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Trial registered on ANZCTR
Registration number
ACTRN12616001708448
Ethics application status
Approved
Date submitted
17/11/2016
Date registered
13/12/2016
Date last updated
24/02/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy
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Scientific title
Postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy
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Secondary ID [1]
290101
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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:
postoperative analgesia
301230
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Condition category
Condition code
Surgery
300076
300076
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0
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Other surgery
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Anaesthesiology
300986
300986
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0
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Pain management
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Oral and Gastrointestinal
300989
300989
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The patients ' demographic data was recorded. The patients will be divided into two groups. Patients distributed to groups with closed envelope technique
Group I (n=60): control group.
All transversus abdominis plane blocks were performed under ultrasound guidance after induction of anesthesia, before beginning of surgery by the same anesthesiologist who performed block at least 20 times. 1mg/kg Bupivacaine (Marcaine (R) AstraZeneca: Istanbul, Turkey)+ Saline 0.9% (Izotonik sodyum klorur (R) (Eczacibasi: Istanbul, Turkey) ( total 40ml) injected in the transversus abdominis fascial plane under direct visualization.
Group II (n=60): 1mg/kg Bupivacaine (Marcaine (R) AstraZeneca: Istanbul, Turkey)+ 0.5 mg/kg ketamine (Ketalar (R) Pfizer: Istanbul, Turkey)+ Saline 0.9% (Izotonik sodyum klorur (R) (Eczacibasi: Istanbul, Turkey) (total 40ml).
The patients received patient-controlled intravenous analgesia (PCA) with 90 ml normal saline + 500 mg tramadol (Tramosel (R), Haver, Istanbul, Turkey) for postoperative pain management (bolus dose: 5 ml, lockout period: 20 minutes,without loading dose). All patients received intravenous analgesia via the same type of PCA (Patient Controlled Analgesia) device for 24 hours period.
When the pain level is higher than three (0=no pain; 10=severe pain), the patient can use the patient controlled analgesia pump. If the pain still exist, additional analgesic will be applied by the same anesthesiologist who assessed outcomes and the number of additional analgesic was recorded..
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Intervention code [1]
295847
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Treatment: Drugs
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Comparator / control treatment
Group II (n=60)
All transversus abdominis plane blocks were performed under ultrasound guidance,
1mg/kg Bupivacaine (Marcaine (R) AstraZeneca: Istanbul, Turkey)+ 0.5 mg/kg Ketamine (Ketalar (R) Pfizer: Istanbul, Turkey)+ Saline 0.9% (Izotonik sodyum klorur (R) (Eczacibasi: Istanbul, Turkey) (total 40ml) injected in the transversus abdominis fascial plane under direct visualization.
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Control group
Active
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Outcomes
Primary outcome [1]
299547
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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]
299547
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Timepoint [1]
299547
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24 hours post surgery
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Primary outcome [2]
299548
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time of first analgesic requirement
this information is taken from patients themselves
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Assessment method [2]
299548
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Timepoint [2]
299548
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at any time in the 24 hours
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Primary outcome [3]
299549
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Pain, assessed by visual analogue scale at rest and during movement.
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Assessment method [3]
299549
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Timepoint [3]
299549
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at 0-2-4-8-12-24. hours
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Secondary outcome [1]
327493
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Adverse effects (itching, allergies, nausea, vomiting, urinary retention, constipation, respiratory depression, bradycardia, hypotension, dizziness ,hallucination i.e.)
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Assessment method [1]
327493
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Timepoint [1]
327493
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during intraoperative process and 24 hours post surgery
Adverse events were recorded. If adverse events were recognized, They were evaluated according to Common Terminology Criteria for Adverse Events (CTC-AE) ver. 4.0.
This adverse events listed are assessed as recorded by treating clinician in the medical records
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Eligibility
Key inclusion criteria
elective surgery
laparoscopic cholecystectomy
ASA (American Society of Anesthesiologist) Score) I-II
who can talk turkish language.
