Light Sedation or Intubated General Anesthesia in Patients With Brain Cancer Undergoing Craniotomy

NCT ID: NCT02193568

Last Updated: 2019-03-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2019-01-24

Brief Summary

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This randomized clinical trial studies light sedation compared with intubated general anesthesia (a loss of feeling and a complete loss of awareness that feels like a very deep sleep) in reducing complications and length of hospital stay in patients with brain cancer undergoing craniotomy. Craniotomy is an operation in which a piece of the skull is removed so doctors can remove a brain tumor or abnormal brain tissue. Light sedation allows patients to remain awake during their surgery, while intubated general anesthesia puts patients to sleep. Surgery complication rates may be reduced if intubated general anesthesia is avoided. Additionally, patients not receiving intubated general anesthesia tend to recover more quickly after surgery. It is not yet known whether light sedation is better at reducing complications and length of hospital stay compared to intubated general anesthesia.

Detailed Description

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PRIMARY OBJECTIVES:

I. To compare the overall hospital length of stay (LOS) in patients undergoing craniotomy with light sedation vs. general anesthesia.

SECONDARY OBJECTIVES:

I. To compare resource utilization between the two groups. II. To assess the frequency of post-operative delirium. III. To measure patient perceptions. IV. To track patient complications during hospital stay - nausea/vomiting, pain, hematology/lab stability, hemodynamic stability.

V. To track re-admission and extended hospital stay rates. VI. To compare cost of both approaches.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive light sedation (awake) and undergo craniotomy.

ARM II: Patients receive intubated general anesthesia and undergo craniotomy.

After completion of study, patients are followed up at 1month and 1 year.

Conditions

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Adult Brain Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Arm I (light sedation)

Patients receive light sedation (awake) and undergo craniotomy.

Group Type EXPERIMENTAL

Arm I (light sedation)

Intervention Type PROCEDURE

If patients experience excessive preoperative anxiety they will receive light sedation of midazolam 1 mg IV.In our standard practice, it is very rare that patients receive anxiolytic premedication for craniotomies, so it is unlikely that many will require midazolam. Two IVs will be placed, one for infusion of meds and one for possible resuscitation.

Arm II (intubated general anesthesia)

Intervention Type PROCEDURE

Undergo craniotomy

Arm II (intubated general anesthesia)

Intervention Type OTHER

Ancillary studies

Arm I (light sedation)

Intervention Type PROCEDURE

Undergo craniotomy

Arm I (light sedation)

Intervention Type OTHER

Ancillary studies

Arm II (intubated general anesthesia)

Patients receive intubated general anesthesia and undergo craniotomy.

Group Type ACTIVE_COMPARATOR

Arm II (intubated general anesthesia)

Intervention Type PROCEDURE

Receive intubated general anesthesia

Arm II (intubated general anesthesia)

Intervention Type PROCEDURE

Undergo craniotomy

Arm II (intubated general anesthesia)

Intervention Type OTHER

Ancillary studies

Arm I (light sedation)

Intervention Type PROCEDURE

Undergo craniotomy

Arm I (light sedation)

Intervention Type OTHER

Ancillary studies

Interventions

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Arm I (light sedation)

If patients experience excessive preoperative anxiety they will receive light sedation of midazolam 1 mg IV.In our standard practice, it is very rare that patients receive anxiolytic premedication for craniotomies, so it is unlikely that many will require midazolam. Two IVs will be placed, one for infusion of meds and one for possible resuscitation.

Intervention Type PROCEDURE

Arm II (intubated general anesthesia)

Receive intubated general anesthesia

Intervention Type PROCEDURE

Arm II (intubated general anesthesia)

Undergo craniotomy

Intervention Type PROCEDURE

Arm II (intubated general anesthesia)

Ancillary studies

Intervention Type OTHER

Arm I (light sedation)

Undergo craniotomy

Intervention Type PROCEDURE

Arm I (light sedation)

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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anesthesia general anesthesia therapeutic conventional surgery questionnaire administration therapeutic conventional surgery questionnaire administration

Eligibility Criteria

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Inclusion Criteria

* Non-pregnant females
* Elective craniotomy for supratentorial brain tumors
* Primary brain cancer (presumed gliomas with no radiographic or clinical evidence of metastatic disease to the brain)
* First craniotomy
* American Society of Anesthesiologists (ASA) I-III
* Body mass index (BMI) \< 35

Exclusion Criteria

* Posterior fossa tumor/approach for tumor resection requiring the prone position
* Traumatic lesions/hematomas
* Emergency case
* Systemic disease burden with metastatic tumor to the brain
* Presence of medical co-morbidities, which, in the opinion of the investigator complicates the surgical procedure or would require additional hospital stay
* Necessity of awake procedure requiring intraoperative participation of patient due to the presence of the lesion in eloquent brain areas
* Prisoners
* Pregnant women
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ohio State University Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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James Elder

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James Elder, MD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University Comprehensive Cancer Center

Locations

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Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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NCI-2014-01110

Identifier Type: REGISTRY

Identifier Source: secondary_id

OSU-12161

Identifier Type: -

Identifier Source: org_study_id

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