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Trial registered on ANZCTR
Registration number
ACTRN12614001121651
Ethics application status
Approved
Date submitted
6/10/2014
Date registered
23/10/2014
Date last updated
25/07/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Post operative analgesic effect of intra-articular ropivacaine at the start and end of hip arthroscopy
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Scientific title
In adult hip arthroscopy patients, does different dosage or pre-emptive timing of intra articular local anaesthetic have an effect on postoperative pain?
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Secondary ID [1]
285448
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Nil
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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:
femoro-acetabular impingement
293215
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labral tear
293216
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postoperative pain
293217
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Condition category
Condition code
Musculoskeletal
293484
293484
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0
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Other muscular and skeletal disorders
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Anaesthesiology
293485
293485
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be allocated into:
1) Standard Care Group: intra-articular injection of Ropivacaine 100mg at the end of hip arthroscopy
2) Treatment Group 1: intra-articular injection of Ropivacaine 200mg at the end of hip arthroscopy
3) Treatment Group 2: intra-articular injection of Ropivacaine 100mg at the beginning and end of hip arthroscopy
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Intervention code [1]
290381
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Treatment: Drugs
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Comparator / control treatment
1) Standard Care Group: Ropivacaine 100mg at the end of hip arthroscopy
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain: measured by - 1) Postoperative VAS (Visual Analogue Scale) after 0.5, 1, 2, 4, 8, 12, and 2) 24 hours, highest and lowest recovery room NRS (numerical rating scale)
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Assessment method [1]
293307
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Timepoint [1]
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Pain measured at: 1) Recovery time and the following time points of: 2)
0.5,1,2,4,8,12 and 24 hrs postoperative
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Secondary outcome [1]
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Recovery room morphine requirements - prospective recording of mg and mg/kg intravenous morphine administered until pain score < or = 6/10
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Assessment method [1]
310775
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Timepoint [1]
310775
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recovery room time
24 hourly postoperative ward
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Secondary outcome [2]
310954
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Recovery room antiemetic requirements - prospective recording of mg of ondansetron and/ or cyclizine administered until cessation of vomiting
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Assessment method [2]
310954
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Timepoint [2]
310954
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Duration of stay in recovery room
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Secondary outcome [3]
310955
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24 hourly ward analgesia requirements - prospective recording of mg and mg/kg subcutaneous morphine and/ or oral oxycodone required for patient satisfaction or pain score < or =6/10
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Assessment method [3]
310955
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Timepoint [3]
310955
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time from discharge to ward until 24 hours from start of surgery
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Secondary outcome [4]
310956
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24 hourly ward antiemetic requirements - prospective recording of mg of ondansetron and/ or cyclizine administered until cessation of vomiting
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Assessment method [4]
310956
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Timepoint [4]
310956
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time from discharge to ward until 24 hours from start of surgery
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Secondary outcome [5]
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Median Recovery room NRS-11 score
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Assessment method [5]
349989
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Timepoint [5]
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Duration of stay in the recovery room
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Eligibility
Key inclusion criteria
All adult patients attending hip arthroscopy at Bellbird Private Hospital performed by the senior author will be eligible to participate in the study.
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Minimum age
18
Years
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Maximum age
75
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
Patients will be excluded from the study if they had previous hip surgery, aged less than 18 or more than 75 years, diagnosis of chronic pain syndrome, contraindications to or allergic reactions to any of the standardized analgesic/ anaesthesia medication or local infiltrate components, ASA 3 or more and those requiring ketamine analgesia or regional block.
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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)
The control and two intervention wings will receive the standard consent discussion as carried out by the senior author. After obtaining written consent, these patients will then be assessed for eligibility to enter the study before being randomly allocated into three different groups. Allocation concealment will be achieved by group allocation being designated to central pharmacy once eligibility is confirmed, and instructions to theatre scrub staff as to which local anaesthetic will be prepared per patient communicated by sealed envelope. Chief recruiter/ investigator and intervening surgeon will be unaware of group allocation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random permuted block sizes of 9, 12 and 15 - to achieve balanced group sizes whilst minimizing excessive runs of single group allocations.
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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
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Statistical analysis will be performed using GraphPad Prism 5 (GraphPad Software, California, USA). Continuous data will be analysed with unpaired t-tests of unequal variance. VAS data will also be treated as continuous data after confirmation of normality by histogram frequency distribution analysis and the Kolgomorov-Smirnoff normality test.
