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Trial registered on ANZCTR
Registration number
ACTRN12613000381785
Ethics application status
Approved
Date submitted
25/03/2013
Date registered
9/04/2013
Date last updated
9/04/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Bispectral index-guided general anaesthesia in combination with interscalene block reduces desflurane consumption in arthroscopic shoulder surgery: a clinical comparison of bupivacaine versus levobupivacaine
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Scientific title
General anaesthesia in combination with interscalene block reduces desflurane consumption in arthroscopic shoulder surgery: a clinical comparison of bupivacaine versus levobupivacaine
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Secondary ID [1]
282172
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none
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Universal Trial Number (UTN)
none
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Trial acronym
Interscalene block plus general anaesthesia and Desflurane consumption
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Patients who had rotator cuff tears or shoulder instability or calcific tendonitis tendinitis were included in this prospective, randomized, double-blind clinical trial.
288683
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Condition category
Condition code
Anaesthesiology
289030
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The patients were allocated into one of three groups in a double-blind manner. Group B (n=20) received a single-shot interscalene brachial plexus block with bupivacaine 0.25% (Marcaine, Astra Zeneca, Sweden) 40 ml before induction. Group L (n=20) received a single-shot ISB with levobupivacaine 0.25% (Chirocaine, Abbott Laboratories, North Chicago, USA) 40 ml before induction in combination with GA.Skin puncture was performed, and the needle was advanced until a contraction of the deltoid or biceps muscle appeared.After evidence of a successful sensory and motor block was obtained, the patients received a standardized anesthetic protocol.Following administration of 100% oxygen, anaesthesia was induced with IV thiopental 5-7 mg/ml and IV fentanyl 2 µg/kg.Then the patients received IV rocuronium 0.6 mg/kg, and the trachea was intubated so that the lungs were mechanically ventilated with a tidal volume of 8-10 ml/kg, with the ventilatory rate adjusted to maintain an end-tidal carbon dioxide concentration (partial pressure) of 30-35 mm Hg. Anaesthesia was continued with delivered (FD) desflurane 6% (FD desflurane Suprane®, Baxter, Puerto Rico, USA) in 60% nitrous oxide with oxygen, and the fresh gas flow was standardized. The desflurane concentration was then titrated to keep the BIS score in the 40-60 range. If the BIS value was less than 40 for more than 30 seconds, the FD desflurane was decreased by 25%. Follow up period is during the surgery and postoperatively 24 hours
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Intervention code [1]
286780
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Treatment: Surgery
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Intervention code [2]
286781
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Not applicable
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Comparator / control treatment
Group C (n=20 - control group) received GA alone. Follow up period is during the surgery and postoperatively 24 hours
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Control group
Active
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Outcomes
Primary outcome [1]
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The goal of this study was to compare the influence of an interscalene brachial plexus block (ISB) performed with either bupivacaine or levobupivacaine in conjunction with general anaesthesia (GA) on desflurane consumption.The desflurane was administered by a Sigma Alpha vaporizer (Penlon Limited, UK), and the amount used was measured in milliliters after completion of each surgical procedure by refilling the vaporizer, which initially had been completely full.
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Assessment method [1]
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Timepoint [1]
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The first time point is the eye opening time after surgery.
It will be assessed at post anesthetic care unit.
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Secondary outcome [1]
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The secondary outcome isanalgesic requirements after surgery .Patient satisfaction (0 = not satisfied, 1 = moderate, 2 = good, 3 = very good) and postoperative pain scores [using a 10 cm Visual Analog Scale (VAS) in which 0 cm = no pain and 10 cm = the worst pain imaginable] were evaluated on arrival at the PACU and at two, four, six, eight, and 24 hours after surgery.
