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Trial registered on ANZCTR
Registration number
ACTRN12610000447055
Ethics application status
Approved
Date submitted
27/05/2010
Date registered
2/06/2010
Date last updated
29/11/2019
Date data sharing statement initially provided
29/11/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of low dose intravenous premedication (co-induction) on cardiac output and induction of anaesthesia
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Scientific title
To explore the effect during induction of anaesthesia of low dose intravenous premedication (co-induction) with a variety of drugs, on cardiac output and the dose of propofol required for loss of consciousness, in patients requiring insertion of arterial line for surgery
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Secondary ID [1]
1179
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Nil
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Secondary ID [2]
288161
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There is no secondary ID.
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Universal Trial Number (UTN)
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Trial acronym
COS Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anaesthetics
252365
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Cardiac output changes
252366
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Condition category
Condition code
Anaesthesiology
237430
237430
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Administration of a small dose of midazolam (0.03mg/kg), propofol (0.4mg/kg), fentanyl (1.5mcg/kg) or placebo by intravenous bolus, 3 minutes prior to induction of anaesthesia by propofol, infused at a rate of 3ml/kg/hr until loss of consciousness as confirmed by syringe drop.
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Intervention code [1]
236823
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Treatment: Drugs
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Comparator / control treatment
Saline bolus administered intravenously 3 mins prior to induction.
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Control group
Placebo
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Outcomes
Primary outcome [1]
253432
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Amount of induction drug required (as determined by time to LOC x infusion rate of 3ml/kg/hr) to loss of consciousness (LOC) as determined by:
1. Syringe drop and
2. Lack of response to command
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Assessment method [1]
253432
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Timepoint [1]
253432
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Time to LOC measured from 'propofol on' time and determined by:
1. Syringe drop (primary indicator)
2. Lack of response to command (every 30 sec until lack of response)
Bi-Spectral Index monitor (BIS) 'below 60' time is also noted and amount of propofol till this point calculated as above.
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Primary outcome [2]
257444
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Change in cardiac output after "coinduction" as assessed by Vigileo ('Minimally Invasive, Arterial Pressure Cardiac Output Monitor'. utilising FloTrac sensor attatched to an Arterial Line).
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Assessment method [2]
257444
0
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Timepoint [2]
257444
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Monitored continually from insertion of arterial line until induction/LOC.
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Secondary outcome [1]
262581
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Nil
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Assessment method [1]
262581
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Timepoint [1]
262581
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Nil
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Eligibility
Key inclusion criteria
Surgery requiring insertion of arterial line,
American Society of Anesthetist (ASA) rating 1,2 or 3
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Minimum age
18
Years
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Maximum age
65
Years
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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
Contra-indication to propofol.
Requirement for specific co-induction drug, other than study drug.
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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)
Identify patients fitting inclusion criteria; consult with rostered anaesthetist re patient/procedure suitability.
Inform patient of study and seek consent. Allocate sequential study number to patient. Administer drug at defined time. Co-induction drug concealed in covered syringe. Drug administered by 'outside' anaesthetist, and not in front of theatre anaesthetist or researcher.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised randomisation 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 4
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/11/2009
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Actual
24/11/2009
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Date of last participant enrolment
Anticipated
29/01/2016
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Actual
15/12/2015
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Date of last data collection
Anticipated
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Actual
29/01/2016
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Sample size
Target
80
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Accrual to date
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Final
50
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Recruitment outside Australia
Country [1]
1855
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New Zealand
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State/province [1]
1855
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Christchurch
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Funding & Sponsors
Funding source category [1]
256158
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Charities/Societies/Foundations
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Name [1]
256158
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Christchurch Anaesthesia Education Trust
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Address [1]
256158
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c/- Dr R French,
Department of Anaesthesia,
Christchurch Hospital ,
Private Bag 4710,
Christchurch 8011,
New Zealand
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Country [1]
256158
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New Zealand
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Primary sponsor type
Charities/Societies/Foundations
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Name
Christchurch Anaesthesia Education Trust
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Address
c/o Dr R French,
Department of Anaesthesia,
Christchurch Hospital,
Private Bag 4710,
Christchurch 8011,
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
251500
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None
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Name [1]
251500
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Address [1]
251500
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Country [1]
251500
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258261
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Upper South A Regional Ethics Committee
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Ethics committee address [1]
258261
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Ministry of Health PO Box 3877 Christchurch 4011
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Ethics committee country [1]
258261
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New Zealand
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Date submitted for ethics approval [1]
258261
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01/10/2008
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Approval date [1]
258261
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13/11/2008
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Ethics approval number [1]
258261
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URA/08/10/065
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Summary
Brief summary
There is good evidence of a true synergy between midazolam and propofol induction and data suggests that pre-dosing with propofol also reduces induction requirements. However, there has been no measure of the actual cardiac output changes in any human studies apart from that of Adachi et al. We plan to explore the relationship between cardiac output and induction doses of propofol in more detail and, in particular, to explore the effect of co-induction agents on cardiac output and to further evaluate cardiac output changes around induction of anaesthesia.
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Trial website
Nil
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Trial related presentations / publications
Kennedy RR, McKellow MA Effect-site sevoflurane concentrations at awakening are close to MAC-awake while end-tidal concentrations are lower. Anesthesiology 2017 Boston Oct 2017 http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2017&index=7&absnum=4770 Kennedy RR, McKellow MA, Williman J Comparing end-tidal and calculated effect-site sevoflurane concentrations at awakening from anaesthesia. International Society for Anesthetic Pharmacology Annual Meeting, Boston, October 2017 https://www.isaponline.org/download_file/382/238 Kennedy RR, McKellow MA, Williman J. A comparison of age-adjusted effect-site volatile anesthetic concentrations and an effect-site volatile and opioid interaction model to describe the time of awakening after volatile anesthesia. Anesthesiology 2015 San Diego October 2015 Kennedy RR, McKellow MA, Williman J, French RA. The distribution of effect-site sevoflurane concentrations at wake-up: a comparison of two systems. International Society for Anesthetic Pharmacology Annual Meeting San Diego October 2015 Kennedy RR, McKellow MA, Williman J, French RA. The influence of covariates on effect-site age-adjusted MAC fraction estimated by GE-Navigator at the point of first response after inhalational anesthesia. International Society for Anesthetic Pharmacology Annual Meeting San Diego October 2015
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Public notes
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Contacts
Principal investigator
Name
29800
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A/Prof Dr R Ross Kennedy
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Address
29800
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Dept of Anaesthesia
Christchurch Hospital
Private Bag 4710
Christchurch 8011
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Country
29800
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New Zealand
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Phone
29800
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+64 3 3640288
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Fax
29800
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+64 3 3640289
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Email
29800
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[email protected]
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Contact person for public queries
Name
13047
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Assoc Prof Ross Kennedy/Margie McKellow
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Address
13047
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c/o Department of Anaesthesia
Christchurch Hospital
Private Bag 4710
Christchurch 8011
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Country
13047
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New Zealand
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Phone
13047
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+64 3 3640288
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Fax
13047
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+64 3 3640289
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Email
13047
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[email protected]
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Contact person for scientific queries
Name
3975
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Assoc Prof Ross Kennedy
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Address
3975
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c/o Department of Anaesthesia
Christchurch Hospital
Private Bag 4710
Christchurch 8011
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Country
3975
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New Zealand
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Phone
3975
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+64 3 3640288
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Fax
3975
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+64 3 3640289
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Email
3975
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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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