Sample size calculation was performed using G*Power 3.1 (University of Dusseldorf, Dusseldorf, Germany) statistical software. Use of 50mg of intra-articular bupivucaine results in a reduction in a mean VAS score reduction of [mean (SD)] 1cm (1.8cm) in the setting of a multimodal analgesic regime5. As the potency of 1mg bupivucaine is approximately equal to 1.5-2mg ropivacaine, the use of 200mg intra-articular ropivacaine should result in an additional VAS score reduction of 1cm, compared with the equivalent of 50mg intra-articular bupivucaine. To detect a mean difference in VAS scores of 0.3cm, the standard deviation quoted and power of 0.8, the sample size required is 150 patients. The final study sample size was terminated at 132 patients when multiple comparisons, the study's new sample Standard Deviation and Mean Differences, and the clinical significance of smaller pain scale differences were taken into account.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
12/11/2014
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Actual
24/09/2014
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Date of last participant enrolment
Anticipated
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Actual
20/04/2016
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Date of last data collection
Anticipated
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Actual
22/04/2016
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Sample size
Target
132
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Accrual to date
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Final
132
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
11501
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Bellbird Private Hospital - Blackburn
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Recruitment postcode(s) [1]
23527
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3130 - Blackburn
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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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Address [1]
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Country [1]
290114
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Primary sponsor type
Individual
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Name
Dr Phong Tran
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Address
Specialist Orthopedic Surgery Clinic
St.Francis Building
Ground Floor, 166 Gipps St
East Melbourne
VIC 3002
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
288746
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Address [1]
288746
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Country [1]
288746
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291762
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Melbourne Health Human Research and Ethics Committee
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Ethics committee address [1]
291762
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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Approval date [1]
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10/01/2014
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Ethics approval number [1]
291762
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2013.195
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Summary
Brief summary
Hip arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a hip joint. Little attention has been paid to the pain management of patients undergoing hip arthroscopy. The aim of this study is to demonstrate the difference in quality of analgesia between dosage and timing of IALA (intra-articular local anaesthetic) administration in the hip joint. 150 patients undergoing hip arthroscopy by the study surgeon in a private hospital setting will be recruited in the study. Group 1 (Group R100E) will be the control group and will be administered 100mg IA Ropivacaine at the end of the procedure, as per standard practice. Group 2 (Group R200E) will be administered 200mg IA Ropivacaine at the end of the procedure. Group 3 (Group R100BE) will be administered 100mg IA Ropivacaine immediately after access is gained to the joint space, and 100mg IA Ropivacaine IA at the end of the procedure. Post-operative pain will be recorded 1) using NRS-11 score in the recovery room and (2)using a VAS scale after 0.5, 1, 2, 4, 8, 12, and 24 hours post-operatively. Patients will receive a standardised general anaesthesia and intraoperative mulitimodal analgesia regimen. Total perioperative intravenous morphine equivalent analgesic requirements, antiemetic requiremeents, will be compared in the 24 hour postoperative period. Requirement for rescue fascia iliaca block will be recorded however the study is not powered to detect a difference in this requirement.
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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
51910
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Dr Chong Oon Tan
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Address
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Specialist Orthopedic Surgery Clinic
St.Francis Building
Ground Floor, 166 Gipps St
East Melbourne
VIC 3002
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Country
51910
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Australia
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Phone
51910
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+61399286161
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Fax
51910
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Email
51910
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[email protected]
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Contact person for public queries
Name
51911
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Chong Oon Tan
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Address
51911
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Specialist Orthopedic Surgery Clinic
St.Francis Building
Ground Floor, 166 Gipps St
East Melbourne
VIC 3002
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Country
51911
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Australia
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Phone
51911
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+61399286161
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Fax
51911
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Email
51911
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[email protected]
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Contact person for scientific queries
Name
51912
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Chong Oon Tan
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Address
51912
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Specialist Orthopedic Surgery Clinic
St.Francis Building
Ground Floor, 166 Gipps St
East Melbourne
VIC 3002
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Country
51912
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Australia
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Phone
51912
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+61399286161
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Fax
51912
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Email
51912
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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.
Download to PDF