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Trial registered on ANZCTR
Registration number
ACTRN12615000431527
Ethics application status
Approved
Date submitted
10/04/2015
Date registered
6/05/2015
Date last updated
16/02/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prewarming of surgical patients to prevent hypotension on induction of anaesthesia
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Scientific title
Prewarming of neurosurgical patients to prevent hypotension on induction of anaesthesia
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Secondary ID [1]
286503
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Nil
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Universal Trial Number (UTN)
U1111-1169-1635
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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:
Hypotension on anaesthetic induction
294718
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Condition category
Condition code
Anaesthesiology
295007
295007
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0
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Anaesthetics
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Surgery
295192
295192
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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
Prewarming of neurosurgical patients for one hour at 46 degrees Celsius with a forced air warmer (Cocoon Convective Warming System 4000, Care Essentials, North Geelong, Victoria, Australia) prior to anaesthetic induction, after placement of intra-arterial blood pressure monitoring. The patient's temperature is measured prior to and at conclusion of warming
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Intervention code [1]
291597
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Treatment: Devices
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Intervention code [2]
291755
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Prevention
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Comparator / control treatment
No prewarming of control group
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Control group
Active
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Outcomes
Primary outcome [1]
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Absolute difference in immediate pre- and nadir post-induction mean arterial pressure (MAP) using an arterial line
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Assessment method [1]
294761
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Timepoint [1]
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Immediately prior to laryngoscopy
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Secondary outcome [1]
314008
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Vasopressor dose and type used, composite secondary outcome. Contemporaneously recorded
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Assessment method [1]
314008
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Timepoint [1]
314008
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Immediately prior to laryngoscopy
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Secondary outcome [2]
314009
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Incidence of hypotension defined as a decrease in mean blood pressure > 20% from immediate pre-induction value.
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Assessment method [2]
314009
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Timepoint [2]
314009
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Immediately prior to laryngscopy
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Eligibility
Key inclusion criteria
1. Neurosurgical patients aged 18 years and over
2. Craniotomy for any indication
3. American Society of Anesthesiologists’ (ASA) physical status 1-3
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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
1. Inadequate English comprehension due to a language barrier, cognitive deficit or intellectual disability
2. Significant cardiorespiratory impairment (i.e. ASA 4-5 patients)
3. Severe hypertension (systolic BP > 180 mmHg, diastolic BP > 110 mmHg in the operating suite admission bay)
4. Antihypertensive therapy with ACE inhibitor/angiotensin II receptor antagonist if administered on the day of surgery
5. Secondary hypertension (e.g. renal artery stenosis, phaeochromocytoma, Cushing's syndrome)
6. Temperature > 37.5 degrees Celcius at baseline
7. Thyroid dysfunction
8. Otitis media/externa (preventing accurate tympanic membrane temperature measurement)
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Study design
Purpose of the study
Prevention
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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)
Simple randomisation using a randomisation table created by computer software (computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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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
The difference in mean arterial blood pressures between pre- and post- anaesthetic induction values between groups of equal or greater than 20 mmHg, assuming a standard deviation of 20 mmHg (accepted population standard deviation), an alpha error of 0.05 and power of 0.8 will require 16 patients in each group (32 patients total).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/02/2015
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Actual
29/01/2015
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Date of last participant enrolment
Anticipated
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Actual
22/06/2015
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Date of last data collection
Anticipated
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Actual
22/06/2015
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Sample size
Target
32
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Accrual to date
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Final
32
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
3687
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Royal Melbourne Hospital - City campus - Parkville
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Funding & Sponsors
Funding source category [1]
291070
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Charities/Societies/Foundations
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Name [1]
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Australian and New Zealand College of Anaesthetists
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Address [1]
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ANZCA House,
630 St Kilda Road,
Melbourne Victoria 3004.
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Country [1]
291070
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Australia
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Primary sponsor type
Individual
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Name
Jai Darvall
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Address
Department of Anaesthesia and Pain Management
Royal Melbourne Hospital
300 Grattan St
Parkville 3050
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Country
Australia
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Secondary sponsor category [1]
289750
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None
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Name [1]
289750
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Address [1]
289750
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Country [1]
289750
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292654
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
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Office for Research Royal Melbourne Hospital 300 Grattan St Parkville VIC 3050
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Ethics committee country [1]
292654
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Australia
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Date submitted for ethics approval [1]
292654
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Approval date [1]
292654
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02/12/2014
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Ethics approval number [1]
292654
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2014.211
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Summary
Brief summary
General anaesthesia, whilst very safe, has some undesirable side effects. Two of these, a fall in body temperature and a fall in blood pressure, are usually very mild and require little treatment. Occasionally, more severe changes can result requiring significant intervention by the anaesthetist. Whilst prewarming of patients prior to surgery is sometimes employed to reduce the drop in body temperature seen with anaesthesia, it is not known whether this warming may also help reduce the fall in blood pressure. Warming patients results in dilation of blood vessels, with some of the circulating blood volume then moving into more peripheral tissues. This is similar to the process that happens under anaesthesia, with the relaxation of blood vessels caused by anaesthetic drugs resulting in lowered blood pressure. This is usually mild and easily correctable with medications and intravenous fluid administered by the anaesthetist, though occasionally can be more serious. This study aims to answer the question of whether prewarming patients may reduce the fall in blood pressure seen with the onset of anaesthesia, due to blood vessels already being dilated, and hence reduce the need for intervention by the anaesthetist.
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Trial website
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Trial related presentations / publications
Published in the Canadian Journal of Anesthesia (Can J Anaesth. 2016 May;63(5):577-583)
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Public notes
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Contacts
Principal investigator
Name
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Dr Jai Darvall
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Address
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Department of Anaesthesia and Pain Management
Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
56414
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Australia
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Phone
56414
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+61393427136
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Fax
56414
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Email
56414
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[email protected]
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Contact person for public queries
Name
56415
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Jai Darvall
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Address
56415
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Department of Anaesthesia and Pain Management
Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
56415
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Australia
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Phone
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+61393427136
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Fax
56415
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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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Jai Darvall
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Address
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Department of Anaesthesia and Pain Management
Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
56416
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Australia
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Phone
56416
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+61393427136
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Fax
56416
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Email
56416
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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
Source
Title
Year of Publication
DOI
Embase
Prewarming neurosurgical patients to minimize hypotension on induction of anesthesia: a randomized trial.
2016
https://dx.doi.org/10.1007/s12630-016-0601-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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