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Trial registered on ANZCTR
Registration number
ACTRN12609000409279
Ethics application status
Approved
Date submitted
14/05/2009
Date registered
3/06/2009
Date last updated
3/06/2009
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does epidural analgesia affect outcome after lower limb bypass surgery?
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Scientific title
A Comparison of the Effects of Epidural Versus Parenteral Analgesia Techniques on Outcome Following Lower Limb Vascular Bypass Surgery
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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:
Peripheral Vascular Disease
4780
0
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Condition category
Condition code
Surgery
237112
237112
0
0
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Other surgery
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Anaesthesiology
237122
237122
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Postoperative Epidural analgesia.
Lumbar epidural anaesthesia provided intraoperatively by catheter is to be continued postoperatively by continuous infusion using Ropivacaine 0.2% at the minimal rate required by titration to provide effective analgesia without producing side effects such as hypotension or excessive lower limb motor block. This is to be continued for 72 hours from the completion of surgery. All patients to receive aspirin 100mg daily. After 72 hours patients to convert to simple oral analgesia.
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Intervention code [1]
4556
0
Treatment: Other
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Comparator / control treatment
Postoperative Parenteral Analgesia.
Lumbar epidural analgesia provided intraoperatively is ceased at the completion of surgery and the epidural catheter removed. Ongoing analgesia thereafter is to be provided using combination oral and parenteral agents on "as required" basis according to ward practice. Agents used include morphine 5-10mg intramuscularly or subcutaneously 3 to 4 hourly, Oxycodone 5-10mg orally 4 to 6 hourly, Paracetamol 0.5-1g orally 6 hourly. All patients to receive aspirin 100mg daily.
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Control group
Active
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Outcomes
Primary outcome [1]
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Vascular Graft Patency.
Graft surveillance is performed at least 4 hourly throughout the hospital admission by assessment of pulses and, in the absence of a pulse, Doppler ultrasound. Graft failure is defined as the requirement for thrombectomy, regrafting or unexpected amputation.
Method of assessment includes patient history review for the duration of inpatient admission. Following discharge, histories are reviewed for information from outpatient appointments where available. Where this is incomplete or unavailable, patients and/or their primary care physician are contacted by telephone call.
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Assessment method [1]
237949
0
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Timepoint [1]
237949
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30 days, 6 months from the day of surgery; graft complications within 30 days define early graft failure; graft complications between 30 days and 6 months define late graft failure.
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Secondary outcome [1]
242045
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Any other postoperative medical or surgical morbidity, defined as presentation of a new illness or exacerbation of a pre-existing illness.
Method of assessment includes patient history review for the duration of inpatient admission. Following discharge, histories are reviewed for information from outpatient appointments where available. Where this is incomplete or unavailable, patients and/or their primary care physician are contacted by telephone call.
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Assessment method [1]
242045
0
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Timepoint [1]
242045
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30 days, 6 months from the day of surgery; morbidity within 30 days defines early morbidity; morbidity between 30 days and 6 months defines late morbidity.
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Eligibility
Key inclusion criteria
Lower limb arterial bypass surgery where the distal vascular anastomosis is below the level of knee joint
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Minimum age
No limit
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Maximum age
No limit
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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
Contraindications to epidural analgesia such as coagulopathy, neurological conditions affecting the lower limbs, orthopaedic or septic complications at proposed epidural insertion site; intolerance of parenteral analgesics
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Study design
Purpose of the study
Treatment
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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)
Sequentially enrolled elective surgical patients, group allocation concealed with opaque envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Compute generated permuted blocks
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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
Parallel
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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
1/01/2001
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
320
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
4958
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Other Collaborative groups
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Name [1]
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Australian and New Zealand College of Anaesthetists
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Address [1]
4958
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630 St.Kilda Rd., Melbourne 3000
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Country [1]
4958
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Australia
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Primary sponsor type
Hospital
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Name
St. Vincent's Hospital Melbourne
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Address
41 Victoria Pde.
Fitzroy
Vic. 3065
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Country
Australia
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Secondary sponsor category [1]
4483
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None
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Name [1]
4483
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Address [1]
4483
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Country [1]
4483
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
7058
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St. Vincent's Hospital Melbourne Research and Ethics Committee
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Ethics committee address [1]
7058
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41 Victoria Pde. Fitzroy Vic. 3065
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Ethics committee country [1]
7058
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Australia
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Date submitted for ethics approval [1]
7058
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Approval date [1]
7058
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05/01/1999
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Ethics approval number [1]
7058
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HREC-A 78/98
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Summary
Brief summary
Epidural anaesthesia has a mitigating influence on adverse metabolic effects that may influence the outcome from surgery. This trial was designed to investigate whether extending epidural analgesia into the postoperative period improves outcome from high risk vascular bypass surgery
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Trial website
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Trial related presentations / publications
Australian and New Zealand College of Anaesthetists (ANZCA) Annual Scientific Meeting Aukland NZ 2005; St. Vincent's Hospital Melbourne 2005
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Public notes
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Contacts
Principal investigator
Name
29604
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Address
29604
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Country
29604
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Phone
29604
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Fax
29604
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Email
29604
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Contact person for public queries
Name
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Dr Desmond McGlade
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Address
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Department of Anaesthesia
St. Vincent's Hospital Melbourne
PO Box 2900
Fitzroy Vic. 3065
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Country
12851
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Australia
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Phone
12851
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613 92884253
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Fax
12851
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613 92884193
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Email
12851
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[email protected]
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Contact person for scientific queries
Name
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Dr Desmond McGlade
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Address
3779
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Department of Anaesthesia
St Vincent's Hospital Melbourne
PO Box 2900
Fitzroy Vic. 3065
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Country
3779
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Australia
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Phone
3779
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613 92884253
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Fax
3779
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613 92884193
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Email
3779
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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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