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Trial registered on ANZCTR
Registration number
ACTRN12610000063011
Ethics application status
Approved
Date submitted
11/01/2010
Date registered
19/01/2010
Date last updated
19/01/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
A Comparison of Liver Function After Hepatectomy in Cirrhotic Patients Between Isoflurane Inhaled and Propofol Intravenous in Anesthesia with Epidural Block
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Scientific title
A prospective randomized controlled trial to compare postoperative liver functions, cytokines and complications between isoflurane inhaled and propofol intravenous anesthesia in cirrhotic patients undergoing hepatectomy for hepatic carcinoma
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Secondary ID [1]
1284
0
nil
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Universal Trial Number (UTN)
nil
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Trial acronym
nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hepatic carcinoma resection among cirrhotic patients
256536
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Condition category
Condition code
Anaesthesiology
256690
256690
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0
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Anaesthetics
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Oral and Gastrointestinal
256707
256707
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cancer
256708
256708
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0
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Liver
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
a) 1-1.5 minimum alveolar concentration (MAC) of isoflurane 1.15-1.75 % , the individual patient's dose is based on the clinical variables;
b) anaesthic administered from 30 minutes before commencement of surgery until completion of surgery (100-200 minutes in total)
c) the mode of administration: inhalation via tracheal tubing.
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Intervention code [1]
255796
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Treatment: Drugs
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Comparator / control treatment
a) Target controled infusing(TCI) of propofol concentration of 3-6 ug.ml-1, the individual patient's dose is also based on the clinical variables
b) anaesthic administered from 30 minutes before commencement of surgery until completion of surgery (100-200 minutes in total)
c) the mode of administration:intravenous infusion
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Control group
Active
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Outcomes
Primary outcome [1]
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Postoperative liver fuctions and hepatocyte injury defined by peak alanine-aminotransferase (ALT) and aspartate-aminotransferase (AST) levels in blood analysis
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Assessment method [1]
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Timepoint [1]
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On operation day,postoperative day 1,3,7
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Secondary outcome [1]
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Serum Cytokine Tumor Necrosis Factor-a (TNFa) and Interleukin-1(IL1) levels
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Assessment method [1]
262823
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Timepoint [1]
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On operation day,postoperative day 1,3,7
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Secondary outcome [2]
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Postoperative recovery: Hospital stay and Complications (eg. incidence rate (%) of hemorrhage,bile leak,wound infection,pleural effusion,hepatic decompensation,infective complications in each group, and postoperative complications were
assessed by treatment-oriented complication score.)
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Assessment method [2]
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Timepoint [2]
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Entire Hospitalization
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Eligibility
Key inclusion criteria
1. Elective liver resection
2. American Society of Anesthesiologists (ASA) physical status II-III patients
3. Primary liver cancer patients who had history of hepatitis B related cirrhosis
4. undergoing combined general and epidural anesthesia
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Minimum age
18
Years
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Maximum age
80
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
1.Contradictions of epidural puncture including coagulate disorder (prothrombin time (PT) longer than 15 sec or/and blood platelets count less than 10,000)
2.Tumor size too large or small ( longitude of tumor was beyond 3-8 cm) or estimated blood loss was large than 1000 cc.
3.Individuals in whom the regional block failed and surgery was performed under general anesthesia alone were also withdrawn from the study.
4.Indivduals fail to be performed Pringer’s maneuver due to technologic problem.
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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)
60 ASA physical status II–III patients who underwent hepatectomy surgery for resection the hepatic neoplasms who had history of hepatitis B related cirrhosis under combined general and epidural anesthesia were enrolled after signed an approved informed consent.
Sequentially-Numbered, Opaque, Sealed Envelopes (SNOSE) were used as allocation concealment method.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization was based on computer-generated codes that were maintained in opaque envelopes until the anesthesia began
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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
nil
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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
Completed
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Date of first participant enrolment
Anticipated
1/12/2008
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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
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
2397
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China
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State/province [1]
2397
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Shanghai
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Funding & Sponsors
Funding source category [1]
256272
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Other
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Name [1]
256272
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Shanghai Rising-Star Program (No 08QA14007)
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Address [1]
256272
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Shanghai Committee of Science and Technology
200 People Avenue
Shanghai,200003, China
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Country [1]
256272
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China
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Primary sponsor type
Other
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Name
Shanghai Rising-Star Program (No 08QA14007)
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Address
Shanghai Committee of Science and Technology
200 People Avenue
Shanghai,200003, China
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Country
China
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
251610
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Country [1]
251610
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258378
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Institutional Review Board of the 3rd affiliated hospital
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Ethics committee address [1]
258378
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225 # Changhai Road the 3rd affiliated hospital, the Second Military Medical University, Shanghai,200438,China
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Ethics committee country [1]
258378
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China
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Date submitted for ethics approval [1]
258378
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01/08/2008
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Approval date [1]
258378
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20/10/2008
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Ethics approval number [1]
258378
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ZD2008008-Y1
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Summary
Brief summary
Liver resection may require hepatic inflow occlusion (Pringle’s maneuver) to diminish intraoperative blood loss, thus may result in transient ischemia followed by reperfusion, which may initiate liver injury and lead to postoperative liver dysfunction. Many protective strategies against ischemia reperfusion (IR) injury in the liver have been proposed, including surgical interventions, use of pharmacologic agents, or gene therapy, however, none of these methods has found its way into routine clinical practice. Therefore, therapeutic strategies to prevent liver tissue damage after IR have become the focus of extensive research efforts. Recently, accumulating evidence suggests volatile anesthetics can attenuate liver IR injury through a mechanism of inducing some endogenous protective molecules such as heme-oxygenase (HO) enzyme system or hypoxia induced factor (HIF) etc, which suggest volatile anesthetics concerning pharmacological pretreatment would most likely be a hopeful way to prolonger the patient’s endurance to hepatic IR. Unfortunately, most of isoflurane hepatoprotection evidences and related mechanisms were based on the result of animal studies, as isoflurane are most clinically used anesthetic during liver resection worldwide. Since Pringle’s maneuver are commonly applied by most of surgeons in our center which also cause an inevitable liver damage perioperatively, therefore providing us an ideal clinic model of hepatic IR injury. In order to test our hypothesis that using volatile anesthetics isoflurane can attenuate live IR injury rather than intravenous propofol in hepatectomy patients. We designed this clinical randomized comparative study to observer hepatectomy patients’ postoperative outcome especially liver function recovery when they received isofluare inhaled anesthesia or propofol injection respectively. We also compared serum proinflammatory factor and liver histiopathologic changes between 2 groups.
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Trial website
nil
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Trial related presentations / publications
nil
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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
30681
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Email
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Contact person for public queries
Name
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Dr. Liqun Yang M.D.
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Address
13928
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Department of Anaesthesia & Intensive Care
the 3rd Affiliated Hospital
the 2nd Military Medical University
225# Shanghai Road,
Shanghai,200438,China
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Country
13928
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China
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Phone
13928
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+8621-81875235
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Fax
13928
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+8621-81875231
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Email
13928
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[email protected]
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Contact person for scientific queries
Name
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Prof. Wei-feng Yu M.D. Ph.D.
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Address
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Department of Anaesthesia & Intensive Care
the 3rd Affiliated Hospital
the 2nd Military Medical University
225# Shanghai Road,
Shanghai,200438,China
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Country
4856
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China
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Phone
4856
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+8621-81875231
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Fax
4856
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+8621-81875231
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Email
4856
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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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