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Trial registered on ANZCTR
Registration number
ACTRN12609001027202
Ethics application status
Approved
Date submitted
23/11/2009
Date registered
27/11/2009
Date last updated
22/02/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of fentanyl with pethidine for pain relief during childbirth.
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Scientific title
Obstetric analgesia: A comparison of intranasal or subcutaneously administered fentanyl with intramuscular administered pethidine in labour and its effects on mother and baby.
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Secondary ID [1]
1149
0
None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Childbirth
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Condition category
Condition code
Reproductive Health and Childbirth
252439
252439
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised into one of three groups.
Group 1. Self administered intranasal fentanyl, under supervision of a midwife.
Group 2. Fentanyl administered subcutaneously
Group 3. Pethidine administered intramuscularly
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Intervention code [1]
241583
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Treatment: Drugs
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Comparator / control treatment
The comparator group will be administered intramuscular (IM) pethidine. Observations will be undertaken as for groups one and two. Results will then be compared to review efficacy and safety.
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Control group
Active
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Outcomes
Primary outcome [1]
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To determine whether fentanyl administered subcutaneously (s.c) or intranasal (I/N) during childbirth will be at least as efficacious as the current practice of administering IM pethidine.
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Assessment method [1]
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Timepoint [1]
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1. Pain scores will be taken once the woman requests a narcotic. This will be undertaken utilising the Visual analogue Scale (VAS) tool. Scores will be collected immediately before injection or inhalation and 30 minutes post administration between contractions. I
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Secondary outcome [1]
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1. To determine whether fentanyl administered s.c or I/N during childbirth will provide fewer adverse effects than that of IM administered pethidine for mother and neonate.
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Assessment method [1]
262400
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Timepoint [1]
262400
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Maternal blood pressure, nausea and sedation levels, will be monitored both before and 30 minutes after drug administration. In addition, neonatal effects including Apgar scores at 1 and 5 minutes, whether narcan has been administered to reverse the effect of the narcotic and the time taken for the baby to establish breathing will be examined.
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Secondary outcome [2]
262410
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2. A questionaire will be utilised to explore whether any of the three treatments have an effect on breastfeeding for women who chose to feed their babies in this manner.
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Assessment method [2]
262410
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Timepoint [2]
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Breastfeeding outcomes will be reviewed at discharge from hospital and 6 weeks postpartum.
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Eligibility
Key inclusion criteria
Healthy women birthing at term (between 37 to 42 weeks gestation). The woman must be in active labour, having regular contractions and a cervical dilatation of at least 3cm.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Women with a substance abuse history (opioid tolerance), premature labour, bronchial asthma, a drug allergy or history of hypersensitivity to opioid substances or women who are taking or have taken Monoamine oxidase inhibitors (MAOI), Selective Serotonin Reuptake Inhibitors (SSRI’s) or tricyclics within the previous fourteen days.
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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)
Women will be recruited through the antenatal clinics so that consent can be obtained prior to the commencement of labour. Once in labour and upon requesting to be administered a narcotic for pain relief the woman will be asked to select an envelope from a container that identifies which narcotic and mode of administration will be undertaken.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not 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
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/05/2010
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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
150
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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]
244061
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University
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Name [1]
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Flinders University
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Address [1]
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GPO Box 2100
Adelaide SA 5001
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Country [1]
244061
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Australia
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Primary sponsor type
University
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Name
Flinders University
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Address
GPO Box 2100
Adelaide SA 5001
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
251407
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Address [1]
251407
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Country [1]
251407
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Other collaborator category [1]
967
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Hospital
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Name [1]
967
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Flinders Medical Centre
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Address [1]
967
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Flinders Drive, Bedford Pk,
South Australia, 5042
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Country [1]
967
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Australia
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Other collaborator category [2]
260567
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Hospital
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Name [2]
260567
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Women's & Children's Hospital
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Address [2]
260567
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72 King William Rd Adelaide SA
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Country [2]
260567
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Australia
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Other collaborator category [3]
260568
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Hospital
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Name [3]
260568
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Inner North Country Health Services
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Address [3]
260568
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Hutchinson Rd Gawler East
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Country [3]
260568
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258160
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Southern Adelaide Health Service / Flinders University FLINDERS CLINICAL RESEARCH ETHICS COMMITTEE
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Ethics committee address [1]
258160
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Flinders Medical Centre, Flinders Drive BEDFORD PARK SA 5042
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Ethics committee country [1]
258160
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Australia
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Date submitted for ethics approval [1]
258160
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24/11/2009
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Approval date [1]
258160
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Ethics approval number [1]
258160
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Ethics committee name [2]
286762
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WCHN Human Research Ethics Committee
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Ethics committee address [2]
286762
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72 King William Rd Adelaide
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Ethics committee country [2]
286762
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Australia
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Date submitted for ethics approval [2]
286762
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Approval date [2]
286762
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10/11/2010
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Ethics approval number [2]
286762
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REC2284/9/13
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Summary
Brief summary
Pethidine is currently the most widely used narcotic administered systemically for the relief of labour pain, but has been shown to have numerous side effects on both mother and neonate. An alternative narcotic, fentanyl when administered intravenously (IV) has been shown to have fewer side effects and a shorter duration of action than does pethidine. There is a lack of research relating to the use of fentanyl administered during labour via alternative routes. Alternative routes have the benefit of being less invasive, requires fewer resources and provides more autonomy to the midwife providing care. This has particular benefits for rural and remote birthing communities. This study will examine the safety and efficacy of fentanyl administered by intranasal (IN) or subcutaneous (s.c) routes for pain relief during childbirth for both mother and neonate. It also will investigate possible maternal and neonatal side effects. Outcomes will be compared with intramuscular (IM) pethidine.
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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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Julie Fleet
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Address
13783
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GPO Box 2100
Adelaide SA 5001
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Country
13783
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Australia
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Phone
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+61 882012071
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Fax
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Email
13783
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[email protected]
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Contact person for scientific queries
Name
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Julie Fleet
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Address
4711
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GPO Box 2100
Adelaide SA 5001
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Country
4711
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Australia
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Phone
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+61 882012071
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Fax
4711
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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
Source
Title
Year of Publication
DOI
Embase
A comparison of fentanyl with pethidine for pain relief during childbirth: A randomised controlled trial.
2015
https://dx.doi.org/10.1111/1471-0528.13249
N.B. These documents automatically identified may not have been verified by the study sponsor.
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