- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT02409979
Impact of Carbon Dioxide Insufflation and Water Exchange on Post-Colonoscopy Outcomes
Impact of Carbon Dioxide Insufflation and Water Exchange on Post-Colonoscopy Outcomes: A Randomized Controlled Trial
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Design: Prospective double blinded two-center randomized controlled trial. Methods: Colonoscopy with CO2 insufflation and water exchange-CO2, water exchange-AI; split-dose bowel preparation; on demand-sedation.
Control method: CO2 insufflation colonoscopy. Study methods: water exchange-CO2 colonoscopy, water exchange-AI colonoscopy.
Population: Consecutive 18 to 80 year-old first-time diagnostic outpatients. After informed consent, assignment to control or study arms based on computer generated randomization list with block allocation and stratification.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
California
-
Los Angeles, California, Förenta staterna, 91343
- Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System
-
-
-
-
CI
-
Iglesias, CI, Italien, 09016
- Digestive Endoscopy Unit, Ospedale S. Barbara
-
-
-
-
-
Ostrava, Tjeckien, 703 84
- Digestive Diseases Center, Vìtkovice Hospital
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- consecutive 18 to 80 year-old first-time diagnostic outpatients agreeing to start procedure without premedication
Exclusion Criteria:
- patient unwillingness to start the procedure without sedation/analgesia
- previous colorectal surgery
- proctosigmoidoscopy or bidirectional endoscopy
- patient refusal or inability to provide informed consent
- inadequate consumption of bowel preparation
- moderate or severe chronic obstructive pulmonary disease requiring oxygen
- medical history of CO2 retention
- history of inflammatory bowel disease
Studieplan
Hur är studien utformad?
Designdetaljer
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Dubbel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Aktiv komparator: Carbon dioxide method
Colonoscopy performed as usual, with the minimal CO2 insufflation required to aid insertion and adequate distension during withdrawal for exploration.
Washing allowed as needed.
Considered to be standard procedure.
|
Insufflation with CO2 during insertion and withdrawal phases of colonoscopy.
|
Experimentell: Water Exchange-CO2
Insufflation not used until the cecum is reached.
Infusion of a sufficient amount of water to render the lumen a slit to progress with the colonoscope.
Part of the infused water will be constantly suctioned back exchanging clean for opaque water.
Air pockets and residual feces will be always aspirated.
Withdrawal phase done using carbon dioxide insufflation.
|
Insertion using water exchange, withdrawal using CO2 insufflation.
|
Experimentell: Water Exchange-AI
Insufflation not used until the cecum is reached.
Infusion of a sufficient amount of water to render the lumen a slit to progress with the colonoscope.
Part of the infused water will be constantly suctioned back exchanging clean for opaque water.
Air pockets and residual feces will be always aspirated.
Withdrawal phase done using air insufflation.
|
Insertion using water exchange, withdrawal using air insufflation.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Change in abdominal bloating sensation after colonoscopy.
Tidsram: Within the first 24 hours after the procedure.
|
Change of patients' sensation of abdominal bloating.
Assessed by blinded observer just after examination, at discharge; and at 1, 3, 6, 12 and 24 hours after the procedure using a questionnaire given to patients.
Measured on an eleven-point Numeric Rating Scale (NRS): 0=none, 10=full bloating.
Results will be recorded by telephone recall.
|
Within the first 24 hours after the procedure.
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Change in pain score after colonoscopy.
Tidsram: Within the first 24 hours after the procedure.
|
Assessed by blinded observer just after examination, at discharge; and at 1, 3, 6, 12 and 24 hours after the procedure using a questionnaire given to patients.
Measured using an eleven-point NRS (0=none, 10=maximum pain).
Results will be recorded by telephone recall.
|
Within the first 24 hours after the procedure.
|
Real-time insertion pain.
Tidsram: 1 hour.
|
Pain assessed using a NRS (0=absence of pain, 2=simply "discomfort", 10=worst pain).
Before the procedure, an endoscopic nurse will explain the NRS scoring system to the patients.
At irregular intervals during colonoscopy (around 60 seconds) assisting nurse will ask patients about discomfort or pain.
The responses will be recorded, and the maximum pain score noted.
