Enhanced Recovery After Laparoscopic Sleeve Gastrectomy - a Randomised Controlled Trial

May 24, 2012 updated by: SACS, University of Auckland, New Zealand
The investigators wish to standardise and optimise perioperative care for consecutive patients undergoing laparoscopic sleeve gastrectomy for weight loss. The investigators will compare patients under a standardised perioperative care program to patients who undergo routine perioperative in our hospital and determine whether patients who had optimised perioperative care went home earlier and had fewer complications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

106

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • New Zealand
      • Auckland, New Zealand, 2025
        • Manukau Surgery Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients undergoing laparascopic sleeve gastrectomy for weight loss by surgeons who have agreed to participate in the study
  • Surgery occurs at Manukau Surgery Centre

Exclusion Criteria:

  • Surgery not occuring in Manukau Superclinic

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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: ERAS
The perioperative management of the patients in this arm will be according to a fast-track protocol designed by the investigators. The preoperative component of this program is the same as routine practice. Intraoperative and postoperative components which are different to routine practice are as described in the intervention section. This protocol is based on current literature regarding Enhanced Recovery After Surgery (ERAS).
Other: Enhanced Recovery After Surgey for Sleeve Gastrectomy

Intraoperative:

  1. Pre-op carbohydrate loading
  2. No pre-op GIK while NBM
  3. Pre-medication
  4. Dexamethasone 4mg as antiemetic, IV Paracetamol (first dose) Parecoxib 40mg
  5. Ondansetron regularly for first 48 hours and Cyclizine, Droperidol or Scopaderm as rescue antiemetics
  6. Fluid restriction
  7. Standardised method of anaesthesia
  8. Give 40ml 0.5% bupivacaine with adrenaline administered prior to placement of laparoscopic port sites
  9. 10ml 0.75% ropivacaine diluted to 50ml with 0.9% normal saline solution administered to surgical site prior to procedure

Postoperative:

  1. Rescue PCA for up to 12 hours. Oxynorm 5mg for rescue pain. Oxycontin 20mg bd/prn postoperatively
  2. Maintenance IV fluids (60ml/hr plasmalyte to be stopped 0800 day 1 post op). Clear oral fluids 2 hours post op. Bariatric free oral fluids morning of day 1
  3. Post operative oxygenation
  4. Incentive spirometry
  5. Drains (e.g. IDC) removed in recovery
  6. Full mobilisation 4-8 hours post op)
  7. Early Follow up
Other Names:
  • ERAS for sleeve gastrectomy
  • Fast-Track for sleeve gastrectomy
No Intervention: non ERAS
The perioperative management of patients in this arm will be according to routine practice currently implemented at our institution.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of Hospital Stay
Time Frame: day of discharge
The trial intends to investigate whether median length of hospital stay for patients under a standardised optimised perioperative care program is less than patients who have routine perioperative care that undergo the same operation.
day of discharge

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Complications
Time Frame: 30 days
The study will investigate complication rate for each group identifying incidence, type and severity of complication according to the Clavien Dindo Classification system
30 days
Readmission rates
Time Frame: 30 days
The number of patients per group who represent to hospital for any reason during a 30 day period after the day of surgery
30 days
Postoperative fatigue
Time Frame: Baseline and postoperative days 1, 7 and 14
A measure functional recovery after surgery as measured by the validated surgical recovery scale.
Baseline and postoperative days 1, 7 and 14
Compliance to the ERAS protocol
Time Frame: through to day 1 postoperatively
Prospectively recording whether components of the ERAS programme are being carried out as per protocol.
through to day 1 postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Auckland, New Zealand

Collaborators

Auckland Medical Research Foundation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2011

Primary Completion (Actual)

May 1, 2012

Study Completion (Actual)

May 1, 2012

Study Registration Dates

First Submitted

February 24, 2011

First Submitted That Met QC Criteria

February 24, 2011

First Posted (Estimate)

February 25, 2011

Study Record Updates

Last Update Posted (Estimate)

May 25, 2012

Last Update Submitted That Met QC Criteria

May 24, 2012

Last Verified

May 1, 2012

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BariatricFastTrack

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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