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Trial registered on ANZCTR
Registration number
ACTRN12618001106224
Ethics application status
Approved
Date submitted
20/06/2018
Date registered
3/07/2018
Date last updated
27/11/2018
Date data sharing statement initially provided
27/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia of Patients Undergoing Laparoscopic Cholecystectomy
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Scientific title
The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia of Adult Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled, Double Blinded Clinical Trial
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Secondary ID [1]
295254
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Nil known
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Universal Trial Number (UTN)
U1111-1215-9561
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Trial acronym
US-ESP for Cholecystectomy
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
cholelithiasis
308425
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postoperative pain
308426
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Condition category
Condition code
Anaesthesiology
307413
307413
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0
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Pain management
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Oral and Gastrointestinal
307532
307532
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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
n the operating room (OR), all of the patients will receive a standard monitoring including electrocardiography, non-invasive blood pressure, peripheral oxygen saturation and bi-spectral index monitoring. After the placement of a 22-gauge intraveous line, 15 ml kg-1 isotonic saline infusion will be started. All patients will receive intravenous 0.05 midazolam for sedation. Then the patients will randomly divided into two groups based on a computerized randomization table created by a researcher who will not involve in the study. There will be two anesthesiologists in the OR. For each randomized patient, the first anesthesiologist will take the corresponding sealed envelope from a folder, which indicates the treatment assigned to the patient, while the second anesthesiologist will be blind to the group allocations. The first anesthesiologist will prepare the drug solutions for use in the study (0.25% bupivacaine or isotonic saline solution) in two identical 20 ml syringes and a 10 ml syringe of isotonic saline for hydrodissection and pass the labeled syringes to the blinded anesthesiologist. And the patients will be placed in sitting position. In the first group (Group US-ESP), the second anesthesiologist will locate the ultrasound probe in longitudinal orientation at the level of T7 spinous process and then place 3 cm laterally from the midline. The ultrasound landmarks, T7 transverse process and the overlying erector spinae muscle, will be identified. Under aseptic conditions, a 80 mm 21-gauge block needle will be inserted in-plane at an angle of 30-40 degrees in cranial-to-caudal direction until the tip contacts the T7 transverse process. After the hydrodissection with 3 mL of isotonic saline solution confirmes correct needle tip position, the anesthesiologist will inject 20 mL of 0.25% bupivacaine deep to the erector spinae muscle. The same procedure will be repeated with 20 mL of 0.25% bupivacaine solution at the contralateral side. The block procedure will take approximately 10-15 minutes and then the anesthesiologists will start induction of anesthesia with intravenous propofol, fentanyl and rocuronium bromide.
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Intervention code [1]
301589
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Treatment: Surgery
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Comparator / control treatment
In the second group (Group Control), the patients will receive the same bilateral US-ESP block with totally 40 ml isotonic saline (20 ml for each side).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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To assess the postoperative opioid consumption in the first 24 hours by calculating the tramadol dose administered by patient controlled analgesia device.
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Assessment method [1]
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Timepoint [1]
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At the postoperative 24th hour
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Secondary outcome [1]
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To assess intraoperative fentanyl consumption by using data-linkage to surgical records
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Assessment method [1]
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Timepoint [1]
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At the end of each surgery
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Secondary outcome [2]
348316
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To assess shoulder pain of the patients by directly asking the patients to rate their pain with a 3-points scale (0=no pain, 1=mild, 2=severe pain)
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Assessment method [2]
348316
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Timepoint [2]
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At the postoperative 15th minute, 30th minute, 60th minute (secondary time-point), 12th hour, 24th hour
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Secondary outcome [3]
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To assess pain scores of the patients by using 11-points numerical rating scale (NRS) at the postoperative 15th minute, 30th minute, 60th minute (secondary time-point), 12th hour and 24th hour
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Assessment method [3]
350660
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Timepoint [3]
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at the postoperative 15th minute, 30th minute, 60th minute (secondary time-point), 12th hour and 24th hour
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Eligibility
Key inclusion criteria
The patients between 18-70 years of age with ASA status I-II, and scheduled for an elective laparoscopic cholecystectomy surgery,
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Minimum age
18
Years
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Maximum age
70
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
The patients with coagulation disorder, known allergy to local anesthetics, infection at the injection site, advanced hepatic or renal failure, chronic opioid consumption and morbid obesity (body mass index over 35 kg m-2)
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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)
central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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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
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We will conduct the statistical analysis using the software Statistical Package for Social Science (SPSS), version 17 (made by SPSS Incorporated, located in Chicago, Illinois, USA).
