Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12615001034527
Ethics application status
Approved
Date submitted
21/05/2015
Date registered
6/10/2015
Date last updated
6/10/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effects of fentanyl added to intrathecal levobupivacaine on requirement for ephedrine and the newborn in elective cesarean section as a randomized trial.
Query!
Scientific title
Effect of fentanyl added to intrathecal levobupivacaine on requirement for ephedrine and the newborn in elective cesarean section
Query!
Secondary ID [1]
286744
0
nil
Query!
Universal Trial Number (UTN)
nil
Query!
Trial acronym
nil
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
cesarean section
295105
0
Query!
Condition category
Condition code
Anaesthesiology
295530
295530
0
0
Query!
Anaesthetics
Query!
Anaesthesiology
295859
295859
0
0
Query!
Other anaesthesiology
Query!
Reproductive Health and Childbirth
295860
295860
0
0
Query!
Childbirth and postnatal care
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
10 minute before cesarean section intrathecal levobupivacaine 0.5 % (Group I), levobupivacaine 0.5 % + 10 microgram fentanyl (Group II) and levobupivacaine 0.5 % + 25 microgram fentanyl (Group III). Following the induction of spinal anesthesia, the subjects were promptly placed in the supine position and were injected with 5 mg bolus ephedrine, followed by 10 microgram kg-1 min-1 ephedrine infusion.
Infusion was discontinued if Systolic blood pressure value reached >100% of the baseline value,
- Infusion was maintained at 10 microgram kg-1 min-1 if SBP value was between 80% and 100% of the baseline value,
- Infusion was maintained at 20 microgram kg-1 min-1 if SBP value was <80% of the baseline value,
- In addition to 5 mg bonus administration, infusion was maintained at 20 microgram kg-1 min-1 if Systolic blood pressure value was < 90 mmHg.
Query!
Intervention code [1]
291896
0
Treatment: Drugs
Query!
Comparator / control treatment
Levobupivacaine 0.5 % dose for spinal anesthesia was determined in reference to patient height. Consistent with the values , the subjects were administered with levobupivacaine 0.5 % (Group I) as a control group, levobupivacaine 0.5 % + 10 microgram fentanyl (Group II) and levobupivacaine 0.5 % + 25 microgram fentanyl (Group III). Levobupivacaine volume was decreased to compensate for the fentanyl volume in Group II and Group III.
Query!
Control group
Active
Query!
Outcomes
Primary outcome [1]
295123
0
Total ephedrine dose administered as assessed using patient medical charts.
Query!
Assessment method [1]
295123
0
Query!
Timepoint [1]
295123
0
At the conclusion of the operation, bolus, infused and total ephedrine doses were calculated.
Query!
Secondary outcome [1]
314816
0
APGAR scores
Query!
Assessment method [1]
314816
0
Query!
Timepoint [1]
314816
0
1 and 5 minutes after birth
Query!
Eligibility
Key inclusion criteria
elective cesarean section
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Females
Query!
Can healthy volunteers participate?
Yes
Query!
Key exclusion criteria
Patients with pre-eclampsia, eclampsia, gestational hypertension, diabetes mellitus, cardiac problems or bleeding diathesis were excluded.
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaque envelopes
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table from a statistic book
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 3 / Phase 4
Query!
Type of endpoint/s
Safety
Query!
Statistical methods / analysis
One Way Anova and Independent Sample T test were used for intergroup comparisons. Chi square and Fisher’s exact chi square tests were used to evaluate the nonnumerical data. The results were expressed as mean +/- standard deviation and statistical significance was set at p<0.05.
There was also a significantly decreased risk of hypotension with increasing ephedrine dose in a cohort study (X^2 = 9.67; P = 0.002). The final power achieved in detecting a linear dose-response relationship for hypotension varied among studies: 6%, 9%, 27%, 88%, and 99%. There was no association between dose and risk of fetal acidosis in a cohort study (X^2 = 3.06; P = 0.08). There was homogeneity of slopes (X^2 =1.32; P = 0.52). We were calculated with a 95% confidence, an alpha of 0.06 and 95% power the sample size was calculated as 150 cases and 150 controls.
X^2 = 9.67; P = 0.002)
(X^2 = 3.06; P = 0.08)
(X^2 = 1.32; P = 0.52
260 cases and 260 controls were evaluated for this study: Group I (n=266), Group II (n=274) and Group III (n=260)
Query!
Recruitment
Recruitment status
Completed
Query!
Date of first participant enrolment
Anticipated
16/12/2013
Query!
Actual
23/12/2013
Query!
Date of last participant enrolment
Anticipated
16/12/2014
Query!
Actual
16/03/2015
Query!
Date of last data collection
Anticipated
Query!
Actual
Query!
Sample size
Target
450
Query!
Accrual to date
Query!
Final
800
Query!
Recruitment outside Australia
Country [1]
6891
0
Turkey
Query!
