- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02635555
The Effects of Height and Weight Adjusted Dose of Local Anesthetic.
The Effects of Height and Weight Adjusted Dose of Local Anesthetic Compared to Standard Dose for Spinal Anesthesia in Elective Cesarean Section
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study design is prospective, randomized, double blind, placebo controlled.
Patients presenting for elective cesarean section under neuraxial block and meeting inclusion criteria will be randomized to two groups:
Group 1: Fixed dose group: Bupivacaine 12 mg, Fentanyl 15 mcg, Morphine 100 mcg Group 2: Height and weight adjusted bupivacaine dose, fentanyl 15 mcg, morphine 100 mcg Patients are fasted as per Canadian guidelines prior to the procedure. All patients have an IV cannula inserted,baseline vitals recorded and routine blood work checked prior to blockade. Routine monitoring (as per Canadian Anesthesia Society (CAS) guidelines) occur during and after the procedure. This includes pulse oximetry (SpO2), ECG and non-invasive blood pressure (NIBP). NIBP monitoring occurs every two minutes for the first 20 minutes post spinal and every 5 minutes thereafter. Oxygen via Hudson mask or nasal prongs is available if required.
Spinal anesthetic is performed with standard doses of drugs and the level of sensory block is tested with ice. Motor block is tested with Bromage scale just before prepping and draping. Once deemed adequate, surgery begins. During surgery, phenylephrine/ephedrine is given to maintain blood pressure as necessary. After surgery, patients are monitored in a recovery area until fit to be transferred to their rooms. If patient reports extreme discomfort or sharp pain during the surgery,conversion to general anesthetic is as per the discretion of the attending anesthesiologist.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ontario
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London, Ontario, Canada, N6A 5W9
- Victoria Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
ASA I and II patients aged 18-40 > 37 weeks gestation
- Scheduled for an elective c-section under spinal anesthetic
- Singleton pregnancy
- Patients height between 150-180cm and with a BMI of <35
- Subject understands the study and consents to participate
Exclusion Criteria:
Contraindication to neuraxial blockade
- Local anesthetic allergy
- Above or below our defined height and BMI criteria
- Emergency C-Section
- Complicated pregnancy including severe toxemia, pregnancy induced hypertension, and placenta previa
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Adjusted Spinal Dose
Patients in this group receive height and weight adjusted dose for spinal anesthesia.During surgery, phenylephrine/ephedrine is given to maintain blood pressure as necessary. Episodes of hypotension will be treated with these vasopressors . |
100 mcg of phenylephrine or 5 mg ephedrine given as deemed necessary for treating episodes of hypotension.
Other Names:
|
Active Comparator: Standard Spinal Dose
Patients in this group receive a fixed standard dose for spinal anesthesia. During surgery, phenylephrine/ephedrine is given to maintain blood pressure as necessary. Episodes of hypotension will be treated with these vasopressors . |
100 mcg of phenylephrine or 5 mg ephedrine given as deemed necessary for treating episodes of hypotension.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Maternal hypotension needing vasopressors.
Time Frame: Until the end of surgery
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Until the end of surgery
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time to adequate surgical anesthetic block
Time Frame: 24 hours after the surgery
|
24 hours after the surgery
|
incidence of nausea, vomiting, pruritus, and respiratory depression
Time Frame: 24 hours after the surgery
|
24 hours after the surgery
|
conversion to general anesthesia due to block failure
Time Frame: 1 hour
|
1 hour
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Shalini Dhir, FRCPC, Western University
Study record dates
Study Major Dates
Study Start (Actual)
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
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Hypotension
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Protective Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Cardiotonic Agents
- Respiratory System Agents
- Central Nervous System Stimulants
- Sympathomimetics
- Vasoconstrictor Agents
- Mydriatics
- Nasal Decongestants
- Adrenergic alpha-1 Receptor Agonists
- Ephedrine
- Phenylephrine
- Oxymetazoline
Other Study ID Numbers
- 107445
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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