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Assessment method [1]
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Timepoint [1]
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the first day after surgery
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Eligibility
Key inclusion criteria
who underwent elective arthroscopic shoulder surgery by the same surgeon were included in this prospective, randomized, double-blind clinical trial.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
who had general contraindications for ISB, obstructive pulmonary disease, diabetes, neuropathy, contralateral diaphragmatic paralysis, a history of allergic reaction to any of the study drugs, ongoing hypnotic therapy, or any documented preoperative systemic disease that could interfere with general anaesthesia were excluded from the study
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary end point of this study was defined as a reduction in desflurane consumption. Sample size estimation was performed by using MINITAB 15 software. Sample size was predetermined by using a power analysis: a=0.05 and ß=0.2, and this showed that 19 patients per group would be sufficient.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/12/2010
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Actual
10/02/2011
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Date of last participant enrolment
Anticipated
30/12/2011
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Actual
28/09/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Turkey
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State/province [1]
4951
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Levent Ozturk
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Address [1]
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Ankara Ataturk Training and Research Hospital, Anesthesiology and Reanimation Department. Bilkent No: 2, Ankara. 06800
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Country [1]
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Turkey
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Primary sponsor type
Individual
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Name
Levent Ozturk
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Address
Ankara Ataturk Training and Research Hospital, Anesthesiology and Reanimation Department. Bilkent No: 2, Ankara. 06800
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Country
Turkey
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Secondary sponsor category [1]
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Individual
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Name [1]
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Elvin Kesimci
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Address [1]
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Ankara Ataturk Training and Research Hospital, Anesthesiology and Reanimation Department. Bilkent No: 2, Ankara. 06800
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Country [1]
285728
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288995
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Ethics Committee Number 5/Ankara
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Ethics committee address [1]
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Saglik Sokak No:2, Ankara. 06530
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Ethics committee country [1]
288995
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Turkey
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Date submitted for ethics approval [1]
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15/12/2009
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Approval date [1]
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23/02/2010
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Ethics approval number [1]
288995
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2229
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Summary
Brief summary
Purpose: The goal of this study was to compare the influence of an interscalene brachial plexus block (ISB) performed with either bupivacaine or levobupivacaine in conjunction with general anaesthesia (GA) on desflurane consumption, which was titrated to maintain the recovery profiles and postoperateve analgesia while also keeping the bispectral index score (BIS) between 40 and 60 in patients undergoing arthroscopic shoulder surgery. Methods: Sixty patients were prospectively randomized to receive GA with desflurane alone (group C) or in combination with a preoperative ISB by either bupivacaine (group B) or levobupivacaine (group L). Results: The eye opening time was 4.0 ± 2.5 minutes for group B, 4.6 ± 2.4 minutes for group L, and 6.2 ± 2.1 minutes for group C (p<0.05). Group B and group L saved 36% and 25% desflurane per unit time respectively when compared with group C (p<0.001and p<0.05) while the mean pain scores and analgesic requirements the first day after surgery were higher in group C (p<0.05). Conclusions: Because of lower desflurane consumption, a superior recovery profile, and a high degree of patient acceptance, this type of balanced anaesthesia may be preferred in arthroscopic shoulder surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Levent Ozturk
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Address
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Ankara Ataturk Training and Research Hospital. Bilkent No: 2, Ankara. 06800
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Country
38698
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Turkey
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Phone
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+903122912706
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Elvin Kesimci
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Address
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Ankara Ataturk Training and Research Hospital. Bilkent No: 2, Ankara. 06800
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Country
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Turkey
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Phone
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+903122912525/3006
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Fax
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Email
38699
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[email protected]
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Contact person for scientific queries
Name
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Elvin Kesimci
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Address
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Ankara Ataturk Training and Research Hospital. Bilkent No: 2, Ankara. 06800
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Country
38700
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Turkey
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Phone
38700
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+903122912525/3006
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Fax
38700
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Email
38700
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Bispectral index-guided general anaesthesia in combination with interscalene block reduces desflurane consumption in arthroscopic shoulder surgery: a clinical comparison of bupivacaine versus levobupivacaine
2015
https://doi.org/10.1186/s12871-015-0087-8
N.B. These documents automatically identified may not have been verified by the study sponsor.
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