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Trial registered on ANZCTR
Registration number
ACTRN12624000741583
Ethics application status
Approved
Date submitted
5/04/2024
Date registered
14/06/2024
Date last updated
14/07/2024
Date data sharing statement initially provided
14/06/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Preoperative Fasting Period on Quality of Recovery in Elderly Patients undergoing Total Knee Arthroplasty
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Scientific title
Effect of Preoperative Fasting Period on Quality of Recovery in Elderly Patients undergoing Total Knee Arthroplasty :a randomised controlled trial
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Secondary ID [1]
311514
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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:
Post-operative quality of recovery
332849
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Total Knee Arthroplasty
332851
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Condition category
Condition code
Anaesthesiology
329565
329565
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0
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Other anaesthesiology
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Musculoskeletal
329567
329567
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0
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Osteoporosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will begin a fasting regime the day before surgery which will involve cessation of solid foods at 2000 hours and cessation of fluids at 2200hrs. All patients will be registered on the morning surgery list. All patients will be overseeing adherence to the fasting regime ward nurse. Strategies used to monitor adherence to the intervention include regular observation. This must be finished by 2200 hours and nursing staff will monitor fluid input. The intervention group will consume 300 ml liquid carbohydrates (100 ml solution includes 22.5 maltodextrin and 2.5 g glucose) up to three hours before surgery and will be monitored by nurses. The duration of time that participants will have to consume the liquid carbohydrates 10 minutes window.
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Intervention code [1]
328511
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Treatment: Other
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Comparator / control treatment
The placebo group will begin a fasting regime the day before surgery which will involve cessation of solid foods at 2000 hours and cessation of fluids at 2200hrs. All patients will be registered on the morning surgery list. All patients will be overseeing adherence to the fasting regime ward nurse. Strategies used to monitor adherence to the intervention include regular observation. This must be finished by 2200 hours and nursing staff will monitor fluid input. The placebo group will consume equal amounts of water three hours before surgery and will be monitored by the nurse. The duration of time that participants will have to consume equal amounts of water 10 minutes window.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Quality of Recovery-15 score
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Assessment method [1]
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QoR-15, a 15-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain. Each item is rated on a scale of 1-10. The increase in scores shows the high quality of recovery.
Minimum value: 0, Maximum value: 150, higher scores mean better.
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Timepoint [1]
337358
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24 hours after completion and closure of surgical procedure
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Secondary outcome [1]
431562
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Quality of Recovery-15 score
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Assessment method [1]
431562
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QoR-15, a 15-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain. Each item is rated on a scale of 1-10. The increase in scores shows the high quality of recovery.
Minimum value: 0, Maximum value: 150, higher scores mean better.
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Timepoint [1]
431562
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postoperative day 7
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Secondary outcome [2]
431563
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Numerical Pain Rating Scale
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Assessment method [2]
431563
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Range 0-10, 0=no pain, 10=the worse pain ever.
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Timepoint [2]
431563
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24 hours after completion and closure of surgical procedure
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Secondary outcome [3]
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Opioid consumption
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Assessment method [3]
431564
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opioid consumption will be obtained by analysing medical records.
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Timepoint [3]
431564
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24 hours after completion and closure of surgical procedure
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Secondary outcome [4]
431565
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Range of knee motion
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Assessment method [4]
431565
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Range of knee motion via goniometer.
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Timepoint [4]
431565
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48 hours after completion and closure of surgical procedure
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Secondary outcome [5]
431566
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Time up and go test, Falls risk assessed via timed up and go test.
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Assessment method [5]
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Patient reporting time of first standing to the side of the bed and time up and go test
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Timepoint [5]
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Postoperative 2 days
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Secondary outcome [6]
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Cognitive Impairment
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Assessment method [6]
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Mini-Mental State Examination Scale (This scale is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. Any score of 24 or more (out of 30) indicates normal cognition. Below this, scores can indicate severe (=9 points), moderate (10-18 points), or mild (19-23 points) cognitive impairment.)
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Timepoint [6]
431568
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preoperatively within 24 hours prior to the procedure and postoperative day 1
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Secondary outcome [7]
431569
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Sleep Quality measured with Likert Scale
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Assessment method [7]
431569
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Patients' perceived sleep quality will be assessed with a Likert scale. Likert scale is scored from Likert scale where 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied and 5 = very satisfied
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Timepoint [7]
431569
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One week after surgery
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Secondary outcome [8]
431570
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Glucose measurement
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Assessment method [8]
431570
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Glucose measurement via random finger-prick test
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Timepoint [8]
431570
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24 hours after completion and closure of surgical procedure.
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Secondary outcome [9]
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Incidence of postoperative delirium (POD) within 1 day after surgery
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Assessment method [9]
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Incidence of POD will be assessed at baseline and once daily within 1 day after surgery (3D-CAM) by anesthesiologist(s).
