- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00537472
Low Dose Spinal Bupivacaine for Total Knee Replacement and Recovery Room Wait Time
Low Dose Spinal Bupivacaine for Total Knee Arthroplasty and Recovery Room Wait Time
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
With the doses of bupivacaine currently being used in spinal anesthetics at our institution, patients' sensory blocks are often much higher than needed to achieve adequate surgical anesthesia. This translates into a prolonged waiting period in the recovery room before the level regresses down to the pre-existing standard for discharge to the ward, as well as the pre-existing level before a post-operative nerve block for extended pain relief can be performed. This prolonged period in the recovery room leads to general delays in operating room usage and thus surgical cancellations. The excessive drug doses currently used also put patients at risk for increasing side effects including low blood pressure, slow heart rates, and nausea and vomiting.
By using a reduced dose of bupivacaine in a spinal anesthetic for a one sided knee replacement, we hope to significantly reduce the recovery room waiting times until the criteria for recovery room discharge or completion of a post-operative nerve block are met, while still providing adequate surgical anesthesia.
Patients will receive either 9 mg (intervention dose) or 13 mg (control dose) of bupivacaine through a spinal injection. Once the patients enter the recovery room after surgery the level of their sensory block will be tested as per usual protocol by the recovery room nurses every 15 minutes until a predefined level has been reached, and the two groups will be compared.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ontario
-
Kingston, Ontario, Canada, K7L 2V7
- Kingston General Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing elective one-sided total knee replacement for osteoarthritis at our institution where spinal anesthesia has been chosen by the patient and the anesthetist
Exclusion Criteria:
- Contraindications to spinal anesthesia (such as increase pressure in brain, bleeding disorder, serious valvular heart disease, serious infection in the blood or on your lower back, certain neurological disorders such as multiple sclerosis, desire for a general anesthetic)
- Allergies to local anesthetics, morphine or fentanyl
- Both knees being done at same surgery
- Revision of a previous knee replacement
- Knee replacement for reasons other than osteoarthritis (such as rheumatoid arthritis)
- Potential for difficult intubation in case of need for general anesthetic
- Patients under 150 cm or over 200 cm
- BMI greater than 40
- Lack of patient consent or patient refusal
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: I
|
Bupivacaine 9 mg intrathecal single shot injection at start of surgery
|
Active Comparator: II
|
Bupivacaine 13 mg intrathecal single shot injection at start of surgery
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time from spinal injection of bupivicaine until recovery room discharge criteria met.
Time Frame: Until recovery room discharge post surgery
|
Until recovery room discharge post surgery
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Need for pharmacologic rescue from inadequate spinal block during the procedure.
Time Frame: Until end of surgery
|
Until end of surgery
|
Time from entrance into recovery room until criteria for a recovery room discharge are met
Time Frame: Until recovery room discharge criteria are met
|
Until recovery room discharge criteria are met
|
Time from entrance into recovery room until criteria for a femoral nerve block for post-operative pain control are met
Time Frame: Until criteria are met for post operative nerve block in recovery room
|
Until criteria are met for post operative nerve block in recovery room
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Melanie Jaeger, MD, FRCPSC, Staff anesthesiologist at Kingston General Hospital
- Study Director: Dale Engen, MD, FRCPSC, Staff anesthesiologist at Kingston General Hospital
- Study Director: Devin Sydor, MD, Anesthesiology resident at Kingston General Hospital/Queen's University
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 6106
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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