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Trial registered on ANZCTR
Registration number
ACTRN12612000211864
Ethics application status
Approved
Date submitted
20/02/2012
Date registered
20/02/2012
Date last updated
13/03/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of propofol and dexmedetomidine for sedation during hip and knee arthoplasty.
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Scientific title
A comparison of propofol and dexmedetomidine for sedation during hip and knee arthoplasty, in adults, assessing patient satisfaction and respiratory and cardiovascular stability.
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Secondary ID [1]
279970
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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:
Sedation during hip and knee arthroplasty, which is often associated with a need for airway support due to respiratory depression and reduced airway tone.
285888
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Condition category
Condition code
Anaesthesiology
286078
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0
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Anaesthetics
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Musculoskeletal
286082
286082
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0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will be usage of dexmedetomidine for sedation in assocation with neuraxial block for hip and knee arthroplasty. Dosage will be at the clinicians' discretion using standard dosages. However typical dosages are a loading dose of 0.5micrograms per kilogram (40micrograms for an 80kg patient) and 0.7 mcg/kg/hr, 56micrograms per kilogram per hour (56 micrograms an hour for an 80kg patient). Dosages are typically reduced for elderly patients. This would be given via intravenous infusion, commencing once the patient is positioned and it would not be combined with other sedative agents.
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Intervention code [1]
284308
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Treatment: Drugs
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Comparator / control treatment
Propofol for sedation. This is typically used via a "target-controlled-infusion" pump which calculates the patients' estimated plasma concentration of propofol using computerised models. A typical plasma "target" for sedation in combination with neuraxial block would be 3 micrograms/millilitre. This is titrated to effect. It would also be given via intravenous infusion commencing once the patient is positioned, and also not combined with other sedative agents.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patient satisfaction with the sedation experience will be assessed postoperatively on an analogue scale. Mean patient satisfaction scores will be compared between groups.
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Assessment method [1]
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Timepoint [1]
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Within one week.
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Secondary outcome [1]
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The outcome will be assessed using clinical assessment. It will be determined by the treating clinician whether one or more of jaw support; laryngeal mask insertion; use of Guedel airway; or endotracheal tube insertion occurs. Lowest pulse and lowest systolic blood pressure will be recorded intraoperatively. This will be recorded on the worksheet.
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Assessment method [1]
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Timepoint [1]
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Intraoperative (less than three hours)
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Eligibility
Key inclusion criteria
Adults with neuraxial block undergoing hip and knee arthroplasty.
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Minimum age
18
Years
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Maximum age
No limit
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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
Any contraindication to sedation.
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Study design
Purpose of the study
Prevention
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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)
Enrolling - discussed with patient prior to surgery and formal consent obtained on or before day of surgery. Clinicians will contact the anaesthetic department who will hold the allocation sequence. Departmental staff will inform the clinicians of assignment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised block registration.
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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
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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
11/03/2012
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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
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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Self funded/Unfunded
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Name [1]
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Dr Mark Suss
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Address [1]
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Department of Anaesthesia
Cabrini Hospital
183 Wattletree Rd
Malvern
Victoria
3144
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Country [1]
284735
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Australia
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Primary sponsor type
Individual
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Name
Dr Mark Suss
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Address
Department of Anaesthesia
Cabrini Hospital
183 Wattletree Rd
Malvern
Victoria 3144
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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]
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Country [1]
283631
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Antonio Grossi
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Address [1]
260555
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Department of Anaesthesia
Cabrini Hospital
183 Wattletree Rd
Malvern
Victoria 3144
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Country [1]
260555
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Dr Chantal McNally
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Address [2]
260610
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Department of Anaesthesia Cabrini Hospital 183 Wattletree Rd Malvern Victoria 3144
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Country [2]
260610
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Australia
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Other collaborator category [3]
260611
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Individual
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Name [3]
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Dr Chantal McNally
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Address [3]
260611
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Department of Anaesthesia Cabrini Hospital 183 Wattletree Rd Malvern Victoria 3144
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Country [3]
260611
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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CHREC Cabrini Health
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Ethics committee address [1]
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Cabrini Hospital 183 Wattletree Rd Malvern Victoria 3144
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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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01/12/2011
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Approval date [1]
286742
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Ethics approval number [1]
286742
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Summary
Brief summary
This trial will compare the sedative medicine propofol with the newer sedative dexmedetomidine. The comparison will take place in a group of patients having replacement of their hips or knees with mechanical joints. The study will look at patients undergoing this surgery under a spinal block, where the body is made numb from the waist downwards. Typically these patients have some sort of sedation to make them more comfortable and less aware of noise or movement in the operating theatre. The most commonly used infusion, propofol has some side effects including reduced breathing efforts, which sometimes requires the anaesthetist to intervene and support the airway or even convert the sedation to a full anaesthetic. A newer sedative medicine, dexmedetomidine appears to have fewer of these effects. It may be that it is a better option for this sort of sedation. Some mild side effects such as changes in pulse rate have been associated with dexmedetomidine but these do not appear to be severe enough to prevent its usefulness in this setting. Patients will be randomized to receive either propofol or dexmedetomidine. They will receive their normal regional (eg “spinal” ) anaesthetic. The researchers will be measuring: Patient satisfaction with the sedation experience (within one week of surgery); Need for airway support; and haemodynamic values intraoperatively.
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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
33800
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Address
33800
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Country
33800
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Phone
33800
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Fax
33800
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Email
33800
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Contact person for public queries
Name
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Dr Mark Suss
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Address
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Department of Anaesthesia
Cabrini Hospital
183 Wattletree Rd
Malvern
Victoria 3144
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Country
17047
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Australia
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Phone
17047
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61395081219
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Fax
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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 Mark Suss
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Address
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Department of Anaesthesia
Cabrini Hospital
183 Wattletree Rd
Malvern
Victoria 3144
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Country
7975
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Australia
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Phone
7975
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61395081219
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Fax
7975
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Email
7975
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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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