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Trial registered on ANZCTR
Registration number
ACTRN12610001090000
Ethics application status
Approved
Date submitted
4/02/2008
Date registered
13/12/2010
Date last updated
6/01/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of intra-operative sedation with low-doses of S-Ketamine on depression in the elderly: randomized double-blind controlled trial
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Scientific title
Intra-operative sedation with S-Ketamine to improve depression in patients with mental depression.
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Secondary ID [1]
253280
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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:
Mental Depression
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Condition category
Condition code
Anaesthesiology
258956
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
70 elderly patients (62 men), from two Brazilian hospitals (Brasilia), classified as depressed (D) and not depressed (ND), according to the Diagnostic and Statistical Manual of Mental Disorders criteria, where divided randomly into four groups. Group D1 and ND1 used for sedation 10 mg of S- Ketamine, plus 1 mg of midazolam and groups D2 and ND2 only 1mg of Midazolam, in intravenous bolus, until 3-4 grade in Ramsay Scale was reached.
Primary efficacy measure was quantitatively estimated by the 21-item Hamilton Depression Rating Scale, one day before and one day after surgery.
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Intervention code [1]
2538
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Treatment: Drugs
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Comparator / control treatment
Groups D2 and ND2 receive 1mg of midazolam, in intravenous bolus, until 3-4 grade in Ramsay Scale was reached.
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Control group
Active
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Outcomes
Primary outcome [1]
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To access improvement of mental depression after treatment with S-ketamine, by using the 21 items Hamilton Depression Rating Scale.
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Assessment method [1]
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Timepoint [1]
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-the day before the surgery (after randomization)
-On the second day of the postoperative period
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Secondary outcome [1]
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To evaluate side effects of S-ketamine: nausea and vomits, allucinations, postoperative pain, cardiovascular effects, respiratory depression, sedation and amnesia.
To mesure them:a intraoperative non invasive blood pressure monitoring and ECG (cardiovascular effects), SpO2 (respiratory depression), Ramsay Scale (sedation), Visual analogic scale (pain) and by questioning the patient (nausea and vomits, psychedelic effects, amnesia)
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Assessment method [1]
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Timepoint [1]
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-the day before the surgery (after randomization)
-On the second day of the postoperative period
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Eligibility
Key inclusion criteria
age>60, males and females;spinal or epidural anaesthesia; patients with depression criteria according to Diagnostic and Statistical Manual of Mental Disorders; patients without depression (control).
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Minimum age
60
Years
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Maximum age
100
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 depression, but that scored < 7 (Hamilton Scale) ;
- arterial hypertension not correctly treated; -unstable angina; severe cardiovascular disease; anaemia (<10 g.dl ; hyper or hypothyroidism not correctly treated; morbid obesity; -convulsive episodes; - schizophrenia; -psychotic disorders; -drug addiction; -patients that used the last 15 days monoamine oxidase inhibitors and lithium
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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)
All patients scheduled for surgery with epidural or spinal anaesthesia were separated into depressed (D) and not depressed (ND) according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Then they were randomized into D1 (depressed with S-ketamine + midazolam), D2 (depressed with midazolam), ND1 (not depressed with S-ketamine + midazolam), ND2 (not depressed with midazolam).
We used for randomization sets of 10 sealed, opaque carbonate envelopes, at the time.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation: for randomization sealed, opaque envelopes were used. In the inside we could find the numbers 1 or 2 and the therapy was prepared accordingly. After that, the name of the patient was written in the envelope, the protocol used was included inside and the envelope was sealed again. It was not open until final results were evaluated.
All depressed patients that met the inclusion criteria were randomized in D1 and D2 groups.
In a sequence of 4 patients not depressed, one of them was elected and then randomized in ND1 and ND2 groups (the other 3 were excluded)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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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
20/05/2006
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Actual
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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
80
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
778
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Brazil
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State/province [1]
778
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Distrito Federal
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Funding & Sponsors
Funding source category [1]
258200
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Hospital
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Name [1]
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Hospital das Forcas Armadas
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Address [1]
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Estrada do Contorno do Bosque
CEP: 70.603-900
Brasilia
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Country [1]
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Brazil
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Primary sponsor type
Individual
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Name
Margarida Castanheira Rodrigues Bretas Bastos, MD
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Address
3 Temple Road
Dartry
Dublin 6
Ireland
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Country
Brazil
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Secondary sponsor category [1]
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University
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Name [1]
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Universidade Catolica de Brasilia
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Address [1]
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Campus Universitario
QS 07 Lote 01 EPTC
Aguas Claras
Taguatinga
CEP 72030-170
Brasilia, DF.
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Country [1]
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Brazil
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Other collaborator category [1]
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Individual
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Name [1]
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Edisio Pereira, MD, PhD
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Address [1]
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SQN 311, Bloco F Apt. 504
CEP 70757-060
BRASiLIA
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Country [1]
194
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Brazil
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Other collaborator category [2]
195
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Individual
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Name [2]
195
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Mauricio Gomes Pereira, MD PhD
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Address [2]
195
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QI 17 conjunto 5 casa 21.
Lago Sul
CEP: 71635250
Brasilia
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Country [2]
195
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Brazil
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Committee: Universidade Catolica de Brasilia (UCB).
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Ethics committee address [1]
5002
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Campus Universitario, QS 07 Lote 01 EPTC Aguas Claras Taguatinga, Cep 72030-170; Brasilia, DF.
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Ethics committee country [1]
5002
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Brazil
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Date submitted for ethics approval [1]
5002
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14/01/2006
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Approval date [1]
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20/05/2006
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Ethics approval number [1]
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number CEP/UCB 47/2006.
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Summary
Brief summary
OBJECTIVES: to determine whether S-ketamine, used as an intra-operative sedative, can alleviate depression, in the elderly, in the immediate postoperative period. To evaluate also if low doses of S-ketamine have no adverse side effects that can restrict its clinical use.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Margarida Castanheira Rodrigues Bretas Bastos, MD
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Address
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3 Temple Road
Dartry
Dublin 6
Ireland
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Country
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Ireland
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Phone
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353 872809987
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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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Margarida Castanheira Rodrigues Bretas Bastos, MD
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Address
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3 Temple Road
Dartry
Dublin 6
Ireland
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Country
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Ireland
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Phone
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353 872809987
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Fax
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Email
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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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