- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02193568
Light Sedation or Intubated General Anesthesia in Patients With Brain Cancer Undergoing Craniotomy
A Prospective, Single-Blinded, Randomized Study of Awake vs Intubated General Anesthesia in Patients Undergoing Elective Craniotomy for Supratentorial Glioma Resection
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. To compare the overall hospital length of stay (LOS) in patients undergoing craniotomy with light sedation vs. general anesthesia.
SECONDARY OBJECTIVES:
I. To compare resource utilization between the two groups. II. To assess the frequency of post-operative delirium. III. To measure patient perceptions. IV. To track patient complications during hospital stay - nausea/vomiting, pain, hematology/lab stability, hemodynamic stability.
V. To track re-admission and extended hospital stay rates. VI. To compare cost of both approaches.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive light sedation (awake) and undergo craniotomy.
ARM II: Patients receive intubated general anesthesia and undergo craniotomy.
After completion of study, patients are followed up at 1month and 1 year.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Ohio
-
Columbus, Ohio, United States, 43210
- Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Non-pregnant females
- Elective craniotomy for supratentorial brain tumors
- Primary brain cancer (presumed gliomas with no radiographic or clinical evidence of metastatic disease to the brain)
- First craniotomy
- American Society of Anesthesiologists (ASA) I-III
- Body mass index (BMI) < 35
Exclusion Criteria:
- Posterior fossa tumor/approach for tumor resection requiring the prone position
- Traumatic lesions/hematomas
- Emergency case
- Systemic disease burden with metastatic tumor to the brain
- Presence of medical co-morbidities, which, in the opinion of the investigator complicates the surgical procedure or would require additional hospital stay
- Necessity of awake procedure requiring intraoperative participation of patient due to the presence of the lesion in eloquent brain areas
- Prisoners
- Pregnant women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Arm I (light sedation)
Patients receive light sedation (awake) and undergo craniotomy.
|
If patients experience excessive preoperative anxiety they will receive light sedation of midazolam 1 mg IV.In our standard practice, it is very rare that patients receive anxiolytic premedication for craniotomies, so it is unlikely that many will require midazolam.
Two IVs will be placed, one for infusion of meds and one for possible resuscitation.
Other Names:
Receive intubated general anesthesia
Other Names:
Undergo craniotomy
Other Names:
Ancillary studies
Other Names:
Undergo craniotomy
Other Names:
Ancillary studies
Other Names:
|
ACTIVE_COMPARATOR: Arm II (intubated general anesthesia)
Patients receive intubated general anesthesia and undergo craniotomy.
|
If patients experience excessive preoperative anxiety they will receive light sedation of midazolam 1 mg IV.In our standard practice, it is very rare that patients receive anxiolytic premedication for craniotomies, so it is unlikely that many will require midazolam.
Two IVs will be placed, one for infusion of meds and one for possible resuscitation.
Other Names:
Receive intubated general anesthesia
Other Names:
Undergo craniotomy
Other Names:
Ancillary studies
Other Names:
Undergo craniotomy
Other Names:
Ancillary studies
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare overall hospital length of stay for patients in each of 2 arms
Time Frame: Up to 1 year
|
Will be summarized for each arm and compared between light sedation and general anesthesia arm using two-sample test.
Regression model will also be used to study the association between the length of stay and the type of anesthesia with potential confounder variables.
|
Up to 1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare resource utilization between two groups
Time Frame: Up to 1 year
|
Compare costs of hospital stay, anesthesia, and surgery
|
Up to 1 year
|
Assess the frequency of post-operative delirium
Time Frame: Up to 1 year
|
Post-operative delirium will be assessed using the Memorial Delirium Assessment Scale (MDAS); a tool developed to measure the severity of delirium and reflects the main diagnostic criteria and symptoms of delirium.
The MDAS is structured as a ten-item, four-point clinician-rated scale (possible range, 0-30) designed to quantify the severity of delirium in medically ill patients.
A score of 13 has been recommended by the original authors as a cutoff for establishing the diagnosis of delirium.
|
Up to 1 year
|
Measure patient perceptions
Time Frame: Up to 1 year
|
Will be measured by asking patients about their overall positive experiences, if they understood rationale behind non-intubated craniotomy; necessary to improve outcomes and minimize complications; self-protection/preservation, if they appreciated receiving information before surgery to help them make informed decisions, and their trust in the surgeon via survey to be conducted at the conclusion of the inpatient stay, before hospital discharge
|
Up to 1 year
|
Track patient complications during hospital stay
Time Frame: Up to 1 year
|
Track patient nausea/vomiting, pain, hematology/lab stability, hemodynamic stability
|
Up to 1 year
|
Track re-admission and extended hospital stay rates
Time Frame: Up to 1 year from the date of surgery
|
Tracking will be done using the EMR and follow-up calls
|
Up to 1 year from the date of surgery
|
Collaborators and Investigators
Investigators
- Principal Investigator: James Elder, MD, Ohio State University Comprehensive Cancer Center
Publications and helpful links
Helpful Links
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 (ACTUAL)
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
- OSU-12161
- NCI-2014-01110 (REGISTRY: CTRP (Clinical Trial Reporting Program))
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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