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Trial registered on ANZCTR
Registration number
ACTRN12621000537853
Ethics application status
Approved
Date submitted
9/03/2021
Date registered
6/05/2021
Date last updated
1/03/2023
Date data sharing statement initially provided
6/05/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The Effect of Coblation vs Bizact Tonsillectomy on Post-Operative Pain: a randomised control trial
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Scientific title
Coblation vs Bizact Tonsillectomy for post-operative pain in adults : a randomised control trial
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Secondary ID [1]
303612
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Nil
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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:
tonsillectomy
321000
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Condition category
Condition code
Surgery
318807
318807
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Tonsillectomy is a painful procedure, especially in adults. Recent technological advances have allowed new methods of tonsillectomy to be performed. Radiofrequency Coblation and ultrasonic Bizact methods both claim to improve the patient’s pain post-operatively. Participants will be blinded and randomised to either the Coblation or Bizact tonsillectomy method. These procedures will be performed by highly experienced ENT surgeons. Analgesia will be standardised (Post-surgical analgesia protocol – Tapentadol, Celebrex with oxycodone after tapentadol runs out. Difflam for breakthrough).
Both Coblation and Bizact tonsillectomy involve pulling the tonsil away from the pharyngeal wall with forceps. The relevant instrument is then used to separate the tonsil capsule from the pharyngeal constrictor muscles. Both instruments provide simultaneous dissection and haemostasis but can sometimes fail to control bleeding 100%, hence the need for “touch-up” bipolar diathermy in some cases. Normal length of procedure would be estimated to be 5-20 minutes in total.
The Evac 70 Coblation wand and Bizact ligasure device are disposable devices, hence needing to be recorded in the operation record and can be checked for adherence to the claimed technique.
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Intervention code [1]
319913
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Treatment: Surgery
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Comparator / control treatment
Coblation tonsillectomy using the Evac 70 Coblation wand
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain after tonsillectomy: measured by visual analogue scores
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Assessment method [1]
326753
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Timepoint [1]
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once daily for 14 days post surgery
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Secondary outcome [1]
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Bleeding during surgery: measured by volume of blood in suction bottles and weight of swabs
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Assessment method [1]
392581
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Timepoint [1]
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Within the surgical procedure
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Secondary outcome [2]
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Bleeding after surgery: measured using Flinders modification of the Stammberger grade for Secondary Post Tonsillectomy Haemorrhage
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Assessment method [2]
392582
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Timepoint [2]
392582
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For period of the 14 days post surgery assessed by the surgeon at the two week follow up appointment
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Secondary outcome [3]
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Duration of surgery: minutes. Recorded by medical staff during the procedure and stored securely with other patient research information.
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Assessment method [3]
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Timepoint [3]
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During the surgical procedure
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Secondary outcome [4]
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Days to normal activity: defined as tolerating normal diet, physical activities and return to work/study where appropriate. Assessed through a study specific questionnaire.
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Assessment method [4]
392584
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Timepoint [4]
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Until which time participants can return to normal activity
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Eligibility
Key inclusion criteria
Over 18 years of age, able to consent, clinical indications for tonsillectomy as recurrent tonsillitis.
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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
History of bleeding disorders, history of general anaesthetic risk, previous peri-tonsillar abscess, tonsillectomy performed due to suspicion of malignancy, contraindications to post-surgical analgesia protocol.
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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)
Sealed Opaque Envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a computer random number generator
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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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
Safety/efficacy
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Statistical methods / analysis
Analysis of normality will be performed then Chi-squared for parametric and Mann-Witney for non-parametric data. P<0.05 will be regarded as significant. Sample size calculations were determined to require 56 to be suffiency powered to show a differnence in pain scores of 1.5. 70 will be recruited to account for drop out.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
24/05/2021
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Actual
1/07/2021
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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
70
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Accrual to date
28
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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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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Professor Simon Carney
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Address [1]
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Suite 200 Southern ENT, Flinders Private Hospital, 1 Flinders Dr, Bedford Park SA 5042
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Professor Simon Carney
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Address
Suite 200 Southern ENT, Flinders Private Hospital, 1 Flinders Dr, Bedford Park SA 5042
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Country
Australia
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Secondary sponsor category [1]
308767
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None
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Name [1]
308767
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Address [1]
308767
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Country [1]
308767
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
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Flinders Medical Centre, Level 6, Ward 6C, Room 6A219, Flinders Dr, Bedford Park SA 5042
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Ethics committee country [1]
308025
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Australia
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Date submitted for ethics approval [1]
308025
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09/03/2021
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Approval date [1]
308025
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03/06/2021
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Ethics approval number [1]
308025
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2021/HRE00092
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Summary
Brief summary
Tonsillectomy is a painful procedure, especially in adults. Recent technological advances have allowed new methods of tonsillectomy to be performed. Radiofrequency Coblation and ultrasonic Bizact methods both claim to improve the patient’s pain post-operatively. This trial will randomise patients to one of these two methods and study post-operative pain outcomes by visual analogue pain scores and days to normal activity. Bleeding during and after surgery, and the duration of surgery, will also be measured. We hypothesize that coblation tonsillectomy will result in reduced post-operative pain, reduced primary and secondary bleeding during and after surgery, a shorter duration of surgery and faster return to normal activity when compared to the Bizact method.
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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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Prof Simon Carney
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Address
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Suite 200 Southern ENT, Flinders Private Hospital, 1 Flinders Dr, Bedford Park SA 5042
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Country
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Australia
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Phone
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+61 8 8277 0288
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Fax
109262
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Email
109262
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[email protected]
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Contact person for public queries
Name
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Simon Carney
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Address
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Suite 200 Southern ENT, Flinders Private Hospital, 1 Flinders Dr, Bedford Park SA 5042
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Country
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Australia
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Phone
109263
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+61 8 8277 0288
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Fax
109263
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Email
109263
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[email protected]
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Contact person for scientific queries
Name
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Simon Carney
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Address
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Suite 200 Southern ENT, Flinders Private Hospital, 1 Flinders Dr, Bedford Park SA 5042
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Country
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Australia
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Phone
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+61 8 8277 0288
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Fax
109264
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Email
109264
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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
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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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