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Trial registered on ANZCTR
Registration number
ACTRN12613001203741
Ethics application status
Approved
Date submitted
30/10/2013
Date registered
4/11/2013
Date last updated
4/11/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pre-emptive intravenous ketorolac analgesia does not alter the risk of bleeding after tonsillectomy in children
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Scientific title
the preoperative use of intravenous ketorolac analgesia does not alter the risk of bleeding after tonsillectomy in children.
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Secondary ID [1]
283481
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nil known
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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:
the use of non-steroidal anti-inflammatory drugs for post-tonsillectomy analgesia in children
290399
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Condition category
Condition code
Anaesthesiology
290790
290790
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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
children scheduled for tonsillectomy with or without adenoidectomy were randomized to receive a slow IV infusion over 15 min of either Ketorolac 1mg kg -1, after induction of anesthesia.
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Intervention code [1]
288192
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Treatment: Drugs
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Comparator / control treatment
the control treatment was a slow IV infusion over 15 min of Paracetamol 15 mg kg-1, after induction of anesthesia.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome measures was the difference between the two groups as regards the hemoglobin level. Hemoglobin (Hb) level was measured in the laboratory as a part of the routine preoperative preparation for tonsillectomy at the hospital. Additionally, non-invasive hemoglobin level (SpHb) was assessed at the same time when blood was drawn from the child for the routine preoperative laboratory investigations, using a multi-wavelength pulse oximetry.SpHb measurement was assessed on arrival at the post anesthesia care unit (PACU) and repeated at 12h, 24h postoperatively and another measurement was obtained at the 7th postoperative day.
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Assessment method [1]
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Timepoint [1]
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the 7th postoperative day
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Secondary outcome [1]
305285
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the difference between the two groups as regards the pain scores ., pain intensity was assessed by an anesthesiologist, blinded to the treatment group using an objective pain score (OPS) immediately upon PACU admission, then 30min, 1h, 2h, 4h, and 6h postoperatively. This OPS took into account the child’s blood pressure, crying, movement and agitation, with each variable scoring 0–2 points (best to worst).
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Assessment method [1]
305285
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Timepoint [1]
305285
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6h postoperatively
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Secondary outcome [2]
305305
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The incidence of postoperative vomiting
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Assessment method [2]
305305
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Timepoint [2]
305305
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24h after surgery
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Eligibility
Key inclusion criteria
ASA physical status I children scheduled for tonsillectomy with or without adenoidectomy. All patients enrolled in this study had normal blood counts, with normal coagulation profile (prothrombin time, activated partial thromboplastin time, platelet count, and bleeding time.
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Minimum age
2
Years
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Maximum age
7
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
Exclusion criteria included the use of paracetamol or NSAIDs within 6 h or any other analgesic medication within 12 h before surgery, and a known allergy to any of the study drugs.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
The required sample size was calculated using the G*Power(copyright) software version 3.1.0 (Institut fur Experimentelle Psychologie, Heinrich Heine Universitat, Dusseldorf, Germany).
The primary outcome measures were the difference between the two groups as regards the pain scores and hemoglobin level. It was estimated that a sample of 70 patients per group would have a power of 82% to detect a medium effect size (d) of 0.5 as regards the outcome measures using a two-sided U test and setting the type I error at 0.05.
Data were analyzed on a personal computer using the IBM(copyright) SPSS(copyright) Statistics version 21 (IBM(copyright)Corp., Armonk, NY, USA). The Shapiro-Wilk test was used to test the normality of numerical data distribution.
Normally distributed data were presented as mean (SD) and the unpaired t test was used for intergroup comparisons. Skewed data were presented as median (interquartile range) and the Mann-Whitney U test was used to compare between-group differences. For comparison of paired skewed data, the Wilcoxon signed ranks test was used. Repeated measures analysis of variance (ANOVA) was used to compare differences among serial measures.
Categorical data were presented as ratio or as number (percentage) and differences between the two groups were compared using the chi square test or Fisher’s exact test, when appropriate.
P < 0.05 is considered statistically significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/12/2011
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Actual
10/12/2011
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Date of last participant enrolment
Anticipated
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Actual
18/05/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
147
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5546
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Saudi Arabia
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State/province [1]
5546
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eastern province
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Funding & Sponsors
Funding source category [1]
288187
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Hospital
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Name [1]
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king Abdulaziz Naval Base Hospital.
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Address [1]
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king Abdulaziz Naval Base , Jubail, 31951
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Country [1]
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Saudi Arabia
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Primary sponsor type
Hospital
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Name
king Abdulaziz Naval Base Hospital.
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Address
king Abdulaziz Naval Base , Jubail, 31951
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Country
Saudi Arabia
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Secondary sponsor category [1]
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None
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Name [1]
286912
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Address [1]
286912
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Country [1]
286912
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hospital Ethics and research Committee
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Ethics committee address [1]
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king Abdulaziz Naval Base Hospital, Jubail 31951.
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Ethics committee country [1]
290097
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Saudi Arabia
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Date submitted for ethics approval [1]
290097
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01/11/2011
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Approval date [1]
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12/11/2011
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Ethics approval number [1]
290097
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Summary
Brief summary
Background Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit platelet aggregation and prolong bleeding time, which may increase the risk of postoperative bleeding. We investigated the effects of ketorolac (a NSAID) on intra- and postoperative hemorrhage with pediatric tonsillectomy. Methods One hundred forty seven children, aged 2-7 years scheduled for tonsillectomy with or without adenoidectomy were randomized to receive a slow IV infusion over 15 min of either Ketorolac 1mg kg -1 (Group K, n=74) or Paracetamol 15 mg kg-1(Group P, n=73) after induction of anesthesia. Perioperative non-invasive hemoglobin (SpHb) was assessed preoperatively and several times after surgery. Bleeding times were measured before and after surgery. Intraoperative blood loss was estimated. Intensity of postoperative pain was measured using an objective pain scores (OPS). Incidence and severity of post-tonsillectomy bleeding (PTB) were recorded till the 7thpostoperative day.
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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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A/Prof Waleed M. Abdelmageed
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Address
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king Abdulaziz Naval Base Hospital , Jubail, 31951,PO Box:413
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Country
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Saudi Arabia
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Phone
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+966 55 7189366
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Fax
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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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Waleed M. Abdelmageed
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Address
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king Abdulaziz Naval Base Hospital , Jubail, 31951,PO Box:413
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Country
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Saudi Arabia
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Phone
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+966 55 7189366
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Fax
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Email
43959
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[email protected]
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Contact person for scientific queries
Name
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Waleed M. Abdelmageed
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Address
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king Abdulaziz Naval Base Hospital , Jubail, 31951,PO Box:413
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Country
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Saudi Arabia
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Phone
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+966 55 7189366
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Fax
43960
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Email
43960
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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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