- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01303731
Comparison of Standard and Minidose Spinal Anesthesia for Cesarean Section Operation Using Marcaine Spinal 0.5% Heavy
Phase IV, Randomized, Parallel Designed, Single Blinded Study, Comparing the Standard and Minidose Spinal Anesthesia Using Marcaine Spinal 0.5% Heavy With Addition of Fentanyl During Cesarean Section
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Spinal anesthesia is the most frequent type of anesthesia used for Cesarian Section. However, despite decades of safe utilization there is still controversy about the best combination of local anesthetics and additives needed to obtain the optimal result. The objectives of this study is to test a combination of low dose local anesthetic Bupivacaine diluted in patient's CSF with lipophilic opiate Fentanyl for compliance with the criteria of optimal spinal anesthesia. Bupivacaine is the most frequently used local anesthetic in the last twenty years . It characterized by fast onset, high potency and long action . Albeit this is intrinsic characteristic of specific local anesthetic, its manifestation can be affected by concentration. It has been shown that dilution of local anesthetic with CSF can result in sensory block with less profound motor block.
Thus dilution of Bupivacaine with CSF in our study would serve double function: it would speed the recovery from the spinal anesthesia and minimize the expression of the motor block.Addition of opiates to local anesthetics has been widely used . It has been shown that this addition improves quality of spinal anesthesia and prolongs analgesia without significant prolongation of recovery from motor block.
In summary, we would use well known safe local anesthetic Bupivacaine in low dose and low concentration (after dilution with patient's CSF) in conjunction with highly lipophilic opiate Fentanyl. We suppose it will result in effective spinal anesthesia with relatively limited motor block, quick recovery of motor function and relatively long lasting analgesia. We expect lower incidence of side effect with this combination than with convenient dose of Bupivacaine.
Good pain relief and swift restoration of ability to ambulate will be important for prevention of postoperative complications, will diminish the need for systemic analgetic drugs that can affect nursing and will increase patients' satisfaction.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Boris Yanovsky, MD
- Phone Number: +972 50 626788
- Email: boris.yanovsky@b-z.org.il
Study Locations
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-
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Haifa, Israel
- Bnai Zion Medical Center
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Contact:
- Boris Yanovsky, MD
- Email: boris.yanovsky@b-z.org.il
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Principal Investigator:
- Boris Yanovsky, MD
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women over 38 weeks of pregnancy, who read and write Hebrew
- ASA class I and II
- Age between 18 and 40 years
- Weight 50-100 kg
- Elective Cesarean Section for singlet pregnancy
Exclusion Criteria:
- Previous history of two or more Cesarean Sections
- Contraindications for regional anesthesia
- Active pain before surgery
- Non singlet pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Standard dose Marcaine Spinal 0.5% Heavy
Standard group - will receive spinal anesthesia induced by Marcaine Spinal 0.5% Heavy 12.5 mg (2.5 ml).
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Spinal anesthesia with Marcaine Spinal 0.5% Heavy 12.5 mg (2.5 ml)
Other Names:
|
Experimental: Minidose of Marcaine Spinal 0.5% Heavy
Minidose group - will receive spinal anesthesia induced by Marcaine Spinal 0.5% Heavy 7.5 mg (1.5 ml) diluted in 0.75ml of patient's CSF (0.25 ml)with addition of Fentanyl 12.5 mcg (total 2.5 ml)
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Spinal anesthesia with Marcaine Spinal 0.5% Heavy 7.5 mg (1.5 ml) diluted in 0.75ml of patient's CSF (0.25 ml)with addition of Fentanyl 12.5 mcg (total 2.5 ml)
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
prominence of motor blockade
Time Frame: up to 2 h
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At the begining of the surgery and at the entry of the patients to PACU motor block will be evaluated
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up to 2 h
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
operative condition
Time Frame: up to 1 h
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Upon completion of surgery attending surgeon will be asked to rate the operative condition.
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up to 1 h
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intraoperative hypotension
Time Frame: up to 1 h
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Number of treatments for hypotensions during the surgery will be monitored.
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up to 1 h
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need for postoperative pain medication
Time Frame: up to 2 h
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The pain or discomfort intensity during the surgery, and at PACU will be graded.
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up to 2 h
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general patient satisfaction
Time Frame: after 24 h
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On the next day, all patients will be asked to rate their satisfaction following the anesthesia.
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after 24 h
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Boris Yanovsky, MD, Bnai Zion Medical Center, Haifa, Israel
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0123-10-BZ
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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