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Trial registered on ANZCTR
Registration number
ACTRN12613000131752
Ethics application status
Approved
Date submitted
26/01/2013
Date registered
4/02/2013
Date last updated
4/02/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluating clinical features of reversed non depolarizing block by using train- of -four (TOF) responses recorded by acceleromyography device in pediatric patients
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Scientific title
Comparison of the effects of sugammadex and anticholinergic-anticholinestarese agents for reversing non depolarizing block in pediatric patients
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Secondary ID [1]
281843
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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:
Adenotonsillitis where surgery is necessary
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Otitis Media where surgery is necessary
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Other ilnessess in pediatric patients that can be operated by ear nose and throat surgeons under general anesthesia
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Condition category
Condition code
Anaesthesiology
288572
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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
2mg/kg sugammadex intravenously will be given only once when T2 point (two contractions) on TOF device is observed in group I patients.
TOF device is used for evaluating the level of neuromuscular block after neuromuscular blocker medications. Entubation and extubation time of the patient decided correctly and easily by using this device. Different kinds of electrical stimulations are used like;Train-Of-Four Ratio,Single twitch,Double-burst stimulation, Post-tetanic count. We used TOF device during the surgery started after anesthesia induction (before neuromuscular blocker agent was given) to extubation time .
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
0.06mg/kg neostigmin + 0.02 mg/kg atropin intravenously will be given only once when T2 point (two contractions) on TOF device is observed in group 2 patients
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Control group
Active
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Outcomes
Primary outcome [1]
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1- T 0.9 reaching time of groups and significant difference between them were tested after reversing agent administration by using TOF accelomyelography device
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Assessment method [1]
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Timepoint [1]
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1- At 15., 30., 60., 90. seconds and 2., 5., 10.,15.,20., 25., 30.minutes after reversing of blockade period.
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Secondary outcome [1]
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1- Extubation time: At the moment of T 0.9 on TOF device inhalation gases were ceased and patients were extubated properly after spontaneous breathing.
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Assessment method [1]
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Timepoint [1]
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1-At 15., 30., 60., 90. seconds and 2., 5., 10.,15.,20., 25., 30.minutes after reversing of blockade period.
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Secondary outcome [2]
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2- Respiration status was assessed as;able to breath and coughing: 2, dyspnea or limited respiration: 1
Respiration status is one of the criteria of Modified Aldrete scoring system which is is commonly used for determining when a patient can safely be discharged from the postanesthesia care unit The Aldrete scoring system takes into account the patient's ability to move, respiration, circulation, consciousness, and oxygen saturation. A maximum of two points are awarded in each category and a score of 9 or 10 is required for discharge.
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Assessment method [2]
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Timepoint [2]
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2- At 5., 10.,15.,20., 25., 30. minutes after extubation
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Secondary outcome [3]
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3- Muscle strength were assessed as;
a)total paralyze: 0, no loss of muscle strength:10
b)head elevation more than 5 seconds yes:1 , no:2
c)exhibiting tongue yes: 1 ,no:2
These are the signs of clinical recovery of neuromuscular function. All of them are subjective, bedside tests used in post anesthesia care unit for determining that a patient can be discharged from the unit.
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Assessment method [3]
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Timepoint [3]
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3- At 5., 10.,15.,20., 25., 30. minutes after extubation
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Secondary outcome [4]
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4-Hemodynamic alterations(changes on hearth rate and mean arterial blood pressure)
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Assessment method [4]
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Timepoint [4]
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4-At 0., 2., 5., 10., 30. minutes after entubation and (as well as) 15., 30., 60., 90. seconds and 2., 5., 10.,15.,20., 25., 30.minutes after reversing of blockade period
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Eligibility
Key inclusion criteria
Pediatric patients age between2-12 and ASA1-2 whom should be performed general anesthesia in supine position for ear nose and throat surgery.
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Minimum age
2
Years
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Maximum age
12
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
Exclusion criteria were; intubation limitations, drug uptake that can cause interaction with rocuronium, neuromuscular diseases, renal diseases and known malign hyperthermia in the family history.
