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Trial registered on ANZCTR
Registration number
ACTRN12619001066178
Ethics application status
Approved
Date submitted
3/06/2019
Date registered
31/07/2019
Date last updated
11/12/2019
Date data sharing statement initially provided
31/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of head positioning on intraoperative optic nerve sheath diameter and postoperative cognitive function of patients undergoing thyroidectomy
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Scientific title
The effect of head positioning on intraoperative optic nerve sheath diameter and postoperative cognitive function of adult patients undergoing thyroidectomy
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Secondary ID [1]
298405
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Nil known
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Universal Trial Number (UTN)
U1111-1234-6123
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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:
tyroid cancer
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mild cognitive impairment
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Condition category
Condition code
Cancer
311583
311583
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0
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Thyroid
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Mental Health
311584
311584
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0
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Studies of normal psychology, cognitive function and behaviour
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Anaesthesiology
311586
311586
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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
In the shoulder roll group (Group 1), patients will lie in supine position with arms tucked and a shoulder roll will be placed behind the shoulders of patients to extend the neck during thyroidectomy surgery. Then head of the operation table will be raised up to 30 degrees from the horizontal plane. The degree of neck extension (Frankfort plane angle) will be measured by using the angle between the Frankfort plane and horizontal plane of the operation table in natural position. Cognitive functions of patients will be evaluated with MoCA by a blinded anesthesiologist during the preoperative assessment and visit at the postoperative 6th hour.
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Intervention code [1]
314648
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Diagnosis / Prognosis
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Comparator / control treatment
In the second group (Group 2), patients will be placed in the same position and the neck will be extended without a shoulder roll. The degree of neck extension (Frankfort plane angle) will be measured by using the angle between the Frankfort plane and horizontal plane of the operation table in natural position. Cognitive functions of patients will be evaluated with MoCA by a blinded anesthesiologist during the preoperative assessment and visit at the postoperative 6th hour.
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Control group
Active
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Outcomes
Primary outcome [1]
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Preoperative (the day before the surgery) and postoperative (at the postoperative 6th hour) cognitive function levels as assessed by MoCA test between the groups
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Assessment method [1]
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Timepoint [1]
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At the preoperative assessment (the day before the surgery) and at the postoperative 6th hour (primary timepoint)
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Secondary outcome [1]
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The difference between groups in optic nerve sheath diameter (ONSD) which will be measured by ultrasonography at different time-points
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Assessment method [1]
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Timepoint [1]
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(T0) before induction of anesthesia, (T1) after induction of anesthesia, (T2) after endotracheal intubation, (T3) after positioning of the head, (T4) 60 min after the induction of anesthesia, (T5) 90 min after the induction of anesthesia (secondary time-point)
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Secondary outcome [2]
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The mean degree of neck extension which will be calculated on a lateral view-photograph by an application named Angles in Photos (copyright (c) 2015 kublaios)
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Assessment method [2]
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Timepoint [2]
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After the positioning of the head in the intraoperative period
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Eligibility
Key inclusion criteria
The patients with American Society of Anesthesiologists (ASA) physical status II, between 18-65 years old and scheduled for an elective thyroidectomy surgery will be included in the study
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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
Patients with a preoperative MoCA score under 24, known acute or chronic ophthalmic diseases, history of previous ophthalmic surgery, increased ICP, ß blocker, calcium canal blocker, statin or nitrate treatment, known psychological disorder, BMI over 40 kg m-2, surgical time shorter than 90 min and longer than 120 minutes will be excluded
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Study design
Purpose of the study
Diagnosis
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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 will be determined using a computer software by a researcher who will not involve in the study
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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 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
Safety
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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). All continuous variables including age, weight, globe size, ONSD, EtCO2, Temp, HR, MAP will be presented as mean and standard deviation (SD), and the categorical variables, gender and T/AT, will be presented as both numbers and percentile (%). The relationship between Frankfort plane angle and ONSD changes will be analyzed by regression model. Linear mixed model will be used to observe the variation of repeated ONSD measurements and the other parameters (EtCO2, Temp, HR, MAP) over time. Moreover, Post hoc analyses will be performed using Bonferroni correction for multiple comparisons
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/07/2019
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Actual
31/07/2019
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Date of last participant enrolment
Anticipated
10/09/2019
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Actual
14/11/2019
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Date of last data collection
Anticipated
11/09/2019
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Actual
14/11/2019
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment outside Australia
Country [1]
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Turkey
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State/province [1]
21557
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Mugla
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Funding & Sponsors
Funding source category [1]
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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]
302945
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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]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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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]
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Turkey
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Date submitted for ethics approval [1]
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10/06/2019
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Approval date [1]
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17/06/2019
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Ethics approval number [1]
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T-XII
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Summary
Brief summary
Hyperextension of the neck is associated with increased postoperative pain and some series complication such as carotid and vertebral artery occlusion which may lead to postoperative cognitive impairment.In the current study, our primary hypothesis is that patients positioned with a shoulder roll will have lower MoCA scores at the postoperative 6th hour than the patients positioned without a shoulder roll. Our secondary hypothesis is that optic nerve sheath diameter (ONSD) which is accepted as a well indicator of changes in ICP, will be greater in the shoulder roll group. Another secondary hypothesis is that the degree of neck extension will be greater in shoulder roll group.In the shoulder roll group (Group 1), patients will lie in supine position with arms tucked and a standard shoulder roll will be placed behind the shoulders of patients to extend the neck. Then head of the operation table will be raised up to 30 degrees from the horizontal plane. In the second group (Group 2), patients will be placed in the same position and the neck will be extended without a shoulder roll.
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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
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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
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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
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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
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[email protected]
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Contact person for scientific 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
93908
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Turkey
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Phone
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+905326726533
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Fax
93908
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Email
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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)?
Between immediately following publication and ending 1 year following main results 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?
only to achieve the aims in the approved proposal
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How or where can data be obtained?
access subject to approvals by Principal Investigator (Basak ALTIPARMAK email:
[email protected]
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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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