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Trial registered on ANZCTR
Registration number
ACTRN12618000754246
Ethics application status
Approved
Date submitted
11/04/2018
Date registered
4/05/2018
Date last updated
16/11/2023
Date data sharing statement initially provided
28/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Lignocaine Infusion in Colorectal Cancer Patient Immune Cells
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Scientific title
A Double-Blind Randomised Placebo-Controlled Trial Assessing the Effect of Peri-Operative Intravenous Lignocaine and Post-Operative Lignocaine Neurovascular Plane Infusion on Natural Killer Cell Function in Laparoscopic Colorectal Cancer Surgery
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Secondary ID [1]
294573
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JHGIS12
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Universal Trial Number (UTN)
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Trial acronym
LICPIC Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
colon cancer
307354
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Condition category
Condition code
Cancer
306461
306461
0
0
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Bowel - Back passage (rectum) or large bowel (colon)
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Inflammatory and Immune System
306462
306462
0
0
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Other inflammatory or immune system disorders
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Anaesthesiology
306463
306463
0
0
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Pain management
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Surgery
306464
306464
0
0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prior to surgery commencing, participants will be randomised to Treatment S or Treatment R. At commencement of anaesthesia the study drug will commence as an intravenous infusion of a 1% lignocaine infusion or placebo at a dose of 1.5mg per kg capped at a maximum weight of 100kg. This infusion will continue into recovery for 1 hour, then will be changed to an infusion of same rate via a catheter placed during the operative procedure into a muscular neurovascular plane in the abdominal wall. The infusion will continue for a maximum of 3 days post-operatively, there is no minumum duration for infusion. The specific duration will be determined by the post-operative recovery of the individual patient. The study drug will be prescribed on standard continous nerve block prescription charts which will be used to confirm compliance to study intervention.
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Intervention code [1]
300865
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Treatment: Drugs
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Comparator / control treatment
0.9% sodium chloride solution
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Control group
Placebo
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Outcomes
Primary outcome [1]
305469
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The composite primary outcome will be the difference in baseline natural killer cell function (cytotoxic and secretory) as measured by flow cytometry and phorbol 12-myristate 13-acetate (PMA) stimulation testing.
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Assessment method [1]
305469
0
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Timepoint [1]
305469
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0 (baseline prior to any administration of medication for procedure), end of hour 1 in operating theatre and hour 2 in recovery, 24, 48 and 72 hours.
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Secondary outcome [1]
345355
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Post-operative analgesic consumption (MilliEquivalents of morphine) assessed by review of medical record.
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Assessment method [1]
345355
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Timepoint [1]
345355
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daily for 3 days and total
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Secondary outcome [2]
345357
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Time (measured in whole days) until return of bowel function as defined as tolerance to solid intake for 24 hours (no vomiting) AND passage of stool whilst in hospital as recorded in the medical record (the day when both of those gut functions has occurred, ie if no vomiting occurs on day 2 and passage of stool occurs at day 3, then day 3 is the outcome time).
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Assessment method [2]
345357
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Timepoint [2]
345357
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Whilst in hospital.
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Secondary outcome [3]
345359
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Mean length of hospital stay (in days)
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Assessment method [3]
345359
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Timepoint [3]
345359
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till discharge
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Secondary outcome [4]
345361
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Incidence of post-operative surgical complications graded by the Clavien-Dindo Classification of Surgical Complications
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Assessment method [4]
345361
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Timepoint [4]
345361
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up to day 30 post-operatively
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Secondary outcome [5]
345362
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Mean difference between groups as measured by serum c-reactive protein.
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Assessment method [5]
345362
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Timepoint [5]
345362
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Daily until discharge
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Secondary outcome [6]
345363
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Incidence of toxic (greater than therapeutic normal range 1.5-5mg/L) serum lignocaine levels measure by direct assay
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Assessment method [6]
345363
0
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Timepoint [6]
345363
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In hours from operation
-end of operation
-hour 1
-hour 2 in recovery
-24, 48 and 72 hours post-operatively
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Secondary outcome [7]
346104
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Mean difference between groups as measured by serum cortisol .
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Assessment method [7]
346104
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Timepoint [7]
346104
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Daily until discharge
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Secondary outcome [8]
368972
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Plasma lignocaine concentration measured by Liquid Chromatography Mass Spectroscopy LCMS
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Assessment method [8]
368972
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Timepoint [8]
368972
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0 (baseline prior to any administration of medication for procedure), end of hour 1 in operating theatre and hour 2 in recovery, 24, 48 and 72 hours.
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Secondary outcome [9]
368973
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Plasma Interleukin-6, Interleukin-2 and Interferon gamma concentration measured by Enzyme-Linked Immunosorbent Assay ELISA
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Assessment method [9]
368973
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Timepoint [9]
368973
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0 (baseline prior to any administration of medication for procedure), end of hour 1 in operating theatre and hour 2 in recovery, 24, 48 and 72 hours.
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Secondary outcome [10]
368974
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Serum cortisol concentration measured by bead-based immunoassay
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Assessment method [10]
368974
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Timepoint [10]
368974
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0 (baseline prior to any administration of medication for procedure), end of hour 1 in operating theatre and hour 2 in recovery, 24, 48 and 72 hours.
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Secondary outcome [11]
368975
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Plasma/Serum C Reactive Protein concentration
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Assessment method [11]
368975
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Timepoint [11]
368975
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0 (baseline prior to any administration of medication for procedure), hour 2 in recovery, 24, 48 and 72 hours.
