comparing epidural and intrathecal analgesia postoperatively. The aim is to improve pain relief and quality of recovery after surgery. Other factors that will be studied include length of stay, need for additional pain relieving drugs and time till oral intake. The participants, assessor and data analyst will be blinded to the treatment groups. The hospital staff will not be blinded.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Michael Duncan
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Address
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Dept. Anaesthesia
Monash Medical Centre
246 Clayton Rd
Vic 3168
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Country
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Australia
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Phone
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0395943283
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Fax
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0395946290
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Michael Duncan
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Address
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Monash Medical Centre
246 Clayton Rd
Vic 3168
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Country
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Australia
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Phone
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0395943283
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Fax
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0395946290
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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