Colonoscopists not participating in gathering the informations.
|
1 hour.
|
Number of episodes of incontinence or of soiled underwear experienced in the 6 hours after colonoscopy.
Tidsram: 6 hours.
|
Recorded at discharge and assessed post-procedure up to 6 hours using a questionnaire given to patients.
Results will be recorded by telephone recall.
|
6 hours.
|
Number of flatus episodes post-procedure.
Tidsram: 24 hours.
|
Recorded at discharge and assessed post-procedure up to 24 hours using a questionnaire given to patients.
Results will be recorded by telephone recall.
|
24 hours.
|
Number of incontinence episodes post-procedure.
Tidsram: 6 hours.
|
Recorded at discharge and assessed post-procedure up to 6 hours using a questionnaire given to patients.
Results will be recorded by telephone recall.
|
6 hours.
|
Toilet use for bowel movement post-procedure.
Tidsram: 6 hours.
|
Recorded at discharge and assessed post-procedure up to 6 hours using a questionnaire given to patients.
Results will be recorded by telephone recall.
|
6 hours.
|
Patients' satisfaction with the procedure.
Tidsram: 24 hours.
|
Assessed post-procedure after 24 hours using a questionnaire given to patients (0=not satisfied, 10=very satisfied).
Results will be recorded by telephone recall.
|
24 hours.
|
Willingness to repeat colonoscopy.
Tidsram: 24 hours.
|
Assessed post-procedure after 24 hours using a questionnaire given to patients (0=not willing to repeat, 10=very likely to repeat).
Results will be recorded by telephone recall.
|
24 hours.
|
Interference of colonoscopy on work/normal activities the same day of the procedure.
Tidsram: Up to 12 hours.
|
Assessed post-procedure after 12 hours using a questionnaire given to patients (0=nothing at all, 10=a lot).
Results will be recorded by telephone recall.
|
Up to 12 hours.
|
Day of work missed the day after the procedure.
Tidsram: 24 hours.
|
Work activities missed the day after colonoscopy due to some effect of the procedure (yes, no).
Assessed post-procedure after 24 hours using a questionnaire given to patients.
Results will be recorded by telephone recall.
|
24 hours.
|
Andra resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Cecal intubation rate.
Tidsram: 1 hour.
|
Cecal intubation will be defined as reaching beyond the ileocecal valve with adequate visualization of the appendix orifice.
|
1 hour.
|
Cecal intubation time.
Tidsram: 1 hour.
|
Defined as the time for passage of the colonoscope from the rectum to the cecum.
|
1 hour.
|
Total procedure time.
Tidsram: 1 hour.
|
Total procedure time (including time required for water infusion, polyp resection or biopsy).
|
1 hour.
|
Adenoma detection rate.
Tidsram: 9 months.
|
Proportion of subjects with at least one adenoma of any size.
|
9 months.
|
On-demand sedation.
Tidsram: 1 hour.
|
Offered at patient request for a NRS score ≥2.
Medications given as per institutional regulation.
Dose titrated based on patients' reported real-time pain score, age, weight and comorbidity.
|
1 hour.
|
Oxygen desaturation.
Tidsram: 1 hour.
|
Significant oxygen desaturation (<85% for >15 seconds) will be recorded.
|
1 hour.
|
Vagal reaction.
Tidsram: 1 hour.
|
Vagal reaction (heart rate <60 beats per minute accompanied by excessive sweating, nausea and/or vomiting) will be recorded.
|
1 hour.
|
Samarbetspartners och utredare
Utredare
- Huvudutredare: Sergio Cadoni, MD, S. Barbara Hospital, Iglesias (CI) Italy
Publikationer och användbara länkar
Allmänna publikationer
- Sumanac K, Zealley I, Fox BM, Rawlinson J, Salena B, Marshall JK, Stevenson GW, Hunt RH. Minimizing postcolonoscopy abdominal pain by using CO(2) insufflation: a prospective, randomized, double blind, controlled trial evaluating a new commercially available CO(2) delivery system. Gastrointest Endosc. 2002 Aug;56(2):190-4. doi: 10.1016/s0016-5107(02)70176-4.