State/province [1]
6891
0
Query!
Funding & Sponsors
Funding source category [1]
291316
0
Government body
Query!
Name [1]
291316
0
Republic of Turkey Ministry of Health,
Query!
Address [1]
291316
0
Republic of Turkey Ministry of Health,Mithatpasa Cad. No: 3 06434 Sihhiye/Ankara
Query!
Country [1]
291316
0
Turkey
Query!
Primary sponsor type
Hospital
Query!
Name
ATATURK TRAINING AND RESEARCH HOSPITAL
Query!
Address
ATATURK TRAINING AND RESEARCH HOSPITAL, 06800, BILKENT ANKARA
Query!
Country
Turkey
Query!
Secondary sponsor category [1]
289996
0
University
Query!
Name [1]
289996
0
YILDIRIM BEYAZIT UNIVERSITY
Query!
Address [1]
289996
0
Yildirim Beyazit University, cankiri Caddesi cicek Sokak No:3, Ulus, Altindag,06512 Ankara, Turkey
Query!
Country [1]
289996
0
Turkey
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
292879
0
ZEKAI TAHIR BURAK HASTANESI ETIK KURULU
Query!
Ethics committee address [1]
292879
0
Zekai Tahir Burak Hospital, Hacettepe Mh., Talatpasa Bulvari, 06230 Ankara, Turkey
Query!
Ethics committee country [1]
292879
0
Turkey
Query!
Date submitted for ethics approval [1]
292879
0
15/09/2012
Query!
Approval date [1]
292879
0
15/08/2013
Query!
Ethics approval number [1]
292879
0
23145
Query!
Summary
Brief summary
Aim: To compare the effects of different doses of fentanyl added to intrathecal levobupivacaine on ephedrine requirement and to evaluate its impact on the fetus in subjects undergoing elective cesarean section. Methods: A total of 800 parturients scheduled for elective cesarean section were enrolled in the study. Those fulfilling the enrollment criteria were randomly assigned to three groups as Group I (n=266), Group II (n=274) and Group III (n=260). All patients were administered with an infusion of Ringer’s lactate solution at 10-12 mL kg-1 in the preoperative period before spinal anesthesia and at 8-10 mL kg h-1 intraoperatively. The dose of levobupivacaine 0.5% was adjusted in reference to patient heights for spinal anesthesia. While Group I was administered with levobupivacaine 0.5%, Group II was administered with levobupivacaine 0.5% + 10 microgram fentanyl and Group III was administered with levobupivacaine 0.5% + 25 microgram fentanyl. In Group II and Group III, levobupivacaine volume was decreased to compensate for the fentanyl volume. Ephedrine infusion was initiated with 5 mg bolus following the puncture for spinal anesthesia. It was then administered at 10 microgram kg-1 min-1. Ephedrine infusion was maintained with respect to baseline systolic blood pressure throughout the operation; and systolic blood pressure, heart rate, nausea-vomiting score as well as the ephedrine doses administered were recorded. Results: Total preoperative ephedrine requirement of the groups were established to be 26.07 +/- 16.39 mg in Group I, 20.72 +/- 12.95 mg in Group II and 16.80 +/- 9.40 mg in Group III. Total ephedrine used was observed to be significantly lower in Group III than in it was in Group I (p<0.05). Group I was also established with a lower mean fetal umbilical venous pH value than that observed in Group III (p<0.05). Conclusion: We conclude that the addition of 25 microgram fentanyl to levobupivacaine, when compared with the administration of levobupivacaine alone, decreases the ephedrine requirement and produces better maternal and newborn hemodynamic stability in elective cesarean section cases administered with spinal anesthesia.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
57382
0
Dr Ayca Ozcan
Query!
Address
57382
0
Ataturk Training and Research Hospital, Department of Anaesthesiology,Eskisehir Yolu Uzeri, 06800,Ankara, Turkey
Query!
Country
57382
0
Turkey
Query!
Phone
57382
0
+905057154125
Query!
Fax
57382
0
Query!
Email
57382
0
[email protected]
Query!
Contact person for public queries
Name
57383
0
Ayca Ozcan
Query!
Address
57383
0
Ataturk Training and Research Hospital, Department of Anaesthesiology,Eskisehir Yolu Uzeri, 06800,Ankara, Turkey
Query!
Country
57383
0
Turkey
Query!
Phone
57383
0
+905057154125
Query!
Fax
57383
0
Query!
Email
57383
0
[email protected]
Query!
Contact person for scientific queries
Name
57384
0
Ayca Ozcan
Query!
Address
57384
0
Ataturk Training and Research Hospital, Eskisehir Yolu Uzeri, 06800,Ankara, Turkey
Query!
Country
57384
0
Turkey
Query!
Phone
57384
0
+905057154125
Query!
Fax
57384
0
Query!
Email
57384
0
[email protected]
Query!
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