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Trial registered on ANZCTR
Registration number
ACTRN12617001372370
Ethics application status
Approved
Date submitted
27/05/2017
Date registered
27/09/2017
Date last updated
27/09/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessment of the effect of intrathecal bupivacaine combined with opioids on postoperative analgesia in patients undergoing cesarean section
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Scientific title
Assessment of the effect of intrathecal bupivacaine combined with opioids (morphine, fentanyl) on postoperative analgesia in patients undergoing cesarean section
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Secondary ID [1]
291186
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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
302075
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Condition category
Condition code
Reproductive Health and Childbirth
301706
301706
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0
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Childbirth and postnatal care
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Surgery
302883
302883
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0
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Other surgery
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Anaesthesiology
303812
303812
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The patients ' demographic data were recorded. Patients distributed to groups with closed envelope technique. The patients divided into three groups.
according to the administered opioids that they receive:
Group II: 8 mg 5% hyperbaric bupivacaine + 20 mcg fentanyl + 50 mcg morphine were administrated intrathecal prior to caesarean procedure by anaesthesiologist
Group III: 8 mg 5% hyperbaric bupivacaine + 20 mcg fentanyl + 100 mcg morphine were administrated intrathecal prior to caesarean procedure by anaesthesiologist
The effectiveness of spinal anesthesia was assessed with the hot-cold sensation test and Bromage scale. The surgery was initiated when the sensorial block level reaches T4 dermatome. Intraoperative pain was monitored using the Visual Analog Scale (VAS). The duration of effective analgesia till the first postoperative analgesic requirements, The additional analgesic requirement within the first 24- hours after the surgery, the amount of additional analgesics, and side effects (nausea, vomiting, pruritus, and headache) were evaluated and recorded.
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Intervention code [1]
297187
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Treatment: Drugs
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Comparator / control treatment
Group I: 8 mg 5% hyperbaric bupivacaine + 20 mcg Fentanyl were administrated intrathecal prior to caesarean procedure
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Control group
Active
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Outcomes
Primary outcome [1]
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time of first analgesic requirement
this information is taken from patients themselves
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Assessment method [1]
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Timepoint [1]
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24 hours post surgery
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Secondary outcome [1]
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Adverse effects (itching, allergies, nausea, vomiting, urinary retention, constipation, respiratory depression, bradycardia, hypotension, dizziness i.e.)
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Assessment method [1]
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Timepoint [1]
331728
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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
- 18 years older
-cesarean section under spinal anesthesia
- who know Turkish and are cooperative
- whose physical status is consistent with ASA II class
-gestational age must be >27 weeks
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-neurological disease
-preeclampsia, diabetes mellitus, infection on the surgical site,
-disorders associated with bleeding/ clotting, severe agitation,
-non-cooperation, rejection of regional anesthesia,
-obesity (body mass index >35 kg/m2),
-height shorter:150 cm,
- known fetal abnormality, placenta previa, history of ablatio placentae, risk for growth retardation and meconium aspiration; pathology that may affect the acid-base balance, antepartum hemorrhage,
-Rh incompatibility
- hypersensitivity to local anesthetics
-history of frequent analgesic use
- allergy to any medicine in the projected study protocol.
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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
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Actual
1/04/2016
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Date of last participant enrolment
Anticipated
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Actual
30/12/2016
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Date of last data collection
Anticipated
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Actual
31/12/2016
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Sample size
Target
1110
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Accrual to date
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Final
1090
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Recruitment outside Australia
Country [1]
8662
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Turkey
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State/province [1]
8662
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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]
295628
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mine akoz
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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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Country [1]
295628
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Turkey
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Funding source category [2]
295629
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Self funded/Unfunded
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Name [2]
295629
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derya karasu
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Address [2]
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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]
295629
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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]
294470
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Individual
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Name [1]
294470
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canan yilmaz
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Address [1]
294470
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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]
294470
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296947
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Bursa Yuksek Ihtisas Training and Education Hospital Clinical Researc Ethics Committee
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Ethics committee address [1]
296947
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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]
296947
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Turkey
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Date submitted for ethics approval [1]
296947
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16/03/2016
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Approval date [1]
296947
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30/03/2016
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Ethics approval number [1]
296947
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2011-KAEK-25 2016/06-02
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Summary
Brief summary
Purpose: Our prospective, randomized, double-blind study aimed to detect the effect of intrathecal bupivacaine combined with opioids on the postoperative analgesia in patients undergoing cesarean section. Material and Methods: 1110 patients with gestational age over 37 weeks, over 18 years of age and who undergoing elective cesarean section with spinal anesthesia were into the following three groups according to intrathecal opioids: Group 1: 8 mg 5% hyperbaric bupivacaine and 20 mcg fentanyl, Group 2: 8 mg 5% hyperbaric bupivacaine and 20 mcg fentanyl + 50 mcg morphine, Group 3: 8 mg 5% hyperbaric bupivacaine and 20 mcg fentanyl + 100 mcg morphine. First analgesic requirement time, intraoperative and postoperative side effects, intraoperative visual analog scale (VAS) were recorded. Results: 1090 patients were included in the statistical evaluation. Intraoperative nausea and vomiting were significantly less in the Group 3 (p=0.047). Intraoperative pruritus was significantly higher in Group 3 compared to the other two groups (p<0.001). There was no difference between the groups in terms of intraoperative VAS values. Postoperative nausea, vomiting, pruritus, hypotension, bradycardia were similar among the groups. Patient satisfaction was lowest in Group 1 and highest in Group 3 (p<0.001). The duration of first analgesia was short in Group 1 (p<0.001). Conclusions: We concluded that, morphine added to bupivacaine and fentanyl for spinal anesthesia increased the duration of the first analgesic requirement and that 50 and 100 mcg of morphine were not superior to each other in terms of side effects and first analgesic duration.
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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 mine aköz
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Address
72510
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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
72510
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Turkey
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Phone
72510
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+905077069100
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Fax
72510
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Email
72510
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[email protected]
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Contact person for public queries
Name
72511
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derya karasu
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Address
72511
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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
72511
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Turkey
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Phone
72511
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+905057281175
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Fax
72511
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Email
72511
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[email protected]
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Contact person for scientific queries
Name
72512
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canan yilmaz
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Address
72512
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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
72512
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Turkey
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Phone
72512
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+905059045989
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Fax
72512
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Email
72512
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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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