- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02776189
Dexmedetomidine Verses Propofol for Paediatric MRI Brain (DPMP)
Comparative Study of Dexmedetomidine-midazolam Combination and Propofol-midazolam Combination for MRI Brain in Paediatric Patient
MRI though not painful requires deep sedation for children due to the loud noise created. With deep sedation comes respiratory depression so the interest in Dexmedetomidine. For standardization MRI brain was chosen and also for the fact that patients usually have history of convulsions where drugs like ketamine may not be a good option. Patients were recruited after ethics committee approval. After pre-medication with intranasal midazolam 0.2 mg/kg body weight, Intravenous access was established and then patients were divided in two groups. One group received intravenous propofol 2mg/Kg and infusion of 100mcg/per kg body weight per minute. The other group received intravenous bolus of Dexmedetomidine 1mcg/kg over 10 minutes and then a infusion of Dexmedetomidine 1mcg/kg/hour.
Primary out come was to study the recovery time of patients sedated with Dexmedetomidine compared to patients sedated with propofol for paediatric MRI brain. Secondary outcome were analysed in terms of time for induction,procedural disruptions due to awakening and haemodynamic stability . Follow up was done on phone for any adverse events.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Patients were evaluated on out patient department basis. On the day of MRI nil per oral status of 6 hours was confirmed and consent taken from the parent. In recovery room after recording of vitals, children were given intranasal midazolam 0.2mg/kg body weight. The intravenous line was secured after the child was sedated. Patients were then divided in two groups. In the MRI console, the dexmedetomidine group received intravenous dexmedetomidine 1mcg/kg body weight over 10 minutes. An intravenous infusion of dexmedetomidine was then started at 1mcg/kg/hour.
The propofol group received 2mg /kg of intravenous propofol and an infusion of 100mcg/kg/minute.
MRI monitoring included pulseoximetry, cardioscope, respiratory pattern and rate. Oxygen was delivered by nasal prongs. Primary outcome measured was the time for recovery.
Secondary outcomes were number of awakening during procedure, haemodynamic stability, induction time and any adverse events.
After MRI the children were observed in the recovery room and discharged after achieving 'modified aldred score' of 10. Vitals and any adverse events were recorded during this phase.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Maharastra
-
Mumbai, Maharastra, India, 400022
- Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- children posted for elective MRI brain
- American society of anaesthesiologist physical status I and II
Exclusion Criteria:
- age less than 1 year and more than 7 years
- American society of anaesthesiologist physical status III and IV
- emergency cases
- upper respiratory tract infection
- patients on digoxin and beta blockers
- allergy to study drugs
- Body mass index more than 35
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Midazolam & Dexmedetomidine
Intra nasal midazolam 0.2 mg per kg body weight before intravenous canulation.
Intravenous dexmedetomidine 1 mcg per kg body weight over 10 minutes followed by infusion of dexmedetomidine at dose of 1 mcg per kg body weight per hour till end of procedure
|
intravenous dexmedetomidine 1 mcg per kg body weight over 10 minutes followed by infusion of dexmedetomidine at dose of 1 mcg per kg body weight per hour till end of procedure
Other Names:
Intra nasal midazolam 0.2 mg per kg body weight before intravenous canulation
Other Names:
|
ACTIVE_COMPARATOR: Midazolam & Propofol
Intra nasal midazolam 0.2 mg per kg body weight before intravenous canulation.
Intravenous propofol 2 mg per kg body weight followed by infusion of propofol at a dose of 100 mcg per kg body weight per min till end of procedure
|
Intra nasal midazolam 0.2 mg per kg body weight before intravenous canulation
Other Names:
intravenous propofol 2mg per kg body weight followed by infusion of propofol at a dose of 100 mcg per kg body weight per min till end of procedure
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Recovery time
Time Frame: 4 hours after procedure
|
Recovery time - time from the end of the procedure till the patient achieves a Modified aldred score of 10.Modified Aldred Score- a score from 0- 10 considering 5 parameters of activity, oxygen saturation, respiration, circulation and consciousness each given score 0,1,2.
Score of 10 patients can be sent home after outpatient anaesthesia.
|
4 hours after procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time for induction
Time Frame: One hour
|
time for induction - time from administration of drug to the patient till the patient is sedated enough for allowing positioning for MRI
|
One hour
|
Procedural disruptions due to awakening of the patient
Time Frame: one hour
|
Number of patients in each group who had one or more awakening during the procedure was compared
|
one hour
|
Bradycardia
Time Frame: 6 hours
|
number of patients having bradycardia after induction till recovery was compared.
Bradycardia is heart rate less than 60 beats per minute
|
6 hours
|
Desaturation
Time Frame: 6 hours
|
Number of patients in each group that had desaturation was compared.
Desaturation was defined as drop in oxygen saturation of less than 98 percent inspite of supplemented oxygen.
Normal oxygen saturation as measured by pulse oximeter is 100 percent on room air.
|
6 hours
|
Collaborators and Investigators
Investigators
- Principal Investigator: nazmeen I Sayed, MBBS,DNB, Lokmanya Tilak Municipal Medical College and Hospital
- Principal Investigator: Naina Dalvi, MBBS,MD, Lokmanya Tilak Municipal Medical College and Hospital
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
Keywords
Additional Relevant MeSH Terms
- Central Nervous System Diseases
- Nervous System Diseases
- Brain Diseases
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Tranquilizing Agents
- Psychotropic Drugs
- Hypnotics and Sedatives
- Adjuvants, Anesthesia
- Anti-Anxiety Agents
- GABA Modulators
- GABA Agents
- Midazolam
- Propofol
- Dexmedetomidine
Other Study ID Numbers
- iec/30/12
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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