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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00164047
Registration number
NCT00164047
Ethics application status
Date submitted
13/09/2005
Date registered
14/09/2005
Date last updated
31/07/2009
Titles & IDs
Public title
ENIGMA - Evaluation of Nitrous Oxide In the Gas Mixture for Anaesthesia: a Randomised Controlled Trial
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Scientific title
Evaluation of Nitrous Oxide In the Gas Mixture for Anaesthesia: a Randomised Controlled Trial
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Secondary ID [1]
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NHMRC 236956
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Secondary ID [2]
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204/02
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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:
Quality of Recovery From Anaesthesia
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Effects of Nitrous Oxide Following Anaesthesia
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Induced Endothelial Dysfunction
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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The primary endpoint is hospital length of stay (LOS), defined from the start of surgery until actual hospital discharge. Patients transferred to another hospital will be tracked until final discharge to home (or other final destination). LOS is likely
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Assessment method [1]
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Timepoint [1]
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Secondary outcome [1]
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Secondary endpoints will be detected by a research assistant who will be masked to Group identity, using chart review up to 30 days postoperatively; confirmation of each will be sought by an independent member of the Endpoint Committee:
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Assessment method [1]
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Timepoint [1]
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Secondary outcome [2]
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Wound infection - if associated with purulent discharge or a positive microbial culture (46)
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Assessment method [2]
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Timepoint [2]
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Secondary outcome [3]
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Myocardial infarction - confirmed by ECG and/or troponin or CK-MB enzyme rise
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Assessment method [3]
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Timepoint [3]
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Secondary outcome [4]
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Venous thromboembolism - symptomatic DVT or PE, confirmed by venography, duplex ultrasonography, V-Q scan or spiral CT, or autopsy
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Assessment method [4]
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Timepoint [4]
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Secondary outcome [5]
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Stroke - a new neurological deficit persisting for 24 hours, confirmed by neurologist assessment and/or CT scan or MRI
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Assessment method [5]
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Timepoint [5]
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Secondary outcome [6]
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Awareness - postoperative recollection of intraoperative events
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Assessment method [6]
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Timepoint [6]
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Secondary outcome [7]
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Blood transfusion - any red cell transfusion within 30 days of surgery
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Assessment method [7]
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Timepoint [7]
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Secondary outcome [8]
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Pneumothorax, atelectasis, or pneumonia - confirmed by chest x-ray; for pneumonia: also 2 or more of temp> 38oC, white cell count >12,000/ml, positive sputum culture
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Assessment method [8]
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Timepoint [8]
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Secondary outcome [9]
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Severe vomiting - at least 2 episodes >6 hrs apart, or if requiring >2 doses of antiemetic medication
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Assessment method [9]
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Timepoint [9]
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Secondary outcome [10]
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Quality of recovery on the morning after surgery -using the validated QoR Score instrument (14), a 9-item patient-orientated measure of early postoperative health status. This is associated with patient satisfaction.
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Assessment method [10]
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Timepoint [10]
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Secondary outcome [11]
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30-day mortality - for safety analysis only (study not powered for this rare event).
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Assessment method [11]
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Timepoint [11]
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Eligibility
Key inclusion criteria
1. Males and females, age 18 years and over
2. Planned general anaesthesia for surgery that includes a skin incision and expected to exceed two hours, and the patient is expected to be in hospital for at least three days
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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
1. Endoscopic or radiological procedures
2. Cardiac surgery
3. Marked impairment of gas-exchange (requiring Fi02> 0.3)
4. Thoracic surgery requiring one-lung ventilation (requiring Fi02> 0.3)
5. Specific circumstances where N2O is contraindicated (eg. volvulus, pulmonary hypertension, raised intracranial pressure)
6. Lack of provision of N2O.
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Study design
Purpose of the study
Prevention
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/04/2003
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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
1/12/2004
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Sample size
Target
2070
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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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Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Bayside Health
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Other collaborator category [2]
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Government body
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Name [2]
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Australia: Theapeutic Goods Administration
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Address [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
We aim to investigate the effectiveness and safety of nitrous oxide (N2O) in anaesthesia. Hypothesis In patients undergoing anaesthesia for major surgery, avoidance of N2O will reduce hospital length of stay when compared with otherwise identically managed surgical patients receiving N2O as a component of their anaesthesia.
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Trial website
https://clinicaltrials.gov/study/NCT00164047
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Trial related presentations / publications
Myles PS, Leslie K, Silbert B, Paech MJ, Peyton P. A review of the risks and benefits of nitrous oxide in current anaesthetic practice. Anaesth Intensive Care. 2004 Apr;32(2):165-72. doi: 10.1177/0310057X0403200202. No abstract available. Myles PS, Leslie K, Chan MT, Forbes A, Paech MJ, Peyton P, Silbert BS, Pascoe E; ENIGMA Trial Group. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 2007 Aug;107(2):221-31. doi: 10.1097/01.anes.0000270723.30772.da. Leslie K, Myles PS, Chan MT, Paech MJ, Peyton P, Forbes A, McKenzie D; ENIGMA Trial Group. Risk factors for severe postoperative nausea and vomiting in a randomized trial of nitrous oxide-based vs nitrous oxide-free anaesthesia. Br J Anaesth. 2008 Oct;101(4):498-505. doi: 10.1093/bja/aen230. Epub 2008 Aug 5.
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Public notes
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Contacts
Principal investigator
Name
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Paul S Myles, MB BS MPH MD
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Address
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The Alfred
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
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
Type
Citations or Other Details
Journal
Myles PS, Leslie K, Chan MT, Forbes A, Paech MJ, P...
[
More Details
]
Results not provided in
https://clinicaltrials.gov/study/NCT00164047
Download to PDF