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Trial registered on ANZCTR
Registration number
ACTRN12618000793213p
Ethics application status
Submitted, not yet approved
Date submitted
26/02/2018
Date registered
10/05/2018
Date last updated
3/09/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Subcutaneous Sumatriptan for Treatment of Post-Operative Neurosurgical Pain
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Scientific title
Subcutaneous Sumatriptan Use for Treatment of Post-Craniotomy Pain- Randomised Double Blinded Placebo controlled Trial
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Secondary ID [1]
294162
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Nil known
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Universal Trial Number (UTN)
U1111-1209-9072
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Trial acronym
SUPS Trial
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
Post-Craniotomy Pain Management
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Condition category
Condition code
Anaesthesiology
305893
305893
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0
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Pain management
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Anaesthesiology
305894
305894
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0
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Anaesthetics
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Neurological
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The patient will be randomised to one of two groups: an active treatment or placebo control group.
Intervention: After completion of the Craniotomy for a surgical condition, the patients in the active treatment group will be administered subcutaneous single dose of 6 mg sumatriptan for active management of post-operative pain. The site of administration will be chosen by the recovery nurse based on individual factors e.g. arm, abdomen, or leg. Following this pain will be re-assessed at five minute intervals and the usual post-operative prescribed opioid regime will be administered. The usual immediate prescribed post-operative regime involves administration of the intravenous recovery protocol to be used in the recovery area. The medication chosen can be e.g. oxycodone, fentanyl or morphine at the discretion of the treating anaesthetist. If the patient is randomised, but medication is not administered, this will be recorded and data analysed on an intention to treat basis. Adherence with protocol compliance will be monitored through regular monthly study audits.
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Intervention code [1]
300452
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Treatment: Drugs
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Comparator / control treatment
The Placebo Control Group: After Completion of the Craniotomy for a surgical condition, patients randomised to the placebo group will be administered subcutaneous normal saline, in the equivalent volume to the treatment drug volume . Post-Operative pain will be re-assessed at five minute intervals, and the usual prescribed opioid regime will be administered. Adherence with protocol compliance will be monitored.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Post-Craniotomy Pain as measured using Visual Analogue Score.
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Assessment method [1]
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Timepoint [1]
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Visual Analogue Score 30 mins post subcutaneous administration of Sumatriptan or placebo.
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Secondary outcome [1]
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Visual Analogue Score 60 minutes post subcutaneous administration of Sumatriptan or placebo.
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Assessment method [1]
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Timepoint [1]
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one time only as measured 60 minutes post trial drug administration.
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Secondary outcome [2]
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Pain level as measured Visual Analogue Scores.
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Assessment method [2]
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Timepoint [2]
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As measured 24 hours post-operatively.
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Secondary outcome [3]
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Quality of Recovery Scores. Validated multi- question Quality of Recovery Score who includes questions about general well-being, support, ease of breathing, nausea, vomiting and pain.
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Assessment method [3]
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Timepoint [3]
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24 hours post-operatively.
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Secondary outcome [4]
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Evaluate total hospital length of stay for each patient- by following up the patient at a weekly time point after surgery and recording the length of stay.
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Assessment method [4]
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Timepoint [4]
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At the end of the hospital stay for each patient.
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Secondary outcome [5]
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Total opioid consumption and other analgesic use- as assessed by reviewing the dosage administered in the medication charts and measuring in the additive fashion.
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Assessment method [5]
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Timepoint [5]
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At 24 hours post-operatively.
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Eligibility
Key inclusion criteria
All adult patients over 18 undergoing Craniotomy
Fully autonomous and able to give a valid consent for surgery and this particular study, or have mild underlying cognitive impairment only with the consent being given by the next of kin.