- Zubarik R, Fleischer DE, Mastropietro C, Lopez J, Carroll J, Benjamin S, Eisen G. Prospective analysis of complications 30 days after outpatient colonoscopy. Gastrointest Endosc. 1999 Sep;50(3):322-8. doi: 10.1053/ge.1999.v50.97111.
- de Jonge V, Sint Nicolaas J, van Baalen O, Brouwer JT, Stolk MF, Tang TJ, van Tilburg AJ, van Leerdam ME, Kuipers EJ; SCoPE consortium. The incidence of 30-day adverse events after colonoscopy among outpatients in the Netherlands. Am J Gastroenterol. 2012 Jun;107(6):878-84. doi: 10.1038/ajg.2012.40. Epub 2012 Mar 6.
- Lee YC, Wang HP, Chiu HM, Lin CP, Huang SP, Lai YP, Wu MS, Chen MF, Lin JT. Factors determining post-colonoscopy abdominal pain: prospective study of screening colonoscopy in 1000 subjects. J Gastroenterol Hepatol. 2006 Oct;21(10):1575-80. doi: 10.1111/j.1440-1746.2006.04145.x.
- Falt P, Liberda M, Smajstrla V, Kliment M, Bartkova A, Tvrdik J, Fojtik P, Urban O. Combination of water immersion and carbon dioxide insufflation for minimal sedation colonoscopy: a prospective, randomized, single-center trial. Eur J Gastroenterol Hepatol. 2012 Aug;24(8):971-7. doi: 10.1097/MEG.0b013e3283543f16.
- Cadoni S, Falt P, Gallittu P, Liggi M, Smajstrla V, Leung FW. Impact of carbon dioxide insufflation and water exchange on postcolonoscopy outcomes in patients receiving on-demand sedation: a randomized controlled trial. Gastrointest Endosc. 2017 Jan;85(1):210-218.e1. doi: 10.1016/j.gie.2016.05.021. Epub 2016 May 17.
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- PG.2015/3645
- Delibera 387/C 17 Marzo 2015 (Annan identifierare: Azienda USL 07 Carbonia, Regione Sardegna)
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Studerar en amerikansk FDA-reglerad produktprodukt
produkt tillverkad i och exporterad från U.S.A.
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
Kliniska prövningar på Buksmärtor
-
Korea University Anam HospitalKorea UniversityAvslutadSmärtmätning | Visual Analog Pain Scale
-
Alanya Alaaddin Keykubat UniversityAvslutadSterilisering, Tubal | Visual Analog Pain Scale
-
Turkish Ministry of Health, Kahramanmaras Provincial...RekryteringVisual Analog Pain ScaleKalkon
-
Technische Universität DresdenRekryteringAbdominal kirurgiTyskland
-
The Cleveland ClinicRekryteringAbdominal kirurgiFörenta staterna
-
Washington University School of MedicineAvslutadAbdominal kirurgiFörenta staterna
-
Sameh FathyAvslutadAbdominal kirurgiEgypten
-
Universidade Federal de Santa MariaAvslutad
-
The Cleveland ClinicIndragenAbdominal kirurgi
-
Bayside HealthNational Health and Medical Research Council, AustraliaAvslutadAbdominal kirurgiAustralien
Kliniska prövningar på Carbon dioxide method
-
Maastricht University Medical CenterAvslutadDyspepsi | Dyspepsi och andra specificerade störningar av magfunktionenNederländerna
-
Hôpital Léon BérardAvslutadN av 1 Studiedesign | Sprintprestanda | Carbon Spiked-sko | Kraft-hastighetsprofilFrankrike
-
Bial R&D Investments, S.A.AvslutadParkinsons sjukdomStorbritannien
-
Icahn School of Medicine at Mount SinaiNational Institute of Mental Health (NIMH)RekryteringFörsta episod psykos (FEP) | Klinisk högrisk för psykos (CHR)Förenta staterna
-
Institut CurieAktiv, inte rekryterandeTrippel negativ bröstcancer | Barncancer | Metastaserande Uveal melanom | Luminal B BröstcancerFrankrike
-
Arcispedale Santa Maria Nuova-IRCCSOtto Bock Healthcare Products GmbHAvslutad
-
Second Affiliated Hospital, School of Medicine,...Rekrytering
-
Forest LaboratoriesIndragenAnalfissurFörenta staterna