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Trial registered on ANZCTR
Registration number
ACTRN12605000771651
Ethics application status
Approved
Date submitted
29/11/2005
Date registered
30/11/2005
Date last updated
26/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
A prospective comparison of early post-operative analgesia in Caesarean Section using bilateral ilio-inguinal block and sub-cutaneous morphine
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Scientific title
A prospective comparison of early post-operative analgesia in Caesarean Section using bilateral ilio-inguinal block and sub-cutaneous morphine
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Secondary ID [1]
288003
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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:
Caesarean Section
927
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Condition category
Condition code
Reproductive Health and Childbirth
995
995
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0
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Fertility including in vitro fertilisation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Bilateral ilio-inguinal nerve blocks will be performed at the end of surgery (with 1% ropivicaine (long acting local anaesthetic)), patients will be followed for 24 hours after surgery
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Intervention code [1]
775
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Treatment: Drugs
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Comparator / control treatment
Bilateral ilio-inguinal nerve blocks will be performed at the end of surgery (with saline (placebo)), patients will be followed for 24 hours after surgery
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Control group
Active
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Outcomes
Primary outcome [1]
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Analgesia: Morphine use
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Assessment method [1]
1325
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Timepoint [1]
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At 6 and 24 hours
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Primary outcome [2]
1326
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Analgesia: time to first anlgesia
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Assessment method [2]
1326
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Timepoint [2]
1326
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The second primary outcome is "time to first analgesia request", therefore the time point is the outcome
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Primary outcome [3]
1327
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Analgesia: VAS scores of pain
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Assessment method [3]
1327
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Timepoint [3]
1327
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VAS scores will be taken at 6 and 24 hours
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Secondary outcome [1]
2368
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Presence and severity of opiod side effects (nausea, vomiting, itch, sedation).
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Assessment method [1]
2368
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Timepoint [1]
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In first 24 hrs.
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Eligibility
Key inclusion criteria
Those scheduled to undergo elective lower uterine segment Caesarean Section for singleton term pregnancy (>37 weeks gestation). Both multiparous and primparous women will be included.
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Minimum age
Not stated
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Maximum age
Not stated
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Inability/unwillingness to give informed consent to participate*Significantly limited English*Height <155cm or >185cm (which may require adjustment of spinal dose)*BMI >35 (which may require adjustment of spinal dose)*Conditions associated with a large uterus (macrosomia, polyhydramnios, multiple pregnancy) or small uterus (intra-uterine growth retardation) which may require adjustment of spinal dose*Classical Caesarean incision*Anticipated complex surgery (eg. multiple previous laparotomies, including >2 previous Caesarean Sections) or additional procedures planned (eg. tubal ligation) which may increase post-operative pain and analgesic requirements*Contra-indication to spinal anaesthesia (such as lack of informed consent, local or generalised infection, coagulopathy, medical or obstetric conditions precluding spinal anaesthesia (eg. significant valvular heart disease, high grade placenta praevia)*Allergy/sensitivity to local anaesthetic, paracetamol, fentanyl, morphine*Allergy/sensitivity to non-steroidal anti-inflammatories (diclofenac), including such conditions as renal impairment, peptic ulcer disease, severe (NSAID-sensitive) asthma*Inability or unwillingness to use a PCA device.
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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)
numbered envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer generated random number table
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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 4
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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
1/02/2006
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Actual
1/03/2006
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Date of last participant enrolment
Anticipated
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Actual
1/07/2006
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
120
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Accrual to date
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Final
21
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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]
1093
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Royal Women's Hospital
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Address [1]
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Royal Women's Hospital
Grattan St
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 Women's Hospital
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Address
Flemington Rd, Parkville Vic 3052
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Country
Australia
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Secondary sponsor category [1]
953
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None
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Name [1]
953
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Nil
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Address [1]
953
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Country [1]
953
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Women's Hospital
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Ethics committee address [1]
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Grattan St 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]
293925
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01/02/2006
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Approval date [1]
293925
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01/02/2006
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Ethics approval number [1]
293925
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n/a
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Summary
Brief summary
Anaesthesia for Caesarean Section is most often performed by an injection of intra-thecal (spinal) or epidural local anaesthetic. This wears after 2-4 hours after which pain needs to be controlled with other agents. The principal class of drugs used for this analgesia are the opioid drugs (eg. oxycodone, codeine or morphine), all of which cause side effects such as nausea, vomiting, itch and sedation. Bilateral ilio-inguinal blocks (superficial injections on each side of the abdominal wall) have been shown to be effective after general anaesthetic in reducing opioid requirements after Caesarean Section. They are also used routinely for procedures such as inguinal hernia repair. We propose to recruit 120 patients undergoing elective Caesarean Section and randomise them to receive ilio-inguinal blocks with either ropivacaine (a long acting local anaesthetic) or saline (placebo). Those who receive placebo blocks will be given subcutaneous morphine at the end of the procedure (the current standard care). We will review patients at 6 and 24 hours seeking a decrease in pain scores, opioid requirements and opioid side effects.
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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 James Griffiths
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Address
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Royal Women's Hospital
Grattan St
Parkville, Vic 3052
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Country
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Australia
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Phone
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+61418306793
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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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Dr Phil Popham
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Address
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Department of Anaesthesia
Royal Women's Hospital
Carlton VIC 3052
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Country
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Australia
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Phone
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+61 3 93442000
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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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Dr James Griffiths
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Address
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PO Box 2002
Ivanhoe East VIC 3079
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Country
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Australia
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Phone
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+61 418306793
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Fax
892
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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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