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Trial registered on ANZCTR
Registration number
ACTRN12617000434392
Ethics application status
Approved
Date submitted
17/10/2015
Date registered
24/03/2017
Date last updated
24/03/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of different anesthesia techniques on intraoperative stress-induced immunosuppression in patients undergoing radical esophagectomy'
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Scientific title
Evaluation of whether different anesthesia techniques can affect intraoperative stress-induced immunosuppression in patients undergoing radical esophagectomy.
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Secondary ID [1]
287687
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Nil known
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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:
patients undergoing radical esophagectomy
296524
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Oesophageal cancer
299995
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Immunosupression
300355
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Condition category
Condition code
Cancer
296785
296785
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0
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Oesophageal (gullet)
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Anaesthesiology
299875
299875
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0
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Anaesthetics
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Surgery
299886
299886
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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 undergoing radical esophagectomy were randomly assigned to one of the two groups. In group I (n=20), patients received total intravenous general anesthesia (Group TIVA); in group II (n=20), patients received total intravenous general anesthesia combined with thoracic epidural anesthesia (Group TIVA+TEA). Each test solution was prepared in a syringe by the first investigator, who was also responsible for subject grouping. Under sterile conditions, a thoracic epidural catheter was placed via the T7–8 interspace and was advanced 3–4 cm cephalad by the first investigator. A test dose of 1% lidocaine 5 mL, alone, was then given by the first investigator via the thoracic epidural catheter, followed by 0.375% ropivacaine 5 mL, to produce a bilateral segmental sensory block to pinprick between the T6 and L4 dermatomes, or given 10mL normal saline. Then neuraxial block was maintained with 0.375% ropivacaine 5 mL/h or normal saline 5 mL/h throughout the surgical procedure by the second anaesthesiologist. Entropy index was used to maintain the depth of anesthesia to a certain level. Plasma levels of stress hormones and cytokines were assessed before surgery and as well as 1 and 3 hours after the beginning of surgery.
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Intervention code [1]
293081
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Treatment: Drugs
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Comparator / control treatment
The Group TIVA+TEA patients received 0.375% ropivacaine 5 mL/h during surgery, while the control group patients received 5 mL/h normal saline as placebo via the thoracic epidural catheter.
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Control group
Placebo
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Outcomes
Primary outcome [1]
296389
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Immunosuppression, assessed by serum assay for plasma cortisol, adrenocorticotropic hormone
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Assessment method [1]
296389
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Timepoint [1]
296389
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before surgery and as well as 1 and 3 hours after the beginning of surgery
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Secondary outcome [1]
327897
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Composite outcome of plasma IL-6 and IL-10.
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Assessment method [1]
327897
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Timepoint [1]
327897
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before surgery and as well as 1 and 3 hours after the beginning of surgery.
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Eligibility
Key inclusion criteria
40 patients, of ASA physical status 1-3 adult patients, undergoing elective surgery for radical esophagectomy were included in this prospective randomized, double-blind, placebo-controlled trial.
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Minimum age
29
Years
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Maximum age
78
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
contraindications for receiving TEA, pre-existing cardiovascular diseases, preoperative treatment with opioids, non-steroidal anti-inflammatory drugs, or other immunomodulatory substances, infection, immune and endocrine system disorders and communication barriers.
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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)
Allocation concealment was established by placing the randomization sequence in consecutively numbered, opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
use of computer-generated codes
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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
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
a=0.05, 1-beta=0.8, a P-value of ,0.05 was considered significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
6/05/2015
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Date of last participant enrolment
Anticipated
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Actual
18/09/2015
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Date of last data collection
Anticipated
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Actual
18/09/2015
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Sample size
Target
40
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Accrual to date
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Final
40
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Recruitment outside Australia
Country [1]
7253
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China
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State/province [1]
7253
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Shanghai
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Funding & Sponsors
Funding source category [1]
292241
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Government body
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Name [1]
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National Natural Science Foundation of China
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Address [1]
292241
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No.83 Shuangqing Road Haidian District Beijing China,100085
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Country [1]
292241
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China
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Primary sponsor type
Government body
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Name
National Natural Science Foundation of China
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Address
No.83 Shuangqing Road Haidian District Beijing China,100085
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Country
China
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Secondary sponsor category [1]
290917
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None
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Name [1]
290917
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Address [1]
290917
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Country [1]
290917
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293706
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Fudan University Cancer Hospital Ethics Committee
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Ethics committee address [1]
293706
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Fudan University, Shanghai Cancer Center, No.270 Dong-an Road, Shanghai, P. R. China, PC 200032
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Ethics committee country [1]
293706
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China
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Date submitted for ethics approval [1]
293706
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02/12/2014
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Approval date [1]
293706
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29/12/2014
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Ethics approval number [1]
293706
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47-12
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Summary
Brief summary
With exposure to severe food safety issues especially in China, the global incidence of cancer has risen dramatically, although survival rate of cancer patients is improving due to the modern medical technology, cancer is the second most common cause of death, exceeded only by heart disease and accounting for one in every four deaths. Although surgery remains the most effective treatment of potentially curable solid tumors, anesthesiologists shoulder the responsibility to minimize worsen fragile immune function of cancer patients in perioperative period. The trial which investigated whether different anesthesia techniques could affect intraoperative stress-induced immunosuppression in patients undergoing radical esophagectomy has significant clinical practical significance and this trial is fully in line with the Declaration of Helsinki human trials, so the ethics committee unanimously supported the trial adoption.
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Trial website
www.shca.org.cn/
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
61038
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Dr Jing Wang
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Address
61038
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Department of Anaesthesiology,Fudan University, Shanghai Cancer Center,
No.270 Dong-an Road, Shanghai, P. R. China, PC 200032.
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Country
61038
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China
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Phone
61038
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86-21-64175590
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Fax
61038
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Email
61038
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[email protected]
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Contact person for public queries
Name
61039
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Changhong Miao
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Address
61039
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Department of Anaesthesiology,Fudan University, Shanghai Cancer Center,
No.270 Dong-an Road, Shanghai, P. R. China, PC 200032.
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Country
61039
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China
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Phone
61039
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86-21-64175590
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Fax
61039
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Email
61039
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[email protected]
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Contact person for scientific queries
Name
61040
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Yun Zhu
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Address
61040
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Department of Anaesthesiology,Fudan University, Shanghai Cancer Center,
No.270 Dong-an Road, Shanghai, P. R. China, PC 200032.
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Country
61040
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China
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Phone
61040
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86-21-64175590
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Fax
61040
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Email
61040
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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
Thoracic epidural anaesthesia and analgesia ameliorates surgery-induced stress response and postoperative pain in patients undergoing radical oesophagectomy.
2019
https://dx.doi.org/10.1177/0300060519866943
N.B. These documents automatically identified may not have been verified by the study sponsor.
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