Values will be expressed as mean±standard deviation, median, or as percentages. The groups will be compared in parametric parameters using independent samples T-test and in non-parametric parameters using Mann-Whitney U test. A p value < 0.05 will be accepted statistically significant.
Sample size of the study was calculated based on a preliminary study with 10 patients in each group. At least 20% difference in postoperative tramadol consumption at the 24th hour was accepted as clinically significant. The mean tramadol consumption in ESP group was 95 mg and it was 128 mg in Control group. Assuming an alpha error as 0.01 and beta error as 0.1, at least 15 patients were needed to provide a power 90%. Considering possible drop-outs, we decided to include at least 20 patients per group.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
6/07/2018
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Actual
6/07/2018
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Date of last participant enrolment
Anticipated
20/07/2018
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Actual
27/07/2018
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Date of last data collection
Anticipated
21/07/2018
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Actual
28/07/2018
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Sample size
Target
40
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Accrual to date
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Final
41
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Recruitment outside Australia
Country [1]
10577
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Turkey
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State/province [1]
10577
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MUGLA
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Funding & Sponsors
Funding source category [1]
299846
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Hospital
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Name [1]
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Mugla Sitki Koçman University Training and Research Hospital
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Address [1]
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Mugla Sitki Koçman Üniversitesi Tip Fakültesi. Marmaris yolu üzeri M kapi karsisi. 48000 Mentese/MUGLA
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Country [1]
299846
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Turkey
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Primary sponsor type
Individual
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Name
Basak ALTIPARMAK
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Address
Mugla Sitki Koçman Üniversitesi Tip Fakültesi. Marmaris yolu üzeri M kapi karsisi. 48000 Mentese/MUGLA
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Country
Turkey
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Secondary sponsor category [1]
299201
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None
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Name [1]
299201
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Address [1]
299201
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Country [1]
299201
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300723
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Mugla Sitki Koçman University Training and Research Hospital Institutional Ethics Committee
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Ethics committee address [1]
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Mugla Sitki Koçman University Training and Research Hospital, Marmaris Yolu üzeri, M Kapi Karsisi, 48000 Mugla
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Ethics committee country [1]
300723
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Turkey
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Date submitted for ethics approval [1]
300723
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28/06/2018
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Approval date [1]
300723
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02/07/2018
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Ethics approval number [1]
300723
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decision number XXI
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Summary
Brief summary
Our primary aims are to assess the effects of US-ESP on postoperative pain scores and opioid consumption after laparoscopic cholecystectomy surgery. Our hypothesis is that US-ESP will reduce postoperative pain scores and opioid consumption of the patients more significantly than control group. Our secondary aims are to assess the intraoperative fentanyl need and postoperative shoulder pain of the groups. Our hypothesis is that the fentanyl need and shoulder pain in ESP group will be lower than control group.
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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 Basak ALTIPARMAK
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Address
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Mugla Sitki Koçman Üniversitesi Tip Fakültesi. Marmaris yolu üzeri M kapi karsisi. 48000 (postcode) Mentese/MUGLA
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Country
84602
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Turkey
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Phone
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+905326726533
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Fax
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Email
84602
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[email protected]
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Contact person for public queries
Name
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Basak ALTIPARMAK
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Address
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Mugla Sitki Koçman Üniversitesi Tip Fakültesi. Marmaris yolu üzeri M kapi karsisi. 48000 (postcode) Mentese/MUGLA
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Country
84603
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Turkey
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Phone
84603
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+905326726533
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Fax
84603
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Email
84603
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[email protected]
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Contact person for scientific queries
Name
84604
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Basak ALTIPARMAK
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Address
84604
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Mugla Sitki Koçman Üniversitesi Tip Fakültesi. Marmaris yolu üzeri M kapi karsisi. 48000 (postcode) Mentese/MUGLA
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Country
84604
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Turkey
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Phone
84604
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+905326726533
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Fax
84604
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Email
84604
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
all of the individual participant data collected during the trial, after de-identification
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When will data be available (start and end dates)?
Immediately following publication on request; ending 1 year after publication
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Available to whom?
only researchers who provide a methodologically sound proposal
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Available for what types of analyses?
any purpose
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How or where can data be obtained?
access subject to approvals by Principal Investigator
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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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