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Trial registered on ANZCTR
Registration number
ACTRN12612000435886
Ethics application status
Approved
Date submitted
12/04/2012
Date registered
18/04/2012
Date last updated
19/04/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of Local Warming versus Local Cooling on Injection Pain After Propofol Administration During Anaesthesia Induction
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Scientific title
Effect of Local Warming versus Local Cooling on Injection Pain After Propofol Administration During Anaesthesia Induction in those Scheduled for Elective Surgery
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Secondary ID [1]
280304
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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:
propofol injection pain
286262
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Condition category
Condition code
Anaesthesiology
286483
286483
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0
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Pain management
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Anaesthesiology
286484
286484
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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
After obtaining local research ethical committee approval and patients’ informed written consent, 120 patients were studied between age groups of 18 and 65 years old, of ASA groups I and III, and who were scheduled for elective surgery under general anesthesia . The exclusion criteria were; being pregnant and breastfeeding women, having a medical history of epilepsy, having cardiac conduction failure,having lipid metabolism disorder, receiving antiarrhytmic or analgesic drugs, having liver or kidney failure, being allergic to propofol and difficulty for iv cannulation.
Without any premedication, the patients were given, 5 ml/kg/hour crystalloid solution, through a 20 G iv cannule which is attached on the dorsum of the hand. Patients in the operation room were monitored for; standard electrocardiography (ECG), blood pressure non invasively and peripheral oxygen saturation (Drager;Infinity delta MS13466E539D,USA). The patients were randomly allocated, using sealed envelopes, to one of following 3 groups of 40 each:
1. Local warming group , (Group I): Before anesthesia induction patients were subjected to 40 degrees C hot application for 2 minutes with a bair hugger device (a device blowing hot air through a blanket to be worn over the body), through the vein trace which the cannula were attached.
2. Local cooling group (Group II): Before anesthesia induction patients were subjected to +2-4 degrees C cooling application for 2 minutes with cold water bags kept in refrigerator, through the infusion vein trace.
3. No intervention group (Group III): Patients in this group were accepted as control group and were not subjected to any procedure.
Propofol prepared in room temperature (10 mg/ml ampoule, Fresenius) were administered as 2,5 mg/kg dose and within one minute to all groups. On the 15th second with the start of injection, the patients were asked about suffering any pain. Findings observed until the injection finished and the response was recorded according to the 5-point Verbal Rating Scale (VRS) (0= no pain, 1= mild pain, 2= moderate pain, 3= severe pain, 4= severe pain accompanied by facial grimacing and arm withdrawal).. After propofol injection, opioid and muscle relaxant (only for patients who will be intubated) were given Then the operation progressed with an intubation or a laryngeal mask. Hemodynamics were measured and recorded at control (T0), 1.(T1), 2.(T2), 3.(T3) minutes.
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Intervention code [1]
284669
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Treatment: Drugs
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Intervention code [2]
284707
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Treatment: Devices
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Comparator / control treatment
In Group III (Control); no intervention was applied.
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Control group
Active
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Outcomes
Primary outcome [1]
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To investigate the effect of local warming and cooling on pain induced by propofol.Findings observed until the injection finished and the response was recorded according to the 5-point Verbal Rating Scale (VRS) (0= no pain, 1= mild pain, 2= moderate pain, 3= severe pain, 4= severe pain accompanied by facial grimacing and arm withdrawal).
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Assessment method [1]
286937
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Timepoint [1]
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Patients were asked about any discomfort at the 15th seconds of injection
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Secondary outcome [1]
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Change in hemodynamics; patients in the operation room were monitored for; standard electrocardiography (ECG), blood pressure non invasively for measurement of the hemodynamic variables
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Assessment method [1]
297032
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Timepoint [1]
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Hemodynamic variables were measured and recorded at control (T0), 1.(T1), 2.(T2), 3.(T3) minutes
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Eligibility
Key inclusion criteria
ASA groups I and III, and who were scheduled for elective surgery under general anesthesia
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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
Being pregnant and breastfeeding women, having a medical history of epilepsy, having cardiac conduction failure,having lipid metabolism disorder, receiving antiarrhytmic or analgesic drugs, having liver or kidney failure, being allergic to propofol and difficulty for iv cannulation.
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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)
After obtaining written informed consent , the patients were randomly assigned to one of the three groups as the responsible anesthesiologist opened the next envelope.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomisation table created by computer software (i.e., computerised 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
Parallel
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Other design features
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Phase
Phase 2
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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
1/09/2011
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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
114
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4249
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Turkey
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State/province [1]
4249
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Funding & Sponsors
Funding source category [1]
285082
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
285082
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Primary sponsor type
Individual
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Name
Serdar Koseoglu
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Address
Ministry of Health, Ankara Training and Research Hospital, Department of Anaesthesiology and Intensive Care, Ulucanlar Cad. 06340, Ankara, Turkey
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Country
Turkey
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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]
283948
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Country [1]
283948
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287097
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Ministry of Health, Ankara Training and Research Hospital Ethics Committee
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Ethics committee address [1]
287097
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Ministry of Health, Ankara Training and Research Hospital, Department of Anaesthesiology and Intensive Care, Ulucanlar Cad. 06340, Ankara, Turkey
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Ethics committee country [1]
287097
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Turkey
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Date submitted for ethics approval [1]
287097
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Approval date [1]
287097
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17/08/2011
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Ethics approval number [1]
287097
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Summary
Brief summary
Purpose: Various drugs and techniques have been proposed in order to prevent propofol induced pain. Local warming or warming of propofol has been reported to be effective in reducing the pain but local cooling has not been studied yet. In this study we aimed to investigate the effect of local warming and cooling on pain induced by propofol. Materials and methods: One hundred and twenty patients undergoing elective surgery were included in this randomized, prospective, single-blinded study. Patients were divided into 3 equal groups. In Group I; warming at + 40 degrees C applied for 2 min prior to propofol administration at the site venous access, in Group II; cooling at + 4 degrees C was applied for 2 min prior to propofol administration at the site venous access. In Group III (Control); no intervention was applied. In each patient, propofol was injected over a period of 1 min at a dose of 2,5 mg/kg. Patients were asked about any discomfort at the 15th seconds of injection. Findings observed until the injection finished and the response was recorded according to the 5-point scale. Results: Demographic data were comparable between groups. The frequency of pain at propofol injection was lower in Group I (47.5%) compared to Group II (77.5%) and III (82.5%) (p= 0.006),( p = <0,001) The frequency of pain did not differ statistically between Group II and III. Conclusions: Application of local warming prior to propofol administration effectively decreased the pain induced by propofol, whereas local cooling had no impact.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Hale Yarkan Uysal
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Address
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Ministry of Health, Ankara Training and Research Hospital, Department of Anaesthesiology and Intensive Care, Ulucanlar Cad. 06340, Ankara, Turkey
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Country
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Turkey
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Phone
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+903125953175
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Fax
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+903123633396
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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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Hale Yarkan Uysal
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Address
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Ministry of Health, Ankara Training and Research Hospital, Department of Anaesthesiology and Intensive Care, Ulucanlar Cad. 06340, Ankara, Turkey
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Country
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Turkey
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Phone
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+903125953175
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Fax
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+903123633396
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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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