- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07734233
Spinal Versus General Anesthesia on Coagulation and Fibrinolysis During Transurethral Resection of the Prostate
Effects of Spinal Versus General Anesthesia on Coagulation and Fibrinolysis in Patients Undergoing Transurethral Resection of the Prostate: A Prospective Randomized Study
Studieoversikt
Status
Intervensjon / Behandling
Detaljert beskrivelse
Transurethral resection of the prostate (TURP) is one of the most commonly performed surgical procedures for benign prostatic hyperplasia. Surgical trauma activates both coagulation and fibrinolytic pathways, and prostate tissue possesses unique fibrinolytic properties due to its high concentration of plasminogen activators. The anesthetic technique may modify perioperative hemostasis through its effects on the neuroendocrine stress response.
The purpose of this prospective randomized study is to compare spinal anesthesia and general anesthesia with respect to perioperative and early postoperative changes in coagulation and fibrinolysis. Venous blood samples are obtained before surgery and at 1 and 24 hours after surgery for measurement of prothrombin time, activated partial thromboplastin time, international normalized ratio, fibrinogen concentration, and D-dimer levels.
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
-
-
Istanbul
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Istanbul, Istanbul, Tyrkia (Türkiye), 34265
- Sultangazi Haseki Training and Research Hospital
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
- Male patients
- Age ≥18 years
- Scheduled for elective bipolar transurethral resection of the prostate
- ASA physical status I-II
- Ability to provide written informed consent
Exclusion Criteria:
- History of deep vein thrombosis or pulmonary embolism
- Known inherited or acquired coagulation disorder
- Severe hepatic insufficiency
- Severe renal insufficiency
- Use of anticoagulants, antiplatelet drugs, or NSAIDs within 10 days before surgery
- Platelet count <100 × 10⁹/L
- INR >1.5
- aPTT >47 seconds
- Contraindications to spinal anesthesia
- Prostate malignancy
- ASA physical status III or higher
- Refusal to participate
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: spinal anesthesia
Participants received spinal anesthesia with hyperbaric bupivacaine for elective bipolar transurethral resection of the prostate (TURP).
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Spinal anesthesia was performed at the L4-L5 interspace using 12.5 mg of hyperbaric bupivacaine for elective bipolar transurethral resection of the prostate (TURP).
Standard intraoperative monitoring and perioperative management were applied.
|
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Aktiv komparator: general anesthesia
Participants received standardized general anesthesia for elective bipolar transurethral resection of the prostate (TURP).
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General anesthesia was induced with intravenous propofol, fentanyl, and rocuronium, and maintained with sevoflurane.
Standard intraoperative monitoring and perioperative management were applied during elective bipolar transurethral resection of the prostate (TURP).
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Prothrombin Time (PT) from Baseline to Postoperative Assessments
Tidsramme: Baseline, 1 hour after surgery, and 24 hours after surgery
|
Prothrombin time (PT) will be measured to evaluate perioperative changes in the extrinsic coagulation pathway.
Unit of Measure: Seconds
|
Baseline, 1 hour after surgery, and 24 hours after surgery
|
|
Change in Activated Partial Thromboplastin Time (aPTT) from Baseline to Postoperative Assessments
Tidsramme: Baseline, 1 hour after surgery, and 24 hours after surgery
|
Activated partial thromboplastin time (aPTT) will be measured to evaluate changes in the intrinsic coagulation pathway.
Units of measure: seconds
|
Baseline, 1 hour after surgery, and 24 hours after surgery
|
|
Change in International Normalized Ratio (INR) from Baseline to Postoperative Assessments
Tidsramme: Baseline, 1 hour after surgery, and 24 hours after surgery
|
INR will be measured as a standardized indicator of coagulation status.
Unit of Measure: Ratio
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Baseline, 1 hour after surgery, and 24 hours after surgery
|
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Change in Fibrinogen Concentration from Baseline to Postoperative Assessments
Tidsramme: Baseline, 1 hour after surgery, and 24 hours after surgery
|
Plasma fibrinogen concentration will be measured to evaluate changes in coagulation activity.
Unit of Measure: mg/dL
|
Baseline, 1 hour after surgery, and 24 hours after surgery
|
|
Change in D-dimer Concentration from Baseline to Postoperative Assessments
Tidsramme: Baseline, 1 hour after surgery, and 24 hours after surgery
|
Plasma D-dimer concentration will be measured to evaluate perioperative fibrinolytic activation.
Unit of Measure: mg/L
|
Baseline, 1 hour after surgery, and 24 hours after surgery
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Incidence of adverse events
Tidsramme: From induction of anesthesia until completion of surgery.
|
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From induction of anesthesia until completion of surgery.
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Samarbeidspartnere og etterforskere
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Urogenitale sykdommer
- Kjønnssykdommer
- Vaskulære sykdommer
- Kardiovaskulære sykdommer
- Kjønnssykdommer, mannlige
- Prostata sykdommer
- Mannlige urogenitale sykdommer
- Embolisme og trombose
- Trombose
- Prostatahyperplasi
- Organiske kjemikalier
- Anilider
- Amides
- Anilinforbindelser
- Aminer
- Anestesi og smertestillende
- Anestesi, ledning
- Anestesi
- Bupivakain
- Anestesi, ryggmarg
- Anestesi, generell
Andre studie-ID-numre
- 18-2024
Plan for individuelle deltakerdata (IPD)
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IPD-planbeskrivelse
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