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Trial registered on ANZCTR
Registration number
ACTRN12609000297224
Ethics application status
Approved
Date submitted
12/03/2009
Date registered
18/05/2009
Date last updated
9/12/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Does prewarming children improve outcomes in children with cerebral palsy having major lower limb surgery?
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Scientific title
A randomised study assessing the effect of prewarming on outcomes of children with cerebral palsy undergoing orthopaedic surgery to prevent hypothermia
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Secondary ID [1]
284143
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Nil
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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:
Children with severe cerebral palsy undergoing elective bilateral femoral valgus derotational osteotomies
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Condition category
Condition code
Anaesthesiology
4736
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0
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Other anaesthesiology
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Surgery
4739
4739
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0
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Other surgery
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Neurological
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is for patients to lie in a bed and be prewarmed with a forced air warming blanket set at 40 degrees for one hour prior to induction of anaesthesia.
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Intervention code [1]
4211
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Treatment: Other
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Comparator / control treatment
The control group will receive routine care (ie: no prewarming). The control group are not required to lie on a theatre trolley for an hour prior to their surgery and will simply wait for their operation as they would for usual surgery.
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Control group
Active
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Outcomes
Primary outcome [1]
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To determine whether prewarming can prevent hypothermia. Skin temperature and core temperature (tympanic) will be measured pre and post anaesthesia. During anaesthesia, temperature will be measured using an oesophageal temperature probe.
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Assessment method [1]
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Timepoint [1]
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Temperature will measured pre-operatively, intra-operatively and post-operatively every 30 minutes until discharge from the post-anaesthesia care unit (PACU).
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Secondary outcome [1]
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To determine whether prewarming effects the duration of recovery from anaesthesia.
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Assessment method [1]
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Timepoint [1]
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Time spent in the post anaesthesia care unit (from arrival until discharge).
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Secondary outcome [2]
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To determine whether prewarming effects the amount of surgical blood loss. To assess intraoperative and postoperative blood loss we will use (a) Weighing packs, (b) Measuring Drains and (c) Haemoglobin Balance method.
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Assessment method [2]
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Timepoint [2]
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Blood loss measured intraoperatively and postoperatively. These measurements will take place at frequent intervals within these periods.
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Secondary outcome [3]
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To determine whether effects the rate of wound infections. Wounds will be classified as infected if there was a purulent discharge or painful erythema that lasted for 5 days and was treated with antibiotics within 6 weeks of surgery.
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Assessment method [3]
9433
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Timepoint [3]
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Postoperative wound infection will be assessed during their inpatient stay and also in their scheduled outpatient visits at 3 and 6 weeks post discharge.
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Eligibility
Key inclusion criteria
1)Children with severe cerebral palsy undergoing elective bilateral femoral valgus derotational osteotomies
2) Children aged between 5 -20 years
3) Any weight
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Minimum age
5
Years
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Maximum age
20
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
1) Any contraindication to inhaled anaesthetic agents (desflurane/nitrous oxide) (eg: malignant hyperthermia)
2) Severe comorbidities that require postoperative admission to intensive care.
3) Contraindications to epidural anaesthesia
(eg: iatrogenic or pathological coagulopathy or platelet dysfunction, local Sepsis, parental refusal to consent)
3) Ambient room temperature > 28 degrees in the pre-surgical centre
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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)
Patients will be identified from the orthopaedic booking list. Patients routinely attend the hospital in the week(s) prior to their surgery. At this point, they will be assessed for inclusion in the study. If they are eligible and the parents provide informed consent, they will be randomised into the study. The allocation concealment was carried out using sealed opaque envelopes. The study will be single blinded (the patient and parent will be aware which treatment group they are allocated to, the anaesthetist will be aware, the surgeon will be blinded, the recovery nurse assessing readiness for discharge will be blinded).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will undergo computer generated block randomisation into two groups: prewarmed versus routine care. Blocks will not be of fixed length.
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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
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Date of first participant enrolment
Anticipated
30/03/2009
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Actual
10/02/2010
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Date of last participant enrolment
Anticipated
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Actual
22/08/2011
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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
13
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Recruitment in Australia
Recruitment state(s)
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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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Royal Children's Hospital
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Address [1]
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Flemington Road,
Parkville
VIC 3052
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Children's Hospital
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Address
Flemington Road,
Parkville
VIC 3052
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Country
Australia
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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]
4204
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Children's Hospital Research Ethics Committee
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Ethics committee address [1]
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Royal Children's Hospital Flemington Road, Parkville VIC 3052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
6693
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Approval date [1]
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24/07/2008
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Ethics approval number [1]
6693
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27157
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Summary
Brief summary
This is a controlled single-blind randomised study assessing the effect of prewarming on outcomes of patients with severe cerebral palsy undergoing major orthopaedic surgery. The study objectives are to assess the effect of prewarming participants prior to anaesthesia with regard to: i) Avoiding hypothermia. ii) Duration of recovery from anaesthesia. iii) Amount of surgical blood loss. iv) Rate of wound infections.
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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 Ben Hallett
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Address
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Department of Anaesthesia & Pain Management
Royal Children's Hospital
Flemington Road
Parkville VIC 3052
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Country
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Australia
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Phone
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+61393455233
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Fax
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+61393456003
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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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Suzette Sheppard
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Address
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Department of Anaesthesia
Royal Children's Hospital
Flemington Road,
Parkville
VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5233
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Fax
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+61 3 9345 6003
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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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Dr Ben Hallett
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Address
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Department of Anaesthesia
Royal Children's Hospital
Flemington Road,
Parkville
VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5233
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Fax
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+61 3 9345 6003
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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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