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Trial registered on ANZCTR
Registration number
ACTRN12622000942752
Ethics application status
Approved
Date submitted
10/03/2022
Date registered
4/07/2022
Date last updated
4/07/2022
Date data sharing statement initially provided
4/07/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Dexmedetomidine as an adjuvant to levobupivacaine and
lidocaine in ultrasound-guided superficial cervical block for
carotid endarterectomy: a prospective, randomised, double-
blinded study
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Scientific title
Duration of sensory block and analgesia when using dexmedetomidine as an adjuvant to levobupivacaine and lidocaine in ultrasound-guided superficial cervical block for carotid endarterectomy: a prospective, randomised, double-blinded study
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Secondary ID [1]
306651
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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:
Superficial cervical block for carotid endarterectomy.
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Condition category
Condition code
Anaesthesiology
322949
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0
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Anaesthetics
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Surgery
323373
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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
Superficial cervical block (SCB) was performed with 2 mg/kg 0.5% levobupivacaine, 200 mg of 2% lidocaine supplemented with saline to a volume of 50 mL. Subject group S
additionally received 50 micrograms of dexmedetomidine in mixture. The anaesthetist who performes the procedure positioned the patient in supine position, with the head resting on pillow, looking to the opposite side. With the patient in the proper position, the skin was disinfected and the transducer is placed at the midpoint of the sternocleidomastoid muscle. The cervical plexus is identified, the needle is passed with in-plane approach behind the sternocleidomastoid muscle, the tip is placed adjacent to the plexus, and 15mL of local anesthetic mixture is administered. The rest of the local anesthetic mixture (35 mL) was injected subcutaneous cephalad and caudad along the length of the sternocleidomastoid muscle posterior border, and along the lower edge of the body of the mandible. The procedure was performed approximately 30 min prior to the initial surgical incision.
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Intervention code [1]
323091
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Treatment: Drugs
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Comparator / control treatment
Patients were randomly assigned into two groups: both groups received 2 mg/kg
0.5% levobupivacaine with 200 mg of 2% lidocaine supplemented with saline to a volume of 50 mL.
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Control group
Active
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Outcomes
Primary outcome [1]
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The onset of sensory block. assessed by anaesthetist review.
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Assessment method [1]
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Timepoint [1]
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Timepoints are 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 (primary endpoint) minutes after performing SCP block.
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Primary outcome [2]
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The duration of sensory block assessed by anaesthetist review.
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Assessment method [2]
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Timepoint [2]
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Timepoints are 2, 4, 6, 8, 10 and 12 (primary endpoint) hours after performing SCP block.
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Primary outcome [3]
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Duration of analgesia. assessed by anaesthetist review.
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Assessment method [3]
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Timepoint [3]
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Timepoints are 2, 4, 6, 8, 10 and 12 (primary endpoint) hours after performing SCP block.
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Secondary outcome [1]
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Bradycardia measured by pulse oximeter.
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Assessment method [1]
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Timepoint [1]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Secondary outcome [2]
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Respiratory depression measured by pulse oximeter
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Assessment method [2]
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Timepoint [2]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Secondary outcome [3]
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Hypotension measured by sphygmomanometer
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Assessment method [3]
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Timepoint [3]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Secondary outcome [4]
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Nausea assessed by patient complaint- data collected from medical records.
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Assessment method [4]
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Timepoint [4]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Secondary outcome [5]
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Shivering assessed by patient complaint- data collected from medical records.
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Assessment method [5]
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Timepoint [5]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Secondary outcome [6]
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Pruritis assessed by patient complaint- data collected from medical records.
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Assessment method [6]
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Timepoint [6]
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Continuously monitored from start of SCP block to 2 hours after surgery completion;
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Secondary outcome [7]
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Vomiting assessed by patient complaint- data collected from medical records.
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Assessment method [7]
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Timepoint [7]
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Continuously monitored from start of SCP block to 2 hours after surgery completion.
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Eligibility
Key inclusion criteria
Patients with a critical stenosis (>70%) of the carotid artery. ASA I, II and III.
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Minimum age
18
Years
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Maximum age
80
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
Patients older than 80 years, ASA > IV, severe liver dysfunction, body mass index >40, allergies to local anesthetics.
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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)
Allocation was done by 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 randomisation table created by computer software
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
28/09/2021
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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
60
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Accrual to date
55
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Final
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Recruitment outside Australia
Country [1]
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Croatia
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State/province [1]
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Country [2]
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Croatia
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State/province [2]
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Zagreb
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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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University hospital centre Sestre Milosrdnice
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Address [1]
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Vinogradska cesta 29, 10000, Zagreb
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Country [1]
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Croatia
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Primary sponsor type
Hospital
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Name
University hospital centre Sestre Milosrdnice
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Address
Vinogradska cesta 29, 10000, Zagreb
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Country
Croatia
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
312285
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None
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Country [1]
312285
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University hospital centre Sestre Milosrdnice Ethical Committee
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Ethics committee address [1]
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Vinogradska cesta 29, 10000, Zagreb
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Ethics committee country [1]
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Croatia
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Date submitted for ethics approval [1]
310522
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Approval date [1]
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09/09/2021
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Ethics approval number [1]
310522
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Summary
Brief summary
Study hypothesis: Dexmedetomidine increases the duration of sensory block and analgesia when using it as an adjuvant to levobupivacaine and lidocaine in ultrasound-guided superficial cervical block for carotid endarterectomy surgery. Numerous additives were tried in combination with local anaesthetics to increase the quality of anaesthesia and prolong postoperative analgesia. Research on use of a-2 receptor agonist dexmedetomidine as an adjuvant in regional anaesthesia has positive effect on duration of block, but there are no studies on usage in superficial cervical block (SCB) in carotid endarterectomy (CEA), where management of mean arterial pressure is essential. We therefore designed a prospective, randomised, double-blinded study to investigate the effect of adding dexmedetomidine to levobupivacaine and lidocaine on the quality of SCB in CEA surgery.,All patients had invasive blood pressure monitoring and parameters were noted every 5 minutes. Patients were randomly assigned into two groups: both groups received 2 mg/kg 0.5% levobupivacaine with 200 mg of 2% lidocaine supplemented with saline to a volume of 50 mL. Subject group S additionally received 50 micrograms of dexmedetomidine in mixture. The onset and duration of sensory block and analgesia, haemodynamic parameters and side effects: bradycardia, hypotension, respiratory depression, nausea, vomiting, pruritus and shivering were recorded.
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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 Matteo Škrtic
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Address
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University Hospital Centre Sestre Milorsdnice
Vinogradska cesta 29, 10000 Zagreb
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Country
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Croatia
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Phone
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+385997347250
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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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Matteo Škrtic
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Address
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University Hospital Centre Sestre Milorsdnice
Vinogradska cesta 29, 10000 Zagreb
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Country
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Croatia
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Phone
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+385997347250
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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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Matteo Škrtic
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Address
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University Hospital Centre Sestre Milorsdnice
Vinogradska cesta 29, 10000 Zagreb
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Country
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Croatia
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Phone
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+385997347250
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Fax
117948
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Email
117948
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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
Source
Title
Year of Publication
DOI
Embase
Hemodynamic Safety and Effect of Dexmedetomidine on Superficial Cervical Block Quality for Carotid Endarterectomy: A Prospective Study.
2023
https://dx.doi.org/10.1053/j.jvca.2023.06.009
N.B. These documents automatically identified may not have been verified by the study sponsor.
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