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Minimum age
18
Years
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Maximum age
75
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
blood coagulation pathologies
allergies against local anaesthetics
inability to understand the study protocol
body mass index >30
infection on the block area
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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
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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
26/12/2016
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Actual
26/12/2016
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Date of last participant enrolment
Anticipated
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Actual
13/02/2017
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Date of last data collection
Anticipated
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Actual
14/02/2017
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Sample size
Target
120
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Accrual to date
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Final
108
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Recruitment outside Australia
Country [1]
8204
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Turkey
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State/province [1]
8204
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Bursa
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Funding & Sponsors
Funding source category [1]
294472
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Self funded/Unfunded
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Name [1]
294472
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Demet Ozer
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Address [1]
294472
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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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Country [1]
294472
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Turkey
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Funding source category [2]
294634
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Self funded/Unfunded
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Name [2]
294634
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Derya Karasu
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Address [2]
294634
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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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Country [2]
294634
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Turkey
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Primary sponsor type
Individual
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Name
Derya Karasu
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Address
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]
293341
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Individual
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Name [1]
293341
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Canan Yilmaz
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Address [1]
293341
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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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Country [1]
293341
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295908
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Yuksek Ihtisas Training and Education Hospital Clinical Researc Ethics Committee
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Ethics committee address [1]
295908
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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]
295908
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Turkey
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Date submitted for ethics approval [1]
295908
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15/08/2016
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Approval date [1]
295908
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05/10/2016
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Ethics approval number [1]
295908
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2011-KAEK-25 2016/17-01
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Summary
Brief summary
Purpose: To study postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy. Methods: In this study the patients who can speak Turkish and who have chololithiasis and planned elective laporoscophic cholecistectomy surgery, aged between 18-75 years with ASA (American Society of Anesthesiologist) Score I-II were included. We excluded patients with blood coagulation pathologies, allergies against local anaesthetics , inability to understand the study protocol, body mass index greater than thirty or infection on the block area. After induction of anaesthesia, anaesthetists placed the bilateral transversus abdominis plane block after visualising with an ultrasound scan and then the operation was allowed. The patients divided into two groups : Group I (n=60): control group. 1mg/kg Bupivacaine (Marcaine (R) AstraZeneca: Istanbul, Turkey)+ Saline 0.9% (Izotonik sodyum klorur solusyonu (R) (Eczacibasi: Istanbul, Turkey) ( total 40ml). Group II (n=60): 1mg/kg Bupivacaine (Marcaine (R) AstraZeneca: Istanbul, Turkey)+ 0.5 mg/kg ketamine (Ketalar (R) Pfizer: Istanbul, Turkey)+ Saline 0.9%(Izotonik sodyum klorur solusyonu (R) (Eczacibasi: Istanbul, Turkey) (total 40ml). After the operation, to obtain minimum level of pain, patients controlled analgesia pump was applied via intravenous way to the patients. Then the level of pain was observed through the visual analog scale at 0-2-4-8-12-24h postoperatively both while coughing and at rest. When the pain level is higher than three (0=no pain; 10=severe pain), the patient can use the patient controlled analgesia pump. If the pain still exist, additional analgesic was applied and the number of additional analgesic will be recorded accordingly.Results: 108 patients completed the study: 53 in Group I and 55 in Group II. For Group II, postoperatively at 0, 2, 4 and 24. hours VAS scores at rest and 0, 2, 4, 12 and 24 hours dynamic VAS scores were significantly lower than Group I (p<0.05).Moreover, the time to first analgesic requirement was longer significantly than Group I (p<0.0001).We couldn’t find any significant difference between the groups in terms of the total tramadol consumption. Conclusions: We concluded that TAP block with bupivacaine and ketamine combination increases the time until the first request for rescue analgesic and it provides effective analgesia on postoperative period after laparoscopic cholecystectomy.
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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 Demet Ozer
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Address
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Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology and Reanimation Mimar Sinan Neighborhood/ Emniyet Street/ 16310 Yildirim/Bursa
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Country
68858
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Turkey
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Phone
68858
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+9055059045989
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Fax
68858
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Email
68858
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[email protected]
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Contact person for public queries
Name
68859
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Derya Karasu
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Address
68859
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Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology and Reanimation Mimar Sinan Neighborhood/ Emniyet Street/ 16310 Yildirim/Bursa
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Country
68859
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Turkey
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Phone
68859
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+90505728117
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Fax
68859
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Email
68859
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[email protected]
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Contact person for scientific queries
Name
68860
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Derya Karasu
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Address
68860
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Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology and Reanimation Mimar Sinan Neighborhood/ Emniyet Street/ 16310 Yildirim/Bursa
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Country
68860
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Turkey
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Phone
68860
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+905057281175
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Fax
68860
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Email
68860
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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
Postoperative analgesic efficacy of ketamine added to bupivacaine in ultrasound guided transversus abdominis plane block for laparoscopic cholecystectomy.
2020
https://dx.doi.org/10.4328/ACAM.6183
N.B. These documents automatically identified may not have been verified by the study sponsor.
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