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Trial registered on ANZCTR
Registration number
ACTRN12614000893606
Ethics application status
Approved
Date submitted
10/08/2014
Date registered
22/08/2014
Date last updated
22/08/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Transient hip and knee flexion for rapid onset spinal anaesthesia (ROSA) for caesarean section, a randomised control study
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Scientific title
Transient hip and knee flexion for rapid onset spinal anaesthesia (ROSA) for women undergoing elective caesarean section, a randomised control study to evaluate the time from completing spinal injection until the anaesthetist determines surgery can proceed and surgery commences.
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Secondary ID [1]
285116
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nil
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Universal Trial Number (UTN)
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Trial acronym
ROSA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anaesthesia for women undergoing elective caesarean section with a target intervention of reducing time to starting caesarean section.
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Condition category
Condition code
Anaesthesiology
292985
292985
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0
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Anaesthetics
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Reproductive Health and Childbirth
293048
293048
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Immediately after finishing intrathecal injection, patients in the control group will be laid supine with a 10-15 degree tilt to the left and their lower limbs straight. The drug and dose of intrathecal injection will remain the choice of the anaesthetist and will not be controlled in this study.
Patients in the intervention group will be laid supine with a 10-15 degree tilt to the left and their lower limbs flexed at the hips and knees maintained for 45 seconds before straightening them as per the control group.
Note that if patient cannot tolerate the positioning, the manoeuvre is to be discontinued immediately and anaesthesia positioning will be continued with the patient's lower limbs straight as per the control group.
Measurement and documentation of the block height will take place every 3 minutes post intrathecal injection using ice to test cold sensation in the anterior axillary line
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Intervention code [1]
289965
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Treatment: Other
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Comparator / control treatment
Immediately after finishing intrathecal injection, patients in the control group will be laid supine with a 10-15 degree tilt to left and their lower limbs straight.
The drug and dose of intrathecal injection will remain the choice of the anaesthetist and will not be controlled in this study.
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Control group
Active
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Outcomes
Primary outcome [1]
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The time from completing spinal injection until the anaesthetist determines surgery can proceed
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Assessment method [1]
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Timepoint [1]
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The time from completing spinal injection until the anaesthetist determines surgery can proceed
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Primary outcome [2]
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The time from completing spinal injection until surgery commences.
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Assessment method [2]
292921
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Timepoint [2]
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The time from completing spinal injection until surgery commences.
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Secondary outcome [1]
309794
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Number of women requiring treatment for hypotension
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Assessment method [1]
309794
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Timepoint [1]
309794
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Prior to conclusion of surgery
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Secondary outcome [2]
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Number of women with high block requiring treatment
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Assessment method [2]
309941
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Timepoint [2]
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Prior to conclusion of surgery
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Secondary outcome [3]
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Number of women not tolerating the position after anaesthesia
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Assessment method [3]
309942
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Timepoint [3]
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Prior to conclusion of surgery
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Secondary outcome [4]
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Number of women dissatisfied with the positioning
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Assessment method [4]
309943
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Timepoint [4]
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Before the 60 seconds are completed to lie supine with left lateral tilt (asking women verbally)
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Secondary outcome [5]
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Number of women requiring general anaesthesia
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Assessment method [5]
309944
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Timepoint [5]
309944
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Prior to conclusion of surgery
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Secondary outcome [6]
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Number of babies with an APGAR <7.
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Assessment method [6]
309945
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Timepoint [6]
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At 1 minute and 5 minutes of life
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Secondary outcome [7]
309946
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Neonatal intubation
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Assessment method [7]
309946
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Timepoint [7]
309946
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Before 20 minutes of life
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Eligibility
Key inclusion criteria
Parturients having elective lower segment caesarean section under spinal anaesthesia
>18 years
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women <18 years old
Women requiring an interpreter when one is unavailable
Women with an intellectual or mental impairment
Women with pre-existing medical, rheumatologic or orthopaedic conditions which prevents them from performing the manoeuvre correctly e.g. recent lower limb fracture, ankylosing spondylitis.
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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)
Participants will be recruited during the routine pre-operative anaesthetic consult prior to caesarean section by a researcher.
During this consult careful explanation of the study aims and procedure as well as risks and benefits will occur.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
We will be using computer-generated random numbers for randomisation of the patients into intervention or control groups. Allocation concealment will be achieved by using consecutively numbered opaque sealed envelopes containing the randomised sequence opened only after the patient is in the operating theatre with all consents signed and baseline data collected.
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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
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/09/2014
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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)
SA
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Recruitment hospital [1]
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
8515
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5006 - North Adelaide
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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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Women's and Children's Hospital
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Address [1]
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72 King William St. North Adelaide
South Australia, 5006
Australia
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr. Allan Cyna
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Address
Women's and Children's Hospital
72 King William St. North Adelaide, SA 5006
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Women's and Children's Hospital
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Address [1]
288468
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72 King William St. North Adelaide
South Australia, 5006
Australia
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Country [1]
288468
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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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Women's and Children's Hospital
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Ethics committee address [1]
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72 King William St. North Adelaide South Australia, 5006 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291477
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Approval date [1]
291477
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09/07/2014
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Ethics approval number [1]
291477
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Summary
Brief summary
The aim of this study is to assess whether, following a spinal anaesthetic for caesarean, transient maternal hip and knee flexion in the left lateral tilt supine position can allow caesarean section to commence earlier than traditional positioning with lower limbs straight. If this technique safely speeds up the onset of "adequate" surgical block suitable for the caesarean operation, it can potentially reduce the rate of caesarean sections requiring general anaesthetics. It is well established that in pregnant women requiring caesarean section most of the anaesthesia related risks have higher rate under general anaesthesia in comparison to spinal anaesthesia.
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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 Allan Cyna
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Address
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Women's and Children's Hospital
72 King William St. North Adelaide
South Australia, 5006
Australia
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Country
50506
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Australia
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Phone
50506
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61405725060
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Fax
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Email
50506
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[email protected]
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Contact person for public queries
Name
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Brigid Brown
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Address
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Women's and Children's Hospital
72 King William St. North Adelaide
South Australia, 5006
Australia
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Country
50507
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Australia
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Phone
50507
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61405725060
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Fax
50507
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Email
50507
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[email protected]
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Contact person for scientific queries
Name
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Chelsea Hicks
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Address
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Women's and Children's Hospital
72 King William St. North Adelaide
South Australia, 5006
Australia
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Country
50508
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Australia
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Phone
50508
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61405725060
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Fax
50508
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Email
50508
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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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