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Trial registered on ANZCTR
Registration number
ACTRN12607000548437
Ethics application status
Approved
Date submitted
28/08/2007
Date registered
24/10/2007
Date last updated
6/05/2008
Type of registration
Prospectively registered
Titles & IDs
Public title
Patient controlled sedation with propofol for emergency department procedures
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Scientific title
Total propofol dose in physician versus patient controlled sedation for emergency department procedures
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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:
Procedural sedation in the emergency department
2501
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Condition category
Condition code
Anaesthesiology
2401
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0
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Pain management
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Anaesthesiology
2598
2598
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A prospective, unblinded, randomised controlled trial will be conducted at a metropolitan tertiary-referral teaching hospital ED with an annual census of 70,000. The use of propofol for procedural sedation by emergency physicians or advanced trainees is an established practice in our ED. After administration of analgesia and confirmation of the diagnosis, eligible patients will be invited to participate in the study. Consented participants will then be randomised to the emergency physician-administered (EPA) propofol sedation group or the patient-controlled propofol sedation (PCS) group. The EPA group will receive propofol sedation at the discretion of the treating physician. The PCS group will undergo sedation using a patient-controlled infusion pump containing propofol. An initial bolus of 0.5-0.75mg/kg will be delivered, followed by self-administered increments of 20 mg with a lockout period of 1 minute.
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Intervention code [1]
2022
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Treatment: Drugs
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Comparator / control treatment
Physician administered propofol as per current practice
Initial bolus dose: 1 mg/kg IV
Subsequent bolus doses: 1 mg/kg IV titrated to response
Total maximum dose: mg/kg IV
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Total propofol dose
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Assessment method [1]
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Timepoint [1]
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At end of procedural sedation
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Secondary outcome [1]
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Length of sedation, depth of sedation, patient satisfaction, ease of procedure for the clinician and adverse event rates
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Assessment method [1]
5857
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Timepoint [1]
5857
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At end of procedural sedation
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Eligibility
Key inclusion criteria
Patient requiring a procedural sedation as part of their treatment in the emergency department
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Minimum age
16
Years
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Maximum age
Not stated
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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
Inadequate English language comprehension,
Physical inability to use the handset of a patient-controlled infusion pump,
Known allergy or hypersensitivity to propofol,
Anticipated airway difficulty,
Pregnancy
Pregnancy.
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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)
Eligible patients will be identified by their treating doctor. Treatment assignments will be randomised into blocks of four patients with the aid of a random number table. Study instructions, data sheets and treatment arm will be placed in serially-numbered, opaque envelopes for use with consecutive enrolments. This envelop is to be opened only after written consent has been provided by the participant.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Treatment assignments will be randomised into blocks of four patients with the aid of a random number table by an associate not involved in patient enrolment.
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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
Parallel
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Other design features
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Phase
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
1/12/2007
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Actual
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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
160
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
420
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4006
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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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Address [1]
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Country [1]
2747
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Primary sponsor type
Hospital
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Name
Royal Brisbane and Women's Hospital
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Address
Butterfield St
Herston 4006
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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]
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Country [1]
2482
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Brisbane and Women's Hospital
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Ethics committee address [1]
4666
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Butterfield St Herston 4006
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Ethics committee country [1]
4666
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Australia
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Date submitted for ethics approval [1]
4666
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11/10/2006
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Approval date [1]
4666
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16/02/2007
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Ethics approval number [1]
4666
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2006/179
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Summary
Brief summary
Procedural sedation is frequently used in Emergency Departments (ED) for orthopaedic reductions, cardioversions and other painful but brief procedures. Various pharmacologic agents have been used, including nitrous oxide, ketamine, propofol and combinations of benzodiazepine and opioid. Propofol, a potent, short-acting sedative agent, has gained widespread popularity and has been shown to be safe for procedural sedation in the ED. The advantages of propofol include rapid onset, short duration of action, antiemetic effect and high degree of patient satisfaction. Potential disadvantages include deep sedation, apnoea and hypotension. Patient controlled sedation (PCS) has been investigated for more than 20 years, primarily for minor procedures in the operating theatre, such as colonoscopy and dental extractions. The potential advantage of the PCS technique is that the patient is able to match their sedation requirement with the noxious stimuli and titrate themselves to an appropriate level of sedation without the risk of over-sedation. A second potential advantage of PCS is the psychological benefit it confers on its user with a sense of control over a stressful and painful procedure. Little data has been published on the use of PCS in the ED setting. The objective of this study is to investigate the efficacy of using propofol in a standard patient-controlled infusion pump for procedural sedation in the ED.
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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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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 public queries
Name
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Anthony Bell
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Address
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Royal Brisbane and Women's Hospital
Butterfield St
Herston 4006
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Country
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Australia
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Phone
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0736367901
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Fax
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0736361643
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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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Kevin Chu
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Address
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Royal Brisbane and Women's Hospital
Butterfield St
Herston 4006
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Country
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Australia
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Phone
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0736367901
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Fax
2097
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0736361643
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Email
2097
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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
No additional documents have been identified.
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