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Trial registered on ANZCTR
Registration number
ACTRN12613000719730
Ethics application status
Approved
Date submitted
26/06/2013
Date registered
1/07/2013
Date last updated
1/07/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Supraglottic Airway Devices and effect on phonation - comparison of Proseal LMA and I-gel airway
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Scientific title
ASA 1 adults undergoing elective procedures with airway secured by either PLMA or I-gel airway and post-operative phonatory changes
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Secondary ID [1]
282741
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none
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Universal Trial Number (UTN)
U1111-1145-0535
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Postoperative phonatory dysfunction
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Dysphonia
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Condition category
Condition code
Anaesthesiology
289795
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0
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Anaesthetics
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Other
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0
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Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Placement of Supraglottic Airway Devices - either I-gel or Proseal LMA under anaesthesia. Pre and Post operative strobolaryngoscopy and phonetic analysis of voice
I-gel is a newly introduced supraglottic airway device, classified as a cuff less pharyngeal sealer. After administration of general anesthesia and muscle relaxation, airway is placed in oropharynx with tip resting in the upper esophageal sphincter. Square wave capon gram and effective chest raise confirms satisfactory placement.
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Intervention code [1]
287404
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Treatment: Devices
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Comparator / control treatment
Active control- Proseal LMA
Proseal LMA is among the most commonly used supraglottic airway devices during anesthesia, classified as a cuffed peri laryngeal sealer with directional sealing and drain tube for stomach. After administration of general anesthesia and muscle relaxation, airway is placed in oropharynx with tip resting in the upper esophageal sphincter. After cuff inflation and ventilation, square wave capon gram and effective chest raise confirms satisfactory placement.
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Control group
Active
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Outcomes
Primary outcome [1]
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Postopertive pharyngolaryngeal morbidity including phonatory changes
Phonatory changes are assessed perceptively by speech pathologist by classifying the voice into normal, rough, breathy and asthenia patterns. Phonetic analysis of voice is performed and jitter, shimmer and Harmonic to Noise ratio are analysed as indicators of micro instability of vocal cords
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Assessment method [1]
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Timepoint [1]
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24 hours after surgery
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Secondary outcome [1]
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Vocal cord dysfunction
Phonetic analysis of voice is done by using PRAAT software. Jitter, Shimmer and Harmonic to Noise ratio are analysed which are found to correlate with micro instability of vocal cords
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Assessment method [1]
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Timepoint [1]
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24 hours after surgery
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Eligibility
Key inclusion criteria
Adults belonging to ASA 1 & 2 physical status undergoing surgeries for 60-120 min under general anaesthesia
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Minimum age
18
Years
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Maximum age
70
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
Head and neck surgeries, surgeries lasting >120 min, anticipated difficult airway, preoperative abnormality in voice
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Study design
Purpose of the study
Prevention
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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)
Sealed opaque envelopes
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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 receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2010
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Actual
2/08/2010
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Date of last participant enrolment
Anticipated
4/06/2012
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Actual
4/06/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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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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India
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Jawaharlal Institute of Postgraduate Medical Education and Research
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Address [1]
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JIPMER, kamraj Street, Puducherry, India 605006
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Country [1]
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India
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Primary sponsor type
University
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Name
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry
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Address
JIPMER, Kamaraj Street, Puducherry, India 605006
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Country
India
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Institute Ethics committee ( Human Studies ), JIPMER, Puducherry
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Ethics committee address [1]
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JIPMER, Kamraj street, Puducherry , India 605006
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Ethics committee country [1]
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India
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Date submitted for ethics approval [1]
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02/07/2010
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Approval date [1]
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13/01/2011
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Ethics approval number [1]
289488
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Summary
Brief summary
Background: Nerve palsies with Proseal laryngeal mask airway (PLMA) are attributed to nerve compression by the inflated cuff. Cuffless anatomically pre-shaped sealers like I–gel airway (IGA) may minimize nerve compression. Materials and methods: Ninety ASA1 adults scheduled for surgeries lasting up to 60 to 120 min were included in the study. Participants were randomly allocated to group PLMA (n=43) and group IGA (n=43). Vocal cord function was evaluated by strobolaryngoscopy, perceptive and phonetic analysis of voice (Jitter, Shimmer and Harmonic to Noise Ratio) preoperatively and 24 hours after surgery. Voice of patients with pharyngolaryngeal complaints was categorized into rough, breathy, asthenic, strain or normal pattern. Results: Jitter (p<0.002), Shimmer (p<0.000) and Harmonic to noise ratio deteriorated significantly in both groups albeit the change being similar in both groups. Incidence of pharyngolaryngeal complaints was 20% and 22.5% in group PLMA and IGA respectively. 10% patients in group PLMA and 12.5% in group IGA developed breathy voice and demonstrated significant deterioration in all phonetic variables. Vocal fold anomalies on stroboscopy were detected in 2 patients in each group. Conclusion: PLMA and IGA both produce significant deterioration in phonetic variables suggesting vocal cord dysfunction after 1 – 2 hours of anaesthesia.
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Trial website
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Trial related presentations / publications
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Public notes
Institution ethical committee meeting is held within the month after the submission of study protocol i.e. on 02/07/2010 in this particular study, and provisional approval is obtained for recruitment of patients. The final approval is obtained in the form of a certificate after further scrutiny of the study protocol, and this has been the institution practice i.e. 13/01/2011 in this study
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Contacts
Principal investigator
Name
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Dr Shriram Vaidya
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Address
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Department of Anaesthesiology, JIPMER, Puducherry , India 605006
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Country
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India
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Phone
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+918903139960
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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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Shriram Vaidya
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Address
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Department of Anaesthesiology, JIPMER, Puducherry , India 605006
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Country
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India
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Phone
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+91-0413-2277283
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Shriram Vaidya
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Address
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Department of Anaesthesiology, JIPMER, Puducherry , India 605006
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Country
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India
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Phone
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+91-0413-2277283
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Fax
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Email
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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
No additional documents have been identified.
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