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Trial registered on ANZCTR
Registration number
ACTRN12615000103561
Ethics application status
Approved
Date submitted
14/01/2015
Date registered
5/02/2015
Date last updated
5/02/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
The impact of neuromuscular blocking agents on traction forces during total hip replacement surgery
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Scientific title
Patients undergoing hip replacement surgery: impact of neuromuscular blockade on the forces required for visualization of the femoral neck.
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Secondary ID [1]
285972
0
none
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Universal Trial Number (UTN)
U1111-1166-0962
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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:
pulling force in Newton reqired to visualize the femoral neck during hip replacement surgery
293911
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Condition category
Condition code
Anaesthesiology
294215
294215
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0
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Anaesthetics
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Surgery
294384
294384
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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
Patients scheduled for elective hip replacement surgery under general anaesthesia will be included. At the start of surgery, at the time the surgeon request a pulling force (via traction table) on a patients leg to expose the femoral neck, the previously non-paralysed patient will receive rocuronium 0.6 mg/kg intravenously. Traction forces will be measured in Newton via an electronic strain gauge build into the traction system and connected to a laptop pc.
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Intervention code [1]
290950
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Treatment: Drugs
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Comparator / control treatment
Traction forces required for visualization of the femoral neck before vs. after intravenous administration of rocuronium 0.6 mg/kg.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
294002
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Change of traction forces required to visualize the femoral neck before and after paralysis with rocuronium.
Assessment via a custom-made strain gauge inserted between the "shoe"-part (fixation of patient foot) and the "handle"-part (tractioning device applying force to leg). Strain gauge conected via 2 input cables to laptop PC showing and recording all changes in force (N) "online".
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Assessment method [1]
294002
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Timepoint [1]
294002
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Start of surgery, at time of initial approach to the femoral neck.
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Secondary outcome [1]
312336
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Change of traction forces with onset of paralysis after rocuronium administration (from no to full paralysis)
Assessment via a custom-made strain gauge inserted between the "shoe"-part (fixation of patient foot) and the "handle"-part (tractioning device applying force to leg). Strain gauge conected via 2 input cables to laptop PC showing and recording all changes in force (N) "online".
Assessment of neuromuscular blockade via NMT module for ulnar nerve stimulation (GE Healthcare, Helsinki, Finland).
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Assessment method [1]
312336
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Timepoint [1]
312336
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As timepoint 1: at the start of surgery at the time of femoral neck approach.
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Eligibility
Key inclusion criteria
scheduled for hip replacement surgery under general anaesthesia
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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
neuromuscular disease, regional or spinal anaesthesia, paralysis at start of surgery
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Identifying inclusion criteria, written informed consent prior to surgery. No treatment allocation as all subjects willl receive same treatment (control is the pre-treatment traction force).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
n/a
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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
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Pharmacodynamics
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Statistical methods / analysis
The study is planned as pilot project. No formal sample size calculation has been performed.
Analysis of data:
KS-test for normal distribution. Comparison of forces pre- vs post paralysis with either paired t-test or wilcoxon rank sum test.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/11/2014
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Actual
31/10/2014
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Date of last participant enrolment
Anticipated
30/10/2015
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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
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
3332
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
9112
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6000 - City Delivery Centre
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Funding & Sponsors
Funding source category [1]
290559
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Self funded/Unfunded
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Name [1]
290559
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Thomas Ledowski
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Address [1]
290559
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University of Western Australia
35 Stirling HWY
Crawley
WA 6009
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Country [1]
290559
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Australia
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Primary sponsor type
Individual
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Name
Thomas Ledowski
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Address
University of Western Australia
35 Stirling HWY
Crawley
WA 6009
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Country
Australia
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Secondary sponsor category [1]
289251
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None
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Name [1]
289251
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Address [1]
289251
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Country [1]
289251
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292203
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Royal Perth Hospital
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Ethics committee address [1]
292203
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Wellington Street Perth WA 6000
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Ethics committee country [1]
292203
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Australia
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Date submitted for ethics approval [1]
292203
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Approval date [1]
292203
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15/11/2012
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Ethics approval number [1]
292203
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2012-144
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Summary
Brief summary
Orthopaedic surgeons frequently claim that the administration of muscle relaxants (NMBA) in patients under general anaesthesia facilitate surgery, especially when significant forces may be required (e.g. dislocation of hip joint, femoral realignment during operation of femoral fractures). However, despite the fact that NMBA are frequently used during general anaesthesia for orthopaedic surgery, no evidence for their benefit on operating conditions exists. Therefore, this trial aims to investigate the influence of NMBA on traction forces during hip replacement surgery. 20 Patients scheduled for hip replacement surgery under general anaesthesia will be included in this trial. Patients will receive a standard general anaesthetic. Patients for this form of hip replacement surgery are generally operated on a special operating table with the patients feet placed in shoe-like brackets. This allows the application of significant tension and torque to the patients operated leg in order to enable the surgical preparation of the hip joint for the prosthesis. With the help of a measurement instrument (Newton Meter installed within the traction mechanic of the operating table) we will measure the forces required to extend a patient's leg to facilitate surgery. Thereafter, an NMBA (rocuronium = most often used NMBA at RPH) will be slowly administered to finally achieve muscle paralysis. During the time of paralysis development, traction forces on the leg will be measured. Aim is to investigate whether NMBA can significantly reduce the forces required during hip replacement surgery.
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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
54050
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Prof Thomas Ledowski
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Address
54050
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School of Medicine and Pharmacology
University of Western Australia
35 Stirling Hwy
Crawley WA 6009
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Country
54050
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Australia
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Phone
54050
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+61 8 92240210
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Fax
54050
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Email
54050
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[email protected]
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Contact person for public queries
Name
54051
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Thomas Ledowski
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Address
54051
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School of Medicine and Pharmacology
University of Western Australia
35 Stirling Hwy
Crawley WA 6009
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Country
54051
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Australia
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Phone
54051
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+61 8 92240210
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Fax
54051
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Email
54051
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[email protected]
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Contact person for scientific queries
Name
54052
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Thomas Ledowski
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Address
54052
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School of Medicine and Pharmacology
University of Western Australia
35 Stirling Hwy
Crawley WA 6009
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Country
54052
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Australia
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Phone
54052
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+61 8 92240210
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Fax
54052
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Email
54052
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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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