- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05474027
Reducing Hypotensive Anesthesia Use With TXA During Orthognathic Surgery
December 13, 2023 updated by: Brian Kinard, University of Alabama at Birmingham
Does Tranexamic Acid Reduce the Need for Deliberate Hypotensive Anesthesia Within Orthognathic Surgery? A Prospective Study
This prospective study will analyze the need for deliberate hypotensive anesthesia (DHA) during orthognathic surgery when tranexamic acid (TXA) is administered.
DHA has been proven to be effective although it comes with multiple risks related to organ hypoperfusion including kidney injury, stroke, and cardiac ischemia.
Therefore, it may be potentially safer for patients to avoid deliberate hypotensive anesthesia if TXA alone adequately controls blood loss and provides adequate surgical site visualization.
Study Overview
Status
Enrolling by invitation
Conditions
Detailed Description
Our goal is to enroll 50 patients.
Patients will be recruited from Dr. Kinard's regularly scheduled orthognathic cases at UAB Highlands Hospital.
The patient will be informed of the study in advance and have consent signed pre-operatively.
Patients will be evaluated for the following variables: sex, age, weight at time of surgery, preoperative hemoglobin, and preoperative hematocrit.
Patients will be included if they are undergoing bimaxillary orthognathic surgery at UAB Highlands Hospital.
All patients treated with orthognathic surgery already are provided 1g of TXA perioperatively and this will be continued through this study.
All patients will be treated with 1g of TXA perioperatively and the anesthesia team will be instructed to limit deliberate hypotensive anesthesia unless otherwise directed by the surgeon.
Perioperative and post-operative measurements will include: estimated blood loss, pre and post-operative hemoglobin, pre and post-operative hematocrit, average mean arterial pressure throughout the case (MAP), maximum MAP (excluding induction and emergence), minimum MAP (excluding induction and emergence), total MAP time under 65 mmHg, length of procedure, and surgeon evaluation of visual field throughout the procedure utilizing Fromme's ordinal scale.
Based on these factors, it will help determine the need for deliberate hypotensive anesthesia during orthognathic surgery when tranexamic acid is administered.
Study Type
Interventional
Enrollment (Estimated)
50
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Timothy Weber, MD
- Phone Number: (314) 750-5550
- Email: webertm@uab.edu
Study Contact Backup
- Name: Brian Kinard, DMD, MD
- Phone Number: (205) 934-5334
- Email: briankinard@uabmc.edu
Study Locations
-
-
Alabama
-
Birmingham, Alabama, United States, 35205
- UAB Hospital-Highlands
-
Contact:
- Brian Kinard, DMD, MD
- Phone Number: 205-934-5334
- Email: briankinard@uabmc.edu
-
Principal Investigator:
- Brian Kinard, DMD, MD
-
Sub-Investigator:
- Timothy Weber, MD
-
Sub-Investigator:
- Chad Dammling, DDS, MD
-
Sub-Investigator:
- Kenneth Taylor, DNP, CRNA
-
-
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
12 years to 75 years (Child, Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Bimaxillary orthognathic surgery completed at UAB Highlands Hospital
Exclusion Criteria:
- History of hypertension or previously diagnosed cardiac problems
- Bleeding diathesis
- TXA medically contraindicated
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: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients Receiving Tranexamic Acid with Avoidance of Hypotensive Anesthesia
|
The anesthesia team will be asked to avoid deliberate hypotensive anesthesia and maintain blood pressure closer to the patient's baseline throughout the surgery.
1g of tranexamic acid will be given intravenously to patient undergoing orthognathic surgery as routinely performed about 5-15 minutes before first surgical incision.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Surgeon's Analysis of Surgical Field Visualization
Time Frame: 1 year
|
The surgeon will evaluate surgical field visibility using Fromme's ordinal scale
|
1 year
|
Mean Arterial Pressure
Time Frame: 1 year
|
Tracking mean arterial pressures throughout surgery, evaluating if patient's blood pressure can be reliably kept around patient's baseline instead of deliberate hypotensive anesthesia.
|
1 year
|
Estimated Blood Loss
Time Frame: 1 year
|
Volume of blood loss recorded during surgical case
|
1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Brian Kinard, DMD, MD, University of Alabama at Birmingham
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 (Actual)
November 11, 2022
Primary Completion (Estimated)
December 1, 2025
Study Completion (Estimated)
December 1, 2025
Study Registration Dates
First Submitted
July 20, 2022
First Submitted That Met QC Criteria
July 22, 2022
First Posted (Actual)
July 26, 2022
Study Record Updates
Last Update Posted (Estimated)
December 14, 2023
Last Update Submitted That Met QC Criteria
December 13, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-300009440
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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