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Trial registered on ANZCTR
Registration number
ACTRN12610000693022
Ethics application status
Approved
Date submitted
19/08/2010
Date registered
20/08/2010
Date last updated
27/02/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
A trial to compare the accuracy of two methods for delivering Propofol in children
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Scientific title
A randomised control trial comparing accuracy of two commercially available pharmacokinetic algorithms for total intravenous anaesthesia (TIVA) using Propofol in children aged 1-16 years
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Secondary ID [1]
252513
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Nil.
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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:
Children having major surgery that necessitates use of an intra-arterial catheter and who are suitable for an intravenous (Propofol)-based anaesthetic.
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Condition category
Condition code
Anaesthesiology
258171
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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
Participants will be randomised to receive a propofol intravenous anaesthetic which will be delivered by either the Kataria or Paedfusor algorithm. These algorithms will deliver the "predicted plasma levels" (Cp).
The intervention will occur only once: ie each participant will be only randomised once and will only have surgery once.
The dose amount given will differ on a case by case basis and propofol delivery will be calculated on target blood level, age and weight.
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Intervention code [1]
257047
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Treatment: Drugs
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Comparator / control treatment
During anaesthesia, approximately 9 blood samples of 0.5ml are obtained from each participant. Samples will be from an intra-arterial catheter. These samples will deliver the "measured plasma levels" (Cm)
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Control group
Active
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Outcomes
Primary outcome [1]
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To determine the accuracy of pharmacokinetic algorithms in children. This will be performed by comparing measured arterial plasma concentrations of Propofol (cm) with concurrent predicted (cp) plasma levels.
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Assessment method [1]
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Timepoint [1]
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Samples to be collected at 3 and 8 minutes post commencement of propofol infusion; 2 minutes after a reduction or increase in the target concentration; during stable anaesthesia (60 minutes between sample if long procedure); just prior to ceasing the Target Controlled Infusion (TCI) system; 3 and 8 minutes after cessation; and upon participant?s eye opening.
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Secondary outcome [1]
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Bispectral index (BIS) measurements as a surrogate measure of Propofol concentration in the brain.
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Assessment method [1]
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Timepoint [1]
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BIS measurements to be taken at same time as arterial measurements: at 3 and 8 minutes post commencement of propofol infusion; 2 minutes after a reduction or increase in the target concentration; during stable anaesthesia (60 minutes between sample if long procedure); just prior to ceasing the TCI system; 3 and 8 minutes after cessation; and upon participant?s eye opening.
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Secondary outcome [2]
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Observation of perceived benefits of Propofol including a possible reduction in post-operative nausea and vomiting and airway problems.
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Assessment method [2]
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Timepoint [2]
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Until participant is discharged from recovery.
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Eligibility
Key inclusion criteria
Children aged 1-16 yrs old having surgery necessitating insertion of an arterial line for intra-operative monitoring
American Society of Anesthesiologists (ASA) status 1-3
Surgical procedure expected to last between 1-8 hours
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Minimum age
1
Years
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Maximum age
16
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
Evidence of severe impairment of respiratory, hepatic, renal or endocrine function
Allergy to any constituents of Propofol
Patients with known intra or extra-cardiac “shunts” (that allow mixing of arterial and venous blood, affecting measurements of Propofol)
Patients who are intended to receive Ketamine at doses greater than 0.4 mg/kg/hr (may interfere with BIS readings)
Treating anaesthetist excluding the patient if unfamiliar with the use of Propofol TCI for anaesthesia maintenance.
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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)
Patients aged 3-16 years of age will be randomised to either the Kataria or Paedfusor algorithm after parents and/or participants give informed consent to participate. Randomisation allocations will be delivered using sealed, opaque, sequentially numbered envelopes. Patients <3 years old will not be randomised, but will be allocated to the Paedfusor algorithm.
This is not a blinded study, ie: anaesthetists will not be blinded to the algorithm that the participants are randomised to.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients aged 3-16 years of age will be randomised to either the Kataria or Paedfusor algorithm in a 1:1 ratio with variable block sizes.
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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 3
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Type of endpoint/s
Pharmacokinetics
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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
1/10/2010
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Actual
25/11/2010
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Date of last participant enrolment
Anticipated
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Actual
14/06/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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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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Hospital
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Name [1]
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Royal Children's Hospital
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Address [1]
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Flemington Road
Parkville
Victoria 3052
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Children's Hospital
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Address
Flemington Road
Parkville
Victoria 3052
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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]
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Address [1]
256727
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Country [1]
256727
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [1]
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Flemington Road Parkville Victoria 3052
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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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16/08/2010
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Approval date [1]
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12/10/2010
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Ethics approval number [1]
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30112
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Summary
Brief summary
The aim of this project is to assess how accurately we can predict what the level of Propofol is in the blood. We will be assessing the accuracy of two paediatric pharmacokinetic algorithms (Paedfusor and Kataria) that are designed to deliver Propofol at a specific blood concentration. The two different programmes deliver the Propofol at different doses according to the target blood level, age and weight. We will do this by comparing measured arterial plasma concentrations of Propofol (cm) with concurrent predicted (cp) plasma levels.
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Trial website
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Trial related presentations / publications
* TIVA in paediatrics Dr Peter Squire ANZCA ASM 2011
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Public notes
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Contacts
Principal investigator
Name
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Dr Peter Squire
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Address
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Department of Anaesthesia & Pain Management
Royal Children's Hospital
Flemington Road
Parkville VIC
3052
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Country
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Australia
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Phone
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+61393455233
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Fax
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+61393456003
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Email
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[email protected]
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Contact person for public queries
Name
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Suzette Sheppard
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Address
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
Flemington Road
Parkville, Victoria 3052
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Country
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Australia
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Phone
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+61 3 9345 5233
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Fax
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+61 3 9345 6003
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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 Peter Squire
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Address
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
Flemington Road
Parkville, Victoria 3052
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Country
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Australia
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Phone
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+61 3 9345 5233
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Fax
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+61 3 9345 6003
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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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