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Trial registered on ANZCTR
Registration number
ACTRN12614000441617
Ethics application status
Approved
Date submitted
10/04/2014
Date registered
29/04/2014
Date last updated
29/04/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Spinal Dexamethasone added to Bupivacaine and Caudal block in Pediatric Lower Extremity Orthopedic Surgery. A Prospective Comparative Study
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Scientific title
The effect of spinal Dexamethasone added to bupivacaine versus caudal block on duration of block and postoperative analgesia in pediatric lower extremity orthopedic surgery
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Secondary ID [1]
284413
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Nil
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Universal Trial Number (UTN)
Nil
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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:
Anaesthesiology for pediatric lower extremity orthopedic surgical procedures
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Condition category
Condition code
Anaesthesiology
291986
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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
Group I (spinal group): dexamesthazone 0.1 mg/ kg added to hyperbaric bupivacaine (0.5 %) given interathecally
Group II (caudal group): isobaric bupivacaine 1.2 ml/kg (0.25%) given caudally.
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Intervention code [1]
289162
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Treatment: Drugs
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Comparator / control treatment
isobaric bupivacaine 1.2 ml/kg (0.25%) given caudally as active control group.
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Control group
Active
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Outcomes
Primary outcome [1]
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comparing the duration of spinal block after addition of dexamethasone versus the duration of caudal blockade
The extent of the sensory block is checked by pin- prick every minute till establishment of sensory block.
Motor block clinically checked by, lack of leg movement
successful block ( absence of any gross purposeful muscular movement),
duration of block (defined by return of forceful movement of the legs) measured by minutes.
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Assessment method [1]
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Timepoint [1]
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successful block ( absence of any gross purposeful muscular movement),
duration of block (defined by return of forceful movement of the legs) measured by minutes.
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Secondary outcome [1]
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assess quality of analgesia and motor block postoperative
The quality of analgesia assessed by using an observational pain scale (OPS) assesses parameters (crying, movement, agitation, verbalization and BP change) each parameter was given a score of 0-2.
Bromage scale for assessing motor block. (0 = Able to raise straight leg, full flexion of knee and feet. 1 = Inability to raise leg, able to flex knees. 2 = Inability to flex knees, able to flex ankles. 3 = Inability to flex ankles.)
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Assessment method [1]
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Timepoint [1]
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Patients were evaluated every 1 hour for the first 4 hours postoperative
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Secondary outcome [2]
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perioperative complications were recorded (bradycardia, tachycardia, shivering, headache, urine retention or nausea and vomiting).
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Assessment method [2]
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Timepoint [2]
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during intraoperative and first 4 hours postoperative
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Eligibility
Key inclusion criteria
patients aged between 1 – 6 years, both males and females, ASA physical status I and II scheduled for lower extremity orthopedic surgical procedures were included in this study.
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Minimum age
1
Years
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Maximum age
6
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
refusal of the parents, infection at the site of the block, bleeding diathesis, children with neurological disorders, and children with known allergy to give local anesthetics.
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients were randomized into two equal groups of patients via a table of random numbers using a computer software
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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
The people analysing the results/data
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Intervention assignment
Parallel
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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
Data are presented as mean +/- (SD) for normally distributed data. Baseline characteristics and outcomes across the groups were compared using the Student's t-test for continuous variables and chi-square analysis for nominal data. All analysis has been calculated using SPSS V.16. A P-value of <0.05 was considered to indicate statistical significance.
The primary point was increase duration of spinal anesthesia in compare to caudal anesthesia duration. For each group for each group 26 patients were required for dexamethasone to increase the mean value of duration by 20% based on a previous pilot study in our institute a = 0.05 and a power of 0.8 with 95% confidence interval.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
26/11/2012
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Actual
26/11/2012
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Date of last participant enrolment
Anticipated
24/10/2013
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Actual
24/10/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
58
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Egypt
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State/province [1]
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Tanta / Gharbia
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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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Rehab S. ELkalla
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Address [1]
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Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt
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Country [1]
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Egypt
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Primary sponsor type
Individual
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Name
Rehab S. ELkalla
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Address
Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt
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Country
Egypt
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Secondary sponsor category [1]
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Individual
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Name [1]
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Mohamad G. Ayaad
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Address [1]
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Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt
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Country [1]
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Egypt
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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institutional ethics committee of the Faculty of Medicine, Tanta University
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Ethics committee address [1]
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Faculty of Medicine, Tanta University, Egypt. EL Geish st. Tanta / Gharbia 31257 Egypt.
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Ethics committee country [1]
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Egypt
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Date submitted for ethics approval [1]
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Approval date [1]
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19/11/2012
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Ethics approval number [1]
290865
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Summary
Brief summary
Addition of dexamethasone was found to prolong duration of spinal block in adults. The primary outcome of this study is comparing the duration of spinal block after addition of dexamethasone and the duration of caudal blockade, Secondary outcome is to assess quality of pain relief and muscle relaxation with hemodynamic stability and rapid recovery between the two groups.
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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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Dr Rehab S. ELkalla
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Address
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Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt.
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Country
47622
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Egypt
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Phone
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+201285700765
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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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Mohamad G. Ayaad
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Address
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Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt.
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Country
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Egypt
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Phone
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+201128396916
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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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Abd ELRahim Dowidar
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Address
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Department of Anesthesia and surgical Intensive care, Faculty of Medicine, Tanta University, Egypt.
EL Geish st.
Tanta / Gharbia
31257
Egypt.
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Country
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Egypt
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Phone
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+201223195015
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Fax
47624
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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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