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Trial registered on ANZCTR
Registration number
ACTRN12617000303347
Ethics application status
Approved
Date submitted
17/02/2017
Date registered
27/02/2017
Date last updated
27/02/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does cocaine routinely used in sinus surgery get absorbed into the body and have an effect on your sleep during anaesthetic?
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Scientific title
The systemic absorption of cocaine and the effect on depth of anaesthesia using intranasal atomised modified Moffat’s solution prior to endoscopic sinus surgery (ESS)
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Secondary ID [1]
291231
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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:
sinusitis
302124
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sinus surgery
302126
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Condition category
Condition code
Surgery
301739
301739
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0
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Other surgery
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Anaesthesiology
301762
301762
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be rendomised pre sinus surgery to receive either a single spray of modified Moffat’s (adrenaline + cocaine) or dilute adrenaline as nasal preparation (active control).
Modified moffats solution contains 100mg cocaine, 1mg adrenaline and normal saline made to a 10ml solution. This is administered 5ml either side into the nose pre-surgry
Adrenaline contains 10 ml 1:10,000 (1mg) sprayed 5ml either side into the nose pre-surgery
Surgery will be carried out as normal
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Intervention code [1]
297212
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Treatment: Drugs
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Comparator / control treatment
Active control group will be patients receiving adrenaline containining 10 ml 1:10,000 (1mg) sprayed 5ml either side into the nose pre-surgery
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Control group
Active
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Outcomes
Primary outcome [1]
301138
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To determine the amount and duration of systemic cocaine absorption administered by intranasal atomised modified Moffat’s solution during ESS (composite primary outcome)
Blood samples will be taken to assess cocaine plasma levels
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Assessment method [1]
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Timepoint [1]
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Blood samples will be taken at: baseline (pre administration of Moffats solution), 10mins, 20mins, 30mins, 60mins, 120mins, 6hrs, 12hrs
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Secondary outcome [1]
331815
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To determine whether this systemically absorbed cocaine has an effect on depth of anaesthesia during ESS by comparing this with patients receiving only a dilute adrenaline spray.
This will be assessed using a a BIS Registered Trademark sensor to determine depth of anaesthesia. BIS Registered Trademark sensors monitor a patient's electroencephalogram (EEG) and using a proprietary algorithm give a number to represent the depth of anaesthesia. The BIS Registered Trademark monitor used for this study will be a bilateral sensor that will provide a spectral array of EEG.
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Assessment method [1]
331815
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Timepoint [1]
331815
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The BIS Registered Trademark monitoring will be carried out during induction and entire anaesthetic given for the operation.
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Eligibility
Key inclusion criteria
patients aged between 18 to 80 years (inclusive) undergoing bilateral endoscopic sinus surgery (ESS)
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Minimum age
18
Years
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Maximum age
80
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
1. Refusal or inability to provide consent
2. Use of cocaine within 2 weeks of surgery
3. Modified Moffat’s solution contraindicated due to safety
4. Sensitivity to cocaine
5. Significant IHD/history of arrhythmias
6. Pregnant/breastfeeding
7. Limited mucosal application of modified Moffat’s or dilute adrenaline solution
8. Grade 3 polyps in 1 or more nasal cavities
9. Obstructing intranasal mass
10. Severe septal deformity
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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)
yes. Central computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
random number generator
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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 assessing the outcomes
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Intervention assignment
Parallel
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Other design features
nil
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Using previous studies a number of required patient was determined to identify trends. Groups will be compared but no formal statistical analysis will be completed
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
4/01/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
7504
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Casey Hospital - Berwick
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Recruitment postcode(s) [1]
15330
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3806 - Berwick
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Funding & Sponsors
Funding source category [1]
295656
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Government body
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Name [1]
295656
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Forensic Science South Australia laboratory
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Address [1]
295656
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21 Divett Pl, Adelaide
South Australia 5000
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Country [1]
295656
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Australia
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Primary sponsor type
Individual
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Name
Dean Page
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Address
Monash Health
246 Clayton Road, Clayton
Victoria 3168
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Country
Australia
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Secondary sponsor category [1]
294501
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None
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Name [1]
294501
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-
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Address [1]
294501
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-
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Country [1]
294501
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296973
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Monash Health HREC
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Ethics committee address [1]
296973
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246 Clayton Road, Clayton Victoria 3168
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Ethics committee country [1]
296973
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Australia
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Date submitted for ethics approval [1]
296973
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21/07/2016
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Approval date [1]
296973
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10/08/2016
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Ethics approval number [1]
296973
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LNR/16/MonH/343
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Summary
Brief summary
Endoscopic sinus surgery (ESS) requires pre-surgery medication applied into the nose to minimise bleeding. At Monash Health we either use a solution called modified Moffat’s solution which contains cocaine, adrenaline and saline, or just adrenaline with saline. Although acting inside the nose a small percentage of both adrenaline and cocaine may be absorbed into the blood. The absorption may depend on the concentration, method of application and time in contact with the lining of the nose. Overall there exists limited research looking at cocaine absorption in the context of sinus surgery. Specifically, no studies have looked at modified Moffat’s solution sprayed into the nose. It is important that we determine how much and for how long cocaine is absorbed so we can advise patients appropriately after the operation. Additionally, it is thought that cocaine may affect a brain chemical called dopamine, and this may in turn affect how much anaesthetic is required to keep you asleep. The study will aim to look at how deeply patients sleep after being administered either the Modified Moffat’s spray or the adrenaline spray. Overall we will aim to enroll a total of 30 patients. Half (15) will receive the modified Moffat’s solution prior to surgery and the other half (15) will receive the dilute adrenaline prior to surgery. Blood samples taken during and after surgery will measure cocaine blood levels.
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Trial website
nil
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Trial related presentations / publications
nil
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Public notes
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Contacts
Principal investigator
Name
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Dr Dean Page
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Address
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ENT Unit, Monash Health
Moorrabbin Cancer Centre
Centre rd East Bentleigh, Victoria
3165
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Country
72590
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Australia
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Phone
72590
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+61 3 99288799
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Fax
72590
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Email
72590
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[email protected]
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Contact person for public queries
Name
72591
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Joanne Rimmer
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Address
72591
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ENT Unit, Monash Health
Moorrabbin Cancer Centre
Centre rd East Bentleigh, Victoria
3165
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Country
72591
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Australia
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Phone
72591
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+61 3 99288799
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Fax
72591
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Email
72591
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[email protected]
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Contact person for scientific queries
Name
72592
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Joanne Rimmer
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Address
72592
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ENT Unit, Monash Health
Moorabbin Cancer Centre
Centre rd East Bentleigh, Victoria
3165
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Country
72592
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Australia
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Phone
72592
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+61 3 99288799
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Fax
72592
0
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Email
72592
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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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