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Eligibility
Key inclusion criteria
All patients with colorectal cancer undergoing elective or semi-elective laparoscopic colon resection at the John Hunter Hospital and Newcastle Private Hospital
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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
a. are under 18 years of age, or
b. refuse or are unable to give written informed consent to participate in the study, or
c. have had previous abdominal surgery where there is a significant chance of the procedure not being able to be completed in a laparoscopic manner, based in the clinical judgement of the operating surgeon, or
d. have severe renal impairment or
e. receive an epidural, spinal or other neuroaxial anaesthetic as determined by the Anaesthetist on day of surgery, or
f. Have a planned stoma formation or
a. Have received neoadjuvant chemo-radiotherapy or have been on immunosuppressive agents in the preceding 8 weeks including glucocorticoids (not including inhaled steroids), antimetabolites, cytostatics (eg platinum compounds), antimetabolites (eg methotrexate, mercaptopurine, azathioprine, 5FU, anthracyclines, cytotoxic antibiotics eg bleomycin) , TNF bindng proteins (eg infliximab), drugs acting on immunophilins or
b. Have known stage 4 colorectal cancer disease
c. have known immunological disease including leukaemia or
d. have known allergy or adverse reaction to lignocaine or opioid drugs or
e. pregnant or lactating or
f. have a history of arrhythmia or long QT syndrome associated with the drugs used in this trial, or
g. Are taking regular opiate narcotics pre-operatively
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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)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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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
Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
11/09/2018
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Actual
11/09/2018
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Date of last participant enrolment
Anticipated
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Actual
20/09/2022
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Date of last data collection
Anticipated
28/10/2022
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Actual
4/11/2022
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Sample size
Target
107
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Accrual to date
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Final
107
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
10626
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John Hunter Hospital - New Lambton
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Recruitment hospital [2]
12568
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Newcastle Private Hospital - New Lambton Heights
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Recruitment hospital [3]
21544
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Calvary Mater Newcastle - Waratah
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Recruitment postcode(s) [1]
22344
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2305 - New Lambton
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Recruitment postcode(s) [2]
24947
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2305 - New Lambton Heights
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Recruitment postcode(s) [3]
36451
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2298 - Waratah
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Funding & Sponsors
Funding source category [1]
299190
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Hospital
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Name [1]
299190
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John Hunter Hospital
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Address [1]
299190
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Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country [1]
299190
0
Australia
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Funding source category [2]
307310
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Charities/Societies/Foundations
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Name [2]
307310
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Colorectal Surgical Society of Australia and New Zealand Foundation Pty Ltd
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Address [2]
307310
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Suite 6, 9 Church St, Hawthorn VIC 3122.
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Country [2]
307310
0
Australia
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Funding source category [3]
307311
0
Hospital
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Name [3]
307311
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John Hunter Hospital Anaesthesia Trust
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Address [3]
307311
0
Locked Bag 1 Hunter Region Mail Centre NSW 2310
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Country [3]
307311
0
Australia
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Funding source category [4]
307312
0
Hospital
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Name [4]
307312
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John Hunter Hospital Surgical Training Fund
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Address [4]
307312
0
Locked Bag 1 Hunter Region Mail Centre NSW 2310
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Country [4]
307312
0
Australia
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District
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Address
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
Australia
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Secondary sponsor category [1]
298453
0
None
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Name [1]
298453
0
NA
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Address [1]
298453
0
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Country [1]
298453
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300115
0
Huner New England Hman Research Ethics Committee
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Ethics committee address [1]
300115
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [1]
300115
0
Australia
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Date submitted for ethics approval [1]
300115
0
28/03/2018
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Approval date [1]
300115
0
03/05/2018
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Ethics approval number [1]
300115
0
2018/ETH00049
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Summary
Brief summary
The study aims to find out if giving local anaesthetic (a medication that numbs an area of the body) into the bloodstream and via small plastic tube placed during surgery into the abdomen will improve part of the immune system in patients undergoing surgery for colorectal cancer. Who is it for? You may be eligible to join this study if you aged 18 years or more and are scheduled to undergo a keyhole operation (laparoscopic surgery) for colorectal cancer to remove a section of the bowel (also known as colon). Study details Participants in this study will be randomly allocated (by chance) into one of two groups. Participants in one group will receive a local anaesthetic drug called Lignocaine infused directly into the bloodstream and also into the abdomen using a small plastic tube placed during surgery. Lignocaine is very commonly used to numb areas of skin or muscle before or during an operation. Importantly it has also been shown to help the natural killer cells (NKC) to destroy cancer cells. NKCs are a special type of white blood cell which recognises and destroys cancer cells. Participants in the other group will instead be given a placebo (salty water). Participants will not know which group they are in. All participants will be monitored for up to 30 days post-surgery in order to evaluate safety and also to see if the natural killer cells in the blood work better after lignocaine is used.
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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
51610
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Prof Stephen Smith
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Address
51610
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
51610
0
Australia
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Phone
51610
0
+61 2 49236397
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Fax
51610
0
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Email
51610
0
[email protected]
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Contact person for public queries
Name
51611
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Rosemary Carroll
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Address
51611
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
51611
0
Australia
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Phone
51611
0
+61 2 49236397
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Fax
51611
0
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Email
51611
0
[email protected]
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Contact person for scientific queries
Name
51612
0
Rosemary Carroll
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Address
51612
0
Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
51612
0
Australia
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Phone
51612
0
+61 2 49236397
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Fax
51612
0
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Email
51612
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Not HREC approved for this at time of initial application and approval. May be reviewed at a later.
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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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