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Minimum age
18
Years
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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
Not autonomous and unwilling to give a valid consent for surgery and this particular study, or have mild underlying cognitive impairment only, with the consent being withheld by the next of kin
Craniotomy for cerebrovascular surgery (i.e. cerebral aneurysm or arteriovenous malformation)
Previous Ischemic or Haemorrhagic CVA
Unstable Angina or Previous AMI
Severe Hepatic Impairment
Uncontrolled Hypertension
Previous Sensitivity to Sumatriptan
Current Treatment with MAOI's
Current Treatment with SSSRI's
Emergency Re-Operative Craniotomy
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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)
Randomisation will be performed in the hospital centrally by the Pharmacy Department. The principal investigators, patients or the nursing staff involved in patient care will not be involved in the process of randomisation.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Sequence will be generated centrally by the hospital Pharmacy Department through permuted block randomisation.
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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
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
This is a single centre, double-blinded, randomised, 18 months duration parallel group trial to compare the efficacy of subcutaneous sumatriptan with placebo followed by standard pain protocols.
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
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Statistical methods / analysis
The Intervention arm will be compared against the control for all primary analysis. Descriptive statistics mean (SD) or median (IQR) will be used for continuous variables. Normality of data will be confirmed through graphic histogram plots and specific data tests.
We plan to use the student's T-test to compare the means of different groups for the continuous outcomes of pain scores. Quantitative variables will be compared using the Student's t-test or Mann Whitney U-test to compare the independent means. When indicated, a one-way repeated measures ANOVA will be performed. Categorical variables will be presented as absolute frequencies and percentage. The two groups will be compared using the X² or Fisher exact test. We plan to conduct the two subgroup analysis-based on the anatomical site of surgery as well as the urgency of surgery.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2018
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Actual
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Date of last participant enrolment
Anticipated
2/12/2019
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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
136
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
21756
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3084 - Heidelberg
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Anaesthesia Department Austin Health
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Address [1]
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145 Studley Road, Heidelberg , Victoria 3084, Australia
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Austin Hospital
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Address
145 Studley Road, Heidelberg , Victoria 3084, Australia
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Country
Australia
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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]
297987
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Country [1]
297987
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
299744
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
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145 Studley Road, Heidelberg, Victoria 3084, Australia
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Ethics committee country [1]
299744
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Australia
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Date submitted for ethics approval [1]
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29/11/2017
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Approval date [1]
299744
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Ethics approval number [1]
299744
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Summary
Brief summary
Craniotomy is one of the common surgeries performed in the modern day and age with brain tumour being the seventh commonest diagnosed cancer in the world. There are multiple other surgical conditions being amenable to craniotomy: Resection of brain tumours and arteriovenous malformations, clipping of brain aneurysms and microvascular decompression for trigeminal neuralgia just to mention a few. Post-craniotomy pain is often under-treated and under-estimated. Both acute and chronic post craniotomy headaches have been found to be common and significant clinical phenomena. In cross-sectional studies of the immediate post-operative pain levels, post craniotomy pain incidence is at 60 percent, more common than generally assumed. Post-operative pain is a common factor in delayed mobilization, lengthened hospital stay, development of anxiety and depression as well as development of chronic pain. Opioids are still the mainstay of post-operative craniotomy pain management. However effective opioid analgesia administration for the purposes of pain relief can precipitate decreased respiration and hypercarbia. We plan to recruit a total of 136 patients in this parallel arm double- blind trial in order to test our hypothesis that patients receiving subcutaneous sumatriptan will have improved analgesia control and recovery scores post-operatively. We will follow up the patients at 30 days to assess these outcomes at the thirty day mark.
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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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Dr Jeremy Russell
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Address
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145 Studley Road, Austin Health, Heidelberg, Victoria 3084
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Country
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Australia
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Phone
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+61 3 94965000
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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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Ana Licina
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Address
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145 Studley Road, Austin Health, Heidelberg, Victoria 3084
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Country
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Australia
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Phone
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+61 3 94965000
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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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Dean Cowie
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Address
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145 Studley Road, Austin Health, Heidelberg, Victoria 3084
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Country
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Australia
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Phone
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+61 3 94965000
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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
Source
Title
Year of Publication
DOI
Embase
Subcutaneous sumatriptan for the treatment of postcraniotomy pain (SUPS trial): Protocol for a randomised double-blinded placebo controlled trial.
2019
https://dx.doi.org/10.1136/bmjopen-2019-032388
N.B. These documents automatically identified may not have been verified by the study sponsor.
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