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Trial registered on ANZCTR
Registration number
ACTRN12618001658202
Ethics application status
Approved
Date submitted
4/10/2018
Date registered
8/10/2018
Date last updated
18/09/2019
Date data sharing statement initially provided
18/09/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Lignocaine Infusion in Obesity
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Scientific title
Intraoperative Lignocaine Infusions: development of an optimised infusion dosing regimen for obese patients
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Secondary ID [1]
296260
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None
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Universal Trial Number (UTN)
U1111-1221-6720
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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:
Bariatrics (Obesity)
309925
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Condition category
Condition code
Anaesthesiology
308699
308699
0
0
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Anaesthetics
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Diet and Nutrition
308722
308722
0
0
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Obesity
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Surgery
308723
308723
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous lignocaine infusion of 1.5mg/kg bolus over 10 minutes on induction of anaesthesia followed by 1.5mg/kg/hour throughout the duration of patient's laparoscopic abdominal procedure which will vary depending on each individual patient's specific surgical requirements.
Intravenous lignocaine infusions are widely regarded as a valuable adjunct to laparoscopic abdominal surgical procedures however their use in this population group, with the current level of evidence, is entirely dependant on anaesthetist preference. As such in some cases intravenous lignocaine infusions would be used regardless but in some cases they will be utilised specifically for the purposes of the study
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Intervention code [1]
312588
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
307674
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Plasma Lignocaine Levels
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Assessment method [1]
307674
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Timepoint [1]
307674
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No specific primary timepoint - aim is to measure levels over 4 hours and model continuously over this time period. The protocol outlines that the following anticipated measurement timepoints - T5minutes post lignocaine bolus completion and then T30minutes, T6o minutes, T120minutes, T180minutes and T240minutes
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Secondary outcome [1]
352546
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Plasma levels of the primary lignocaine active metabolite - monoethylglycinexylididem (MEGX)
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Assessment method [1]
352546
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Timepoint [1]
352546
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The protocol outlines that the following anticipated measurement timepoints - T5minutes post lignocaine bolus completion and then T30minutes, T6o minutes, T120minutes, T180minutes and T240minutes
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Secondary outcome [2]
352585
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Plasma levels of the secondary lignocaine active metabolite - glycylxylidide (GX
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Assessment method [2]
352585
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Timepoint [2]
352585
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The protocol outlines that the following anticipated measurement timepoints - T5minutes post lignocaine bolus completion and then T30minutes, T6o minutes, T120minutes, T180minutes and T240minutes
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Secondary outcome [3]
352586
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Plasma levels of alpha-1-glycoprotein
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Assessment method [3]
352586
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Timepoint [3]
352586
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The protocol outlines that the following anticipated measurement timepoints - T5minutes post lignocaine bolus completion and then T30minutes, T6o minutes, T120minutes, T180minutes and T240minutes
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Eligibility
Key inclusion criteria
Patients scheduled for elective laparoscopic abdominal surgery
Surgical duration expected to be of at least 90 minutes duration
Patients of a range of BMIs according to the WHO definitions - 10 patients with a BMI of < 35kg/m2, 10 patients with a BMI of 35-40kg/m2 and 10 patients with a BMI > 40kg/m2
Informed consent by patient or legally authorised representative to participate in study and to store specimens for immediate and future analysis.
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Minimum age
18
Years
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Maximum age
90
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
Known or suspected allergy to study drug (lignocaine)
Acute or chronic renal disease (eGFR < 60)
Acute or chronic liver disease
Congestive cardiac failure
Cardiac conduction abnormalities
Pregnancy
History of seizure disorder
Known vascular disease of the upper limb (e.g. Raynauds disease), or other contraindication to arterial catheterisation
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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)
N/A
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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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
An open-label plasma pharmacokinetic study of lignocaine infusions in the perioperative setting
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
Analysis of lignocaine infusions in the bariatric population will be guided by Professor Jason Roberts and his pharmacometric team but at this stage it is anticipated to assess: total and free lignocaine concentrations, Cmax, tmax, Vd, elimination half-life, clearance and area under the curve. Added into this modelling will be data in regards to MEGX and GX concentrations, Cmax and max along with AAG levels which are particularly variable with obesity and will potentially alter the active lignocaine concentration levels by altering the bound fraction.