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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)
Randomization was performed using a sealed opaque envelope with a computer- generated block random allocation.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization was performed using a sealed opaque envelope with a computer- generated block random allocation.
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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 administering 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
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Shapiro Wilk test was performed in order to reveal constant variants’ distributions. For constant variants descriptive analysis involved mean ± standard deviation or median (minimum-maximum) values and for the categorical variants involved values of number of cases and percentages (%). Significance of differences of mean values tested by Student’s t test while significance of differences of median values tested by Mann Whitney U test. Categorical variants analysed by Pearson’s Chi square or Fischer’s Chi-square test. Repeated measurements, including heart rate, mean arterial pressure, saturation and TOF data were evaluated by variant analysis of repeated measurements. Greenhouse-Geisser method was performed in order to detect differences among groups, in terms of follow-up durations and characteristics. Since P<0.05 was accepted as error value, Bonferroni correction was performed to avoid type 1 mistakes in all multiple comparisons.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/10/2011
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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
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]
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Ankara
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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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Address [1]
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Country [1]
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Turkey
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Primary sponsor type
Hospital
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Name
Ministry of Health Ankara Training and Research Hospital
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Address
Ulucanlar caddesi Sukriye mahallesi No:89 06340 Altindag/Ankara
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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]
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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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Local Ethics Committee of Ministry of Health Ankara Training and Research Hospital
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Ethics committee address [1]
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Sukriye mahallesi Ulucanlar caddesi No:89 06340 Altindag/Ankara
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Ethics committee country [1]
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Turkey
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Date submitted for ethics approval [1]
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29/07/2011
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Approval date [1]
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10/08/2011
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Ethics approval number [1]
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0428
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Summary
Brief summary
Sixty children age between 2-12 in ASA I-II scheduled for elective surgery in supine position were enrolled to this randomized, prospective, double-blinded study after the permission of local ethics committee and parents written informed consent. Patients were randomized to two groups as Group I (sugammadex) and Group II (neostigmine). Propofol (2mg/kg) and fentanyl (1?g/kg) were administered for induction and sevoflurane for maintenance of anaesthesia. Neuromuscular function was monitored by acceleromyography (TOF Watch SX) and train-of-four (TOF) mode of stimulation. Rocuronium (0.6mg/kg) was used for NMB and 0.1-0.2 mg/kg additional doses were given if necessary. At reappearance of T2, sugammadex 2mg/kg in group I and neostigmine 0.06mg/kg+atropine 0.02 mg/kg in group II were administered. Patients were extubated after TOF 0.9 was achieved. No statistically significant difference was observed between the groups according to age, gender, weight, duration of operation, mean arterial pressure, SpO2, fentanyl and rocuronium usages (p>0.05).Heart rate decreased significantly after reversal agent in group I at 15th,30th and 60th seconds of evaluation whereas it increased significantly in group II (p<0.0004).Time from administration of reversal agent to TOF 0.9 was faster with sugammadex (68 second) than with neostigmine (392 second) (p<0.001). Muscle strength was significantly higher in group I than in group II. The result of this study shows sugammadex is a safe and effective agent for reversing rokuronium–induced NMB in paediatric patients with a faster recovery of neuromuscular function than neostigmine.
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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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A/Prof Hulya Basar
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Address
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Ministry of Health Ankara Training and Research Hospital Anesthesiology and Reanimation Department Sukriye mahallesi Ulucanlar caddesi No:89 06340 Altindag/Ankara
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Country
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Turkey
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Phone
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+90 312 5953180
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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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Hulya Basar
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Address
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Ministry of Health Ankara Training and Research Hospital Anesthesiology and Reanimation Department
Sukriye mahallesi Ulucanlar caddesi No:89 06340 Altindag/Ankara
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Country
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Turkey
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Phone
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+90 312 5953180
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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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Turkay Cakan
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Address
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Ministry of Health Ankara Training and Research Hospital Anesthesiology and Reanimation Department
Sukriye mahallesi Ulucanlar caddesi No:89 06340 Altindag/Ankara
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Country
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Turkey
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Phone
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+90 312 5953175
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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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