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Trial registered on ANZCTR
Registration number
ACTRN12618000553279
Ethics application status
Approved
Date submitted
22/11/2017
Date registered
13/04/2018
Date last updated
13/04/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
A New Technique of Abdominal Wall Anesthesia: A Feasibility Study in Children
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Scientific title
A New Neurostimulator Guided Technique of Rectus Sheath Block: Study of Feasibility and Local Anesthetic Spread in Children
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Secondary ID [1]
293423
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None
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Universal Trial Number (UTN)
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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:
Regional Anesthesia
305580
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Condition category
Condition code
Anaesthesiology
304810
304810
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After induction of general anesthesia we performed neurostimulator guided bilateral rectus sheath block in 58 children (average age 34.5 months, body mass 16.4 kg) with ultrasound assessment of block area after doing the blockade in order to chek if local anesthetic have spread properly.
Materials: Ultrasound scanner SonoSite Titan; SonoSite Inc., Washington, USA; Neurostimulator Stimuplex HNS 12, B.Braun, Melsungen, Germany; Insulated needle Stimuplex A, 21G, 50 mm, B.Braun, Melsungen, Germany
Drugs: Bupivacaine 0.25% 0.3 ml/kg for each side.
Operator: Pediatric anesthesiologist with at least 10 years experience in pediatric anesthesia and 5 years experience in regional anesthesia.
The number of times: Once.
The location: Operating theatre in teaching hospital.
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Intervention code [1]
299665
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Treatment: Surgery
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Proper local anesthetic spread between rectus abdominis muscle and its posterior sheath. It was assesssed by ultrasound examination of block area immediately after procedure. According to scanning results all neurostimulator guided rectus sheath blocks were divided into 3 groups as follows: optimal spread (local anesthetic solution is between rectus abdominis muscle and posterior rectus sheath), suboptimal spread (most of local anesthetic solution is between rectus abdominis muscle and posterior rectus sheath, infiltration of rectus abdominis muscle with local anesthetic is evident) and non-optimal spread (local anesthetic solution is in the rectus abdominis muscle tissue, there is no or minimum of local anesthetic between rectus abdominis muscle and posterior rectus sheath).
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Assessment method [1]
304020
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Timepoint [1]
304020
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immediately after block
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Secondary outcome [1]
340731
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Clinical efficacy (motor response on incision). If there was no patients' movements on incision we assumed that block was effective.
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Assessment method [1]
340731
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Timepoint [1]
340731
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Beginning of the surgery (incision).
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Secondary outcome [2]
343009
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Clinical efficacy (fentanyl requirements). If patient demonstrated hemodynamic response (tachycardia, hypertension) on surgery we added fentanyl 1 mcg/kg. If there was no need to add fentanyl during surgery we assumed that the block is effective.
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Assessment method [2]
343009
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Timepoint [2]
343009
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End of surgery
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Eligibility
Key inclusion criteria
elective umbilical or paraumbilical hernia surgery, 1-2 ASA physical status
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Minimum age
1
Years
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Maximum age
15
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
Urgent surgery, >2 ASA physical status, lack of parental consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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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
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Actual
1/02/2016
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Date of last participant enrolment
Anticipated
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Actual
8/11/2016
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Date of last data collection
Anticipated
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Actual
8/11/2016
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Sample size
Target
50
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Accrual to date
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Final
58
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Recruitment outside Australia
Country [1]
9389
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Ukraine
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State/province [1]
9389
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Funding & Sponsors
Funding source category [1]
298048
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Hospital
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Name [1]
298048
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Lviv Regional Children's Clinic Hospital
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Address [1]
298048
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Lysenka str. 31, Lviv 79008, Ukraine
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Country [1]
298048
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Ukraine
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Primary sponsor type
Individual
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Name
Andrew Albokrinov
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Address
Lviv Regional Children’s Clinic Hospital, Lysenka str. 31, Lviv 79008, Ukraine.
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Country
Ukraine
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Secondary sponsor category [1]
297122
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None
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Name [1]
297122
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Address [1]
297122
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Country [1]
297122
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299070
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Lviv Regional Children’s Hospital Ethics Committee
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Ethics committee address [1]
299070
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Lysenka str. 31, Lviv 79008
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Ethics committee country [1]
299070
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Ukraine
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Date submitted for ethics approval [1]
299070
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18/01/2016
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Approval date [1]
299070
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27/01/2016
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Ethics approval number [1]
299070
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1-1-2016
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Summary
Brief summary
Rectus sheath block is a valuable regional technique for abdominal wall midline analgesia. It can be used for variety of surgical procedures such as midline laparotomy, umbilical and paraumbilical hernia repair, and laparoscopic surgery. Not all operating theatres, especially in low income countries, are equipped with ultrasound scanners for carrying out US guided regional blocks. In cases of total absence of objective control, neurostimulator guided technique of RSB can be useful. Objective of the study was to check the feasibility of performing neurostimulator guided rectus sheath block. Neurostimulator guided RSB was performed on patients who underwent umbilical or paraumbilical hernia surgery. After performing the block ultrasound scanning of block area and clinical efficacy assessment was performed. Optimal spread of local anaesthetic was achieved in 86 cases (74.14%), and suboptimal spread – in 30 cases (25.86%) of neurostimulator guided rectus sheath blocks. There were no cases of non-optimal local anaesthetic spread. In all cases neurostimulator guided rectus sheath block had high clinical efficacy (there was no motor response to incision and no need for fentanyl administration). We conclude that rectus sheath block can be performed under neurostimulator guidance. Neurostimulator guided rectus sheath block resulted in optimal or suboptimal local anaesthetic spread. Clinical efficacy of neurostimulator guided rectus sheath block was high. Sample size was 58 patients. Neurostimulator guided rectus sheath block was performed bilaterally to each of them. So there were 116 rectus sheath blocks performed. Of them there were 86 optimal and 30 suboptimal spread of local anesthetic.
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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
79190
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Dr Andrew Albokrinov
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Address
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Lviv Regional Children’s Clinic Hospital, Lysenka str. 31, Lviv 79008, Ukraine.
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Country
79190
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Ukraine
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Phone
79190
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+380672867103
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Fax
79190
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Email
79190
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[email protected]
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Contact person for public queries
Name
79191
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Andrew Albokrinov
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Address
79191
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Lviv Regional Children’s Clinic Hospital, Lysenka str. 31, Lviv 79008, Ukraine.
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Country
79191
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Ukraine
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Phone
79191
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+380672867103
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Fax
79191
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Email
79191
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[email protected]
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Contact person for scientific queries
Name
79192
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Andrew Albokrinov
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Address
79192
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Lviv Regional Children’s Clinic Hospital, Lysenka str. 31, Lviv 79008, Ukraine.
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Country
79192
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Ukraine
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Phone
79192
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+380672867103
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Fax
79192
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Email
79192
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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
Embase
A new neurostimulator guided technique of rectus sheath block: Study of feasibility and local anesthetic spread in children.
2019
https://dx.doi.org/10.5114/ait.2019.85871
N.B. These documents automatically identified may not have been verified by the study sponsor.
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