The pharmacometric team at the RBWH Burns, Trauma and Critical Research Centre will then use PMetrics software to develop population pharmacokinetic modelling followed by regression analysis to statistically validate the model and apply Monte-Carlo simulation to create a population model of 1000 patients.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
3/12/2018
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Actual
10/06/2019
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Date of last participant enrolment
Anticipated
1/01/2020
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Actual
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Date of last data collection
Anticipated
31/01/2020
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Actual
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Sample size
Target
30
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Accrual to date
29
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
12106
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
24268
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4029 - Herston
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Funding & Sponsors
Funding source category [1]
300854
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Hospital
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Name [1]
300854
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Royal Brisbane and Women's Hospital Anaesthetic Research Department
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Address [1]
300854
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Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country [1]
300854
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Australia
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Primary sponsor type
Hospital
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Name
RBWH Anaesthetic Department
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Address
Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country
Australia
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Secondary sponsor category [1]
300406
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Individual
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Name [1]
300406
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Dr Angela Tognolini
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Address [1]
300406
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C/O Anaesthetic Research Department
Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country [1]
300406
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301629
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The Prince Charles Hospital Human Research Ethics Committee (TPCH HREC - EC00168)
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Ethics committee address [1]
301629
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C/O the TPCH Research Committee Executive Officer The Prince Charles Hospital 627 Rode Road Chermside Queensland 4032
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Ethics committee country [1]
301629
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Australia
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Date submitted for ethics approval [1]
301629
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15/10/2018
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Approval date [1]
301629
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05/11/2018
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Ethics approval number [1]
301629
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HREC/2018/QPCH/43981
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Summary
Brief summary
Perioperative lignocaine infusions have significant benefits for patients undergoing major abdominal surgery in regards to analgesia, reduced opioid requirements, earlier return of normal bowel function and potentially even enhanced recovery and discharge after surgery. Currently there is significant heterogeneity in the various suggested lignocaine dosing regimens and a real paucity of evidence in regards to optimal dosing in the bariatric population. As a result, despite the benefits of perioperative lignocaine infusions particularly in the bariatric population, clinicians cannot be confident about the efficacy and safety of currently suggested lignocaine infusion regimes in this population group. As a result our objective is to develop a pharmacokinetic model of lignocaine infusion including patients at the extremes of BMI and thus develop a regimen for bariatric patients that achieves safe but effective therapeutic dosing.
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Trial website
N/A
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
87590
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Dr Angela Tognolini
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Address
87590
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C/O RBWH Anaesthetic Department
Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country
87590
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Australia
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Phone
87590
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+61 7 36468111
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Fax
87590
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Email
87590
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[email protected]
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Contact person for public queries
Name
87591
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Lizanne Dagleish
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Address
87591
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C/O RBWH Anaesthetic Research Department
Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country
87591
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Australia
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Phone
87591
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+61 7 36468111
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Fax
87591
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Email
87591
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[email protected]
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Contact person for scientific queries
Name
87592
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Angela Tognolini
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Address
87592
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C/O RBWH Anaesthetic Department
Royal Brisbane and Women's Hospital
Cnr of Bowen Bridge Road and Butterfield Street
Herston
Queensland
4029
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Country
87592
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Australia
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Phone
87592
0
+61 7 36468111
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Fax
87592
0
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Email
87592
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This is a pharmacokinetic trial for lignocaine infusions in the bariatric population as such the collected data is deidentified and pooled making each individual patient's data on its own irrelevant to the overall outcome.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
4851
Study protocol
[email protected]
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.
Download to PDF