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Trial registered on ANZCTR
Registration number
ACTRN12617000431325
Ethics application status
Approved
Date submitted
13/02/2017
Date registered
24/03/2017
Date last updated
24/03/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of peritubal infiltration with bupivacaine and morphine on postoperative analgesia in patients undergoing percutaneous nephrolithotomy
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Scientific title
The effect of peritubal infiltration with bupivacaine and morphine on postoperative analgesia in patients undergoing percutaneous nephrolithotomy
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Secondary ID [1]
291177
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none
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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:
postoperative analgesia
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Kidney stones
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Condition category
Condition code
Anaesthesiology
301688
301688
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0
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Pain management
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Surgery
301689
301689
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0
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Other surgery
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Renal and Urogenital
301690
301690
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All patients underwent spinoepidural anesthesia. The patients ' demographic data recorded. The patients were divided into two groups. Patients distributde to groups with closed envelope technique.
Group P (n=66): Peritubal infiltration group was given 0.25% bupivacaine [Bustesin(R), Vem, Ankara, Turkey] 20 mL + 5 mg morphine (0.5 ml) [Morphine HCl(R), Galen, Istanbul, Turkey] into the renal capsule, peripheral fat tissue, muscle tissue, subcutaneous tissues and skin after a nephrostomy tube was inserted using a 22G spinal needle advanced towards 6 and 12 O’clock positions as guided by a fluoroscopy along nephrostomy catheter by urologist at the end of the surgery. The anesthetic solution was observed by fluoroscopy, which was evenly distributed throughout the nephrostomy catheter.
Postoperative pain control was achieved with epidural patient-controlled analgesia (PCA)(CADD-Legacy(R) PCA, Smiths Medical, St Paul, USA) for the first 24 hours post surgery. Epidural PCA was prepared including 40 mL 0.5% bupivacaine + 500 mcg fentanyl +
110 mL 0.9% NaCl, to a total of 160 mL epidural solution as postoperative analgesic for all
patients . Without a basal infusion,
bolus dose was set as 5 mL, key duration as 20 min and hourly limit as 15 mL.
In first 24 h pain scores, time of the first analgesic demand, the mean number of analgesic demands and postoperative complications were compared between groups.
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Intervention code [1]
297174
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Treatment: Drugs
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Comparator / control treatment
Group C (n=64): control group. None of the patients received a peritubal injection. Postoperative pain control was achieved with epidural patient-controlled analgesia (PCA).
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Control group
Active
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Outcomes
Primary outcome [1]
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rate of analgesic consumption in the 24 hours after surgery
Datas of analgesic agent consumption are assessed by review of medical records. Analgesic consumption will be calculated by the total amount of analgesic agents spent on Patient-controlled analgesia (PCA)
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Assessment method [1]
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Timepoint [1]
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24 hours after surgery
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Primary outcome [2]
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Pain, assessed by visual analogue scale at rest and during movement.
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Assessment method [2]
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Timepoint [2]
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at 0-2-4-8-12-24. hours
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Secondary outcome [1]
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Postoperative complications were assessed according to the Modified Clavien classification (MCC) (Fever (higher than 38 degrees), Emezis, Vomiting, Headache, Itching, Blood transfusion, Infection, Arteriovenous fistula, Acute Coronary Syndrome, i.e)
Adverse events were recorded. If adverse events were recognized,
This complications listed were assessed as recorded by treating clinician in the medical records
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Assessment method [1]
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Timepoint [1]
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during intraoperative process and 24 hours post surgery
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Eligibility
Key inclusion criteria
-patients who underwent percutaneous nephrolithotomy
- aged between 18 and 65 years,
-whose the American Society of Anesthesiologists (ASA) score was I-III,
-body mass index was <30 kg/m2,
-stone size measured >2 cm,
- duration of surgery was <3 h
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Minimum age
18
Years
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Maximum age
65
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
-allergic to local anesthetics or morphine,
- patients having a contraindication to neuro-axial block,
-patients given general anesthesia,
- those with a bleeding disorder,
-those having alcohol or substance abuse,
-patients who underwent surgical interventions from multiple sites
-patients who underwent bilateral PNL
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
25/05/2015
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Date of last participant enrolment
Anticipated
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Actual
23/05/2016
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Date of last data collection
Anticipated
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Actual
24/05/2016
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Sample size
Target
130
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Accrual to date
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Final
130
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Recruitment outside Australia
Country [1]
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Turkey
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State/province [1]
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Bursa
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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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Isra Karaduman
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Address [1]
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Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country [1]
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Turkey
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Primary sponsor type
Individual
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Name
Isra Karaduman
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Address
Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country
Turkey
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Secondary sponsor category [1]
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Individual
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Name [1]
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Canan Yilmaz
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Address [1]
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Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country [1]
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Bursa Yuksek Ihtisas Training and Education Hospital Clinical Researc Ethics Committee
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Ethics committee address [1]
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Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Ethics committee country [1]
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Turkey
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Date submitted for ethics approval [1]
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02/03/2015
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Approval date [1]
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20/05/2015
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Ethics approval number [1]
296938
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2011-KAEK-25 2015/10-09
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Summary
Brief summary
Objective: We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic consumption through the patient-controlled analgesia (PCA) device in patients who underwent percutaneous nephrolithotomy combined with spinoepidural anesthesia. Material and Methods: Patients aged between 18 and 65 years and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients underwent spinoepidural anesthesia. 20 mL of 0.25 percent bupivacaine + 5 mg morphine (0.5 mL) in Group P (n=66), were infiltrated the renal capsule, perinephric fat, muscles, subcutaneous tissue and skin with a 22G spinal needle under fluoroscopy. In Group C (n= 64), none of the patients received a peritubal injection. Postoperative pain control was achieved with epidural PCA. In first 24 h pain scores, time of the first analgesic demand, the mean number of analgesic demands and postoperative complications were compared between groups. Results: The mean Visual Analog Scale (VAS) score at postoperative 8, 12, 24 h and dynamic VAS score at postoperative 4, 8, 12, 24 h were significant lower in Group P. VAS score at postoperative 4 h was not significant. Time of the first analgesic demand (262.2 min) was significantly longer in Group P. Conclusion: Our study results suggest that peritubal infiltration of bupivacaine with morphine after percutaneous nephrolithotomy is an effective method for postoperative pain control and reduces analgesic consumption.
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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
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Dr Isra Karaduman
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Address
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Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country
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Turkey
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Phone
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+905077561163
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Isra Karaduman
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Address
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Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country
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Turkey
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Phone
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+905077561163
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Fax
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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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Derya Karasu
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Address
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Health Sciences University Bursa Yuksek Ihtisas Training Education Hospital Clinic of Anesthesiology and Reanimation
Mimar Sinan Neighborhood /Emniyet Street/16310 Yildirim/Bursa
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Country
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Turkey
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Phone
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+905057281175
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Fax
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Email
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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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