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Trial registered on ANZCTR
Registration number
ACTRN12614000066684
Ethics application status
Approved
Date submitted
17/12/2013
Date registered
21/01/2014
Date last updated
21/01/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Association between Thenar Eminence and I-gel Dimensions in Paediatric Patients
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Scientific title
The Association between Thenar Eminence and I-gel Dimensions Regarding Width and Length for Paediatric Patients Scheduled for Elective Surgery
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Secondary ID [1]
283787
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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:
Describe an anatomic landmark to find the appropriate size of the I-gel for use in paediatric patients
290765
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Condition category
Condition code
Anaesthesiology
291128
291128
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
The duration of the procedure
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Target follow-up type
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Description of intervention(s) / exposure
After obtaining local research ethical committee approval, two hundred and seventy ASA Class I or II patients between 0 to 12 years old, who were scheduled for elective surgery under general anaesthesia not requiring tracheal intubation were recruited to the study. Written informed consent was taken from the parents. Children with risk factors for difficult airway or regurgitation and syndrome or disorders influencing bone or soft tissue growth were excluded. Patients in the operating room were monitored for standard electrocardiography (ECG), blood pressure non invasively and peripheral oxygen saturation (SpO2). After preoxygenation, anaesthesia induction was performed with 8% sevoflurane in 50% nitrous oxide and oxygen, followed by intravenous access and administration of fentanyl 1 micro.kg-1. No muscle relaxants were used. Adequate anaesthetic depth was confirmed by lack of a motor response to jaw thrust. The i-gel is a novel supraglottic airway management device, made of a medical grade thermoplastic elastomer, which is soft, gel-like and transparent. Its non-inflatable cuff fits snugly onto the perilaryngeal framework. The size of the I-gel selected was based on the patient’s body weight according to the manufacturer recommendation . (size 1: 2-5 kg, size 1.5: 5-12 kg, size 2: 10-25 kg, size 2.5: 25-35 kg). Size 1.5 i-gel was inserted in children weighing 10-12 kg, and if there was an audible leak it was decided to change the size 1.5 to size 2. The device was inserted with “sniffing the morning air” position, and depending upon the airway manipulations (like neck flexion, head extension, jaw thrust, or deep rotation) required to insert the device. Correct insertion was judged by symmetric chest expansion, square wave of the capnograph trace, and absence of audible leak. The number of insertion attempts was noted, and it was considered a failure if the insertion was not successful in three attempts. In this case, patient was intubated, and excluded from the study. After successful insertion of the I-gel, thenar eminence dimensions were determined from left hand while fingers were placed in neutral position. Measurements were performed with a ruler in approximately 15 seconds. Long axis (Th-l) was measured from joining point of thumb to hand crease and short axis (Th-w) constitutes the largest portion of the thenar eminence from lateral end of the thumb to the first vital crease. Width (Ig-w) and length (Ig-l) of the I-gel’s (size 1-1.5-2-2.5) soft non-inflatable cuff was measured. The manufacturer's dimensions of the I-gel which was inserted into the patients were compared with the measurements obtained from thenar eminence.
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Intervention code [1]
288473
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Not applicable
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Comparator / control treatment
There was no control treatment.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To investigate the association between thenar eminence and i-gel dimensions regarding for width and length in paediatric patients.
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Assessment method [1]
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Timepoint [1]
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Thenar eminence and I-gel dimensions were measured immediately after I-gel was successfully inserted into the participant.
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Secondary outcome [1]
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The secondary outcome was the number of the patients which the i-gel was placed successfully at the first attempt. Correct insertion was judged by symmetric chest expansion, square wave of the capnograph trace, and absence of audible leak. This outcome was assessed and documented by the anaesthesiologist.
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Assessment method [1]
306016
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Timepoint [1]
306016
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Immediately after correct insertion was confirmed by the anaesthesiologist the number of insertion attempts was noted.
