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Trial registered on ANZCTR
Registration number
ACTRN12608000091303
Ethics application status
Approved
Date submitted
14/02/2008
Date registered
15/02/2008
Date last updated
26/07/2011
Type of registration
Prospectively registered
Titles & IDs
Public title
Laparoscopic Humidification Trial. Warm Humid Insufflation for Laparoscopic Appendicectomy in Children: a Randomised Controlled Trial.
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Scientific title
Paediatric Laparoscopic Appendicectomy Humidification Trial: Does Warm Humid Insufflation Gas versus Cool Dry Gas result in Less Post-operative Pain?
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Secondary ID [1]
251884
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WARMIST
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Universal Trial Number (UTN)
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Trial acronym
WARMIST
Warm humid insufflation for Appendix Removal by Minimally Invasive Surgery Trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Laparoscopic Appendicectomy
2839
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Condition category
Condition code
Surgery
2971
2971
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The use of a laparoscopic humidification device to warm (to body temperature ) and humidify insufflation gas (carbon dioxide) for laparoscopic appendicectomy for the duration of the pneumoperitoneum
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Intervention code [1]
2569
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Treatment: Surgery
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Comparator / control treatment
Standard cool (room temperature) dry insufflation gas (carbon dioxide) for laparoscopic appendicectomy for the duration of the pneumoperitoneum
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Control group
Active
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Outcomes
Primary outcome [1]
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Number (%) of patients requiring post-operative morphine
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Assessment method [1]
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Timepoint [1]
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Within 48 hours of surgery
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Primary outcome [2]
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Dose of morphine used
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Assessment method [2]
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Timepoint [2]
3846
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In recovery and at 6 hourly intervals from the end of surgery
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Primary outcome [3]
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Post-operative pain scores
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Assessment method [3]
3847
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Timepoint [3]
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At 6 hourly intervals from the end of surgery
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Secondary outcome [1]
6479
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Length of stay in the Post-Anaesthetic Care Unit (PACU)
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Assessment method [1]
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Timepoint [1]
6479
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Time at discharge from PACU post-operatively
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Secondary outcome [2]
6480
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Length of hospital stay
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Assessment method [2]
6480
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Timepoint [2]
6480
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At discharge from hospital
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Secondary outcome [3]
6481
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The degree of fogging of the laparoscope lens
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Assessment method [3]
6481
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Timepoint [3]
6481
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Intraoperative - fogging score completed by surgeon immediately post-operatively
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Eligibility
Key inclusion criteria
Children with clinical signs of acute appendicitis undergoing laparoscopic appendicectomy
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Minimum age
8
Years
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Maximum age
14
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
Excluded criteria are previous open abdominal surgery, neurological disorder that may interfere with reliable use of patient controlled analgesia device (PCA), an abdominal prostheses such as a gastrostomy or ventriculo-peritoneal shunt, immunosuppression and allergy to morphine.
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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)
The surgical registrar / surgeon informs the acute theatre nurse coordinator that the patient will be a trial patient. The coordinator can then ensure the Theatre Trial Pack is available in theatre 2. The randomisation stream – Uncomplicated or Complicated – will need to be communicated to the theatre nursing staff.
The circulating nurse takes the top envelope from the appropriate pile – Uncomplicated or Complicated – and opens the sealed envelope to determine the allocation arm – Humidifier On or Off.
It is essential that the allocation is not revealed to the medical staff or the scrub nurse. It is essential that the allocation is not revealed to the medical staff or the scrub nurse.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random number generator using http://randomization.com. Stratification will take place for clinically generalised peritonitis (complicated) versus clinically localised appendicitis (uncomplicated).
Randomisation allocations placed in sequentially numbered opaque envelopes, a set for each stratification group.
The sequence will be concealed until recruitment is complete.
In theatre, at the request of the surgeon (surgical registrar) the circulating nurse will open the top envelope from either the peritonitis or localised appendicitis pile, as requested.
Prior to insufflation the circulating nurse will turn the humidifier on for patients randomised to the intervention arm, and leave it turned off for control patients.
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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
Not Applicable
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Type of endpoint/s
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
1/01/2010
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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
190
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
796
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New Zealand
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State/province [1]
796
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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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Auckland District Health Board
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Address [1]
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Park Road, Grafton
Private Bag 92024
Auckland
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Country [1]
3095
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New Zealand
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Primary sponsor type
Individual
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Name
James Hamill
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Address
Department of Paediatric Surgery
Starship Children's Hospital
Grafton Road, Grafton
Private Bag 92024
Auckland
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Country
New Zealand
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Auckland District Health Board
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Address [1]
2783
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Private Bag 92024
Auckland
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Country [1]
2783
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
5040
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Ethics committee address [1]
5040
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Ethics committee country [1]
5040
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Date submitted for ethics approval [1]
5040
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15/02/2008
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Approval date [1]
5040
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Ethics approval number [1]
5040
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Summary
Brief summary
In laparoscopic surgery, the use of dry, cold insufflation gas (to inflate the abdominal cavity for a clear view of operating field) results in the drying of the lining of the cavity, which has been suggested to be a negative determinant of length of recovery. Adult studies using warm humidified insufflation gas were suggestive of decreased post-operative pain, decreased fogging of the camera lens, decreased operative time and decreased length of Post-Anaesthetic Care Unit (PACU) stay - although findings were variable. No such studies have been done in children. This study will be the first in the paediatric population, aiming to measure; post-operative pain using the amount of PCA (patient controlled analgesia) morphine use; pain score; length of PACU and hospital stay and fogging of camera using Laparoscopic Fogging Criteria.
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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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James Hamill
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Address
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Department of Paediatric Surgery
Starship Children's Hospital
Private Bag 92024
Auckland
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Country
11534
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New Zealand
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Phone
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+64 9 3074949
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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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James Hamill
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Address
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Department of Paediatric Surgery
Starship Children's Hospital
Private Bag 92024
Auckland
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Country
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New Zealand
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Phone
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+64 9 3074949
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Fax
2462
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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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