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Timepoint [9]
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postoperative 1 day
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Secondary outcome [10]
434716
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Thirst
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Assessment method [10]
434716
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thirst; 5: very satisfied, 4: somewhat satisfied, 3: neutral, 2: somewhat dissatisfied, 1: very dissatisfied
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Timepoint [10]
434716
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Before the operating room admission and postoperative 1 day
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Secondary outcome [11]
434717
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Hunger
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Assessment method [11]
434717
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Hunger; 5: very satisfied, 4: somewhat satisfied, 3: neutral, 2: somewhat dissatisfied, 1: very dissatisfied
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Timepoint [11]
434717
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Before the operating room admission and postoperative 1 day
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Secondary outcome [12]
434718
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Mouth dryness
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Assessment method [12]
434718
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Mouth dryness; 5: very satisfied, 4: somewhat satisfied, 3: neutral, 2: somewhat dissatisfied, 1: very dissatisfied
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Timepoint [12]
434718
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Before the operating room admission and postoperative 1 day
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Secondary outcome [13]
434719
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Nausea and vomiting
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Assessment method [13]
434719
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Nausea and vomiting; 5: very satisfied, 4: somewhat satisfied, 3: neutral, 2: somewhat dissatisfied, 1: very dissatisfied
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Timepoint [13]
434719
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Before the operating room admission and postoperative 1 day
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Secondary outcome [14]
434720
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Fatigue
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Assessment method [14]
434720
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Fatigue; 5: very satisfied, 4: somewhat satisfied, 3: neutral, 2: somewhat dissatisfied, 1: very dissatisfied
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Timepoint [14]
434720
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Before the operating room admission and postoperative 1 day
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Eligibility
Key inclusion criteria
Physical status according to the American Society of Anesthesiologists (ASA) II-III
Patients scheduled for total knee arthroplasty
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Minimum age
65
Years
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Maximum age
85
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
Previous operation on the same knee
Hepatic or renal insufficiency
Younger than 65 years old
Patients undergoing general anesthesia
Allergy or intolerance to one of the study medications
ASA IV
Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of >5mg/day for one month)
impaired gastrointestinal motility
Fasting glucose >200
Acquired immunodeficiency
Severe malnutrition
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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
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
30/06/2024
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Actual
30/06/2024
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Date of last participant enrolment
Anticipated
13/10/2024
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Actual
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Date of last data collection
Anticipated
20/10/2024
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Actual
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Sample size
Target
100
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Accrual to date
100
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Final
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Recruitment outside Australia
Country [1]
26143
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Turkey
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State/province [1]
26143
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Karaman
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Country [2]
26144
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Turkey
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State/province [2]
26144
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Karaman
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Funding & Sponsors
Funding source category [1]
315803
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Hospital
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Name [1]
315803
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Karaman Training and Research Hospital
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Address [1]
315803
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Country [1]
315803
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Turkey
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Primary sponsor type
Hospital
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Name
Karaman Training and Research Hospital
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Address
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Country
Turkey
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Secondary sponsor category [1]
317928
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None
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Name [1]
317928
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Address [1]
317928
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Country [1]
317928
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314661
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Karamanoglu Mehmetbey Üniversitesi Tip Fakültesi Klinik Arastirmalar Etik Kurulu
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Ethics committee address [1]
314661
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Department of Anesthesiology and Intensive Care Medicine, Karamanoglu Mehmetbey University Faculty of Medicine, University Mh. Sehit Ömer Halis Demir Street Blok No:7 Interior No:1, Karaman, Turkey.
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Ethics committee country [1]
314661
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Turkey
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Date submitted for ethics approval [1]
314661
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11/08/2023
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Approval date [1]
314661
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13/09/2023
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Ethics approval number [1]
314661
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08-2023/06
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Summary
Brief summary
As an essential aspect of enhanced recovery after surgery, the advantages of preoperative oral carbohydrate loading (eg, improving patients' comfort during preoperative preparation, reducing nausea and vomiting, and reducing insulin resistance) have been shown by many studies. We hypothesized that in elderly patients undergoing total knee replacement surgery, preoperative oral carbohydrate loading would reduce the incidence of postoperative delirium and improve patient recovery.
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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 Tayfun Et
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Address
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Karaman Training and Research Hospital, Mh., 1984. Sk. No:1, 70200 Merkez/Karaman Merkez/Karaman, Türkiye.
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Country
132322
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Turkey
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Phone
132322
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+905063670717
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Fax
132322
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Email
132322
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[email protected]
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Contact person for public queries
Name
132323
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Tayfun Et
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Address
132323
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Karaman Training and Research Hospital, Mh., 1984. Sk. No:1, 70200 Merkez/Karaman Merkez/Karaman, Türkiye.
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Country
132323
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Turkey
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Phone
132323
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+905063670717
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Fax
132323
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Email
132323
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[email protected]
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Contact person for scientific queries
Name
132324
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Tayfun Et
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Address
132324
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Karaman Training and Research Hospital, Mh., 1984. Sk. No:1, 70200 Merkez/Karaman Merkez/Karaman, Türkiye.
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Country
132324
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Turkey
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Phone
132324
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+905063670717
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Fax
132324
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Email
132324
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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)?
No
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No/undecided IPD sharing reason/comment
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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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