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Eligibility
Key inclusion criteria
ASA Class I or II patients between 0 to 12 years old, who were scheduled for elective surgery under general anaesthesia not requiring tracheal intubation
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Minimum age
3
Days
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Maximum age
144
Months
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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
Children with risk factors for difficult airway or regurgitation and syndrome or disorders influencing bone or soft tissue growth were excluded.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
A total sample size of 258 was required to detect at least 0.20 correlations between thenar eminence and i-gel’s cuff measurements with a power of 90% at the 5% significance level. Sample size estimation was performed by using NCSS and PASS 2000 (Hintze J. 2001. NCSS and PASS. Number Cruncher Statistical Systems. Kaysville, Utah.) software. This study was designed to enroll 270 patients to allow for potential dropout of subjects.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2013
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Actual
1/05/2013
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Date of last participant enrolment
Anticipated
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Actual
27/09/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
258
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5686
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Turkey
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State/province [1]
5686
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Funding & Sponsors
Funding source category [1]
288446
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Self funded/Unfunded
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Name [1]
288446
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Address [1]
288446
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Country [1]
288446
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Primary sponsor type
Individual
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Name
Ozgun CUVAS APAN
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Address
Giresun University Medical Faculty, Department of Anaesthesiology and Intensive Care Medicine, Nizamiye Yerleskesi, Orhan Yilmaz Cad. Mumcular Sokak No:1 Postal Code: 28200, Merkez, Giresun.
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Country
Turkey
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Secondary sponsor category [1]
287149
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None
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Name [1]
287149
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Address [1]
287149
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Country [1]
287149
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290320
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Kirikkale University Ethics Committee
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Ethics committee address [1]
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Kirikkale University Medical Faculty, Ankara yolu 7. Kilometre Postal code: 71450, Yahsihan, Kirikkale.
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Ethics committee country [1]
290320
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Turkey
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Date submitted for ethics approval [1]
290320
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Approval date [1]
290320
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15/04/2013
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Ethics approval number [1]
290320
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Summary
Brief summary
Background and goal of study: A practical anatomic landmark may be helpful to perform the appropriate size of the airway devices easily in paediatric patients. The aim of this study was to investigate the association between thenar eminence and i-gel dimensions regarding for width and length in paediatric patients. Materials and methods: After approval from institutional review board and local ethics committee, two hundred and seventy ASA Class I or II patients between 0 to 12 years old, who were scheduled for elective surgery under general anaesthesia not requiring tracheal intubation, were recruited to this prospective study. Children with risk factors for difficult airway or regurgitation and syndrome or disorders influencing bone or soft tissue growth were excluded. Operation was cancelled in seven patients. After induction, adequate anaesthetic depth was confirmed by lack of a motor response to jaw thrust. The size of the i-gel selected was based on the patient’s body weight according to the manufacturer recommendation. The number of insertion attempts was noted, and it was considered a failure if the insertion was not successful in three attempts. After successful insertion of the i-gel, thenar eminence dimensions were determined from left hand while fingers were placed in neutral position. Long axis (Th-l) was measured from junction point of the thumb to wrist curl and short axis (Th-w) constitutes the largest portion of the thenar eminence from lateral end of the thumb to the first hand line. The dimensions of I-gel’s soft non-inflatable cuff [width (Ig-w) and length (Ig-l)] which placed to the patients were compared with measurements obtained from thenar eminence. Degrees of association between continuous variables were calculated by Pearson’s correlation coefficient. A p value< 0.05 was considered statistically significant.
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Trial website
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Trial related presentations / publications
None.
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Ozgun CUVAS APAN
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Address
45066
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Giresun University Medical Faculty, Department of Anaesthesiology and Intensive Care Medicine, Nizamiye Yerleskesi, Orhan Yilmaz Cad. Mumcular Sokak No:1 Postal Code: 28200, Merkez, Giresun.
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Country
45066
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Turkey
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Phone
45066
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+90454 310 16 00
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Fax
45066
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Email
45066
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[email protected]
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Contact person for public queries
Name
45067
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Ozgun CUVAS APAN
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Address
45067
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Giresun University Medical Faculty, Department of Anaesthesiology and Intensive Care Medicine, Nizamiye Yerleskesi, Orhan Yilmaz Cad. Mumcular Sokak No:1 Postal Code: 28200, Merkez, Giresun.
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Country
45067
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Turkey
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Phone
45067
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+90454 310 16 00
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Fax
45067
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Email
45067
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[email protected]
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Contact person for scientific queries
Name
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Ozgun CUVAS APAN
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Address
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Giresun University Medical Faculty, Department of Anaesthesiology and Intensive Care Medicine, Nizamiye Yerleskesi, Orhan Yilmaz Cad. Mumcular Sokak No:1 Postal Code: 28200, Merkez, Giresun.
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Country
45068
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Turkey
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Phone
45068
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+90454 310 16 00
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Fax
45068
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Email
45068
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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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