Optimal Dose of Intravenous Oxycodone for Endotracheal Intubation

NCT ID: NCT02484352

Last Updated: 2017-07-21

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

95 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2017-02-12

Brief Summary

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Intravenous form of oxycodone is recently used for the adjunct of anesthetic agents to avoid adverse effects of the stimulation of endotracheal intubation. The potency ratio of oxycodone to fentanyl is not absolutely defined. The aim of this study was to assess the optimal dose of intravenous oxycodone for attenuation of hemodynamic responses to laryngoscopy and endotracheal intubation.

A prospective, randomized, double-blind study was conducted. Ninety one patients were randomly divided into 5 group based on the dose of oxycodone; 0, 0.05, 0.1, 0.15, 0.2 mg/kg. After giving each assigned dose of intravenous oxycodone, anesthesia was induced with thiopental and rocuronium. Heart rate (HR) and blood pressure (BP) was collected at baseline, before intubation, 1, 2, 3 minutes after intubation. The change of BP was calculated by (highest BP after intubation - baseline BP)/baseline BP.

Detailed Description

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Endotracheal intubation is almost always associated with increase of catecholamine and arterial blood pressure. To prevent the responses to laryngoscopy and tracheal intubation, adjuvant use of opioid to sedative drugs during anesthetic induction phase are common. Intravenous form of oxycodone is recently used for the adjunct of anesthetic agents to avoid adverse effects of the stimulation of endotracheal intubation. However, The potency ratio of oxycodone to fentanyl is not absolutely defined. Therefore, the investigators aimed to assess the optimal dose of intravenous oxycodone for attenuation of hemodynamic responses to laryngoscopy and endotracheal intubation.

The patients were randomly divided into five different groups based on the dose of oxycodone; 0. 0.05, 0.1, 0.15, 0.2 mg/kg. The drug was prepared by a person who is not participating the anesthetic management and surgery of the patient. In five groups, the drug was mixed with normal saline which makes the total drug volume to be 10 ml. After monitoring was started including ECG, noninvasive blood pressure, and pulse oximetry, the anesthesiologist who has no information about the drug give the drug when starting induction of anesthesia. Thiopental 4-5 mg/kg and rocuronium 0.6-0.9 mg/kg was given subsequently. Manual ventilation was done with sevoflurane 3-5 volume% for 2-3 minutes and tracheal intubation was done. Maintenance of anesthesia was done with 50% O2 with nitrous oxide and sevoflurane. Mechanical ventilation was done with tidal volume 10 ml/kg and respiratory rate 12 /min. The baseline hemodynamic data including heart rate and blood pressure was recorded and those before intubation, 1,2,3 minutes after intubation were obtained. The discrepancies between the highest and baseline, the lowest blood pressure and heart rate and baseline were used to make out the proportion of hemodynamic changes. This proportion of the hemodynamic changes were compared in five groups. In addition, the use of vasopressor was also recorded and the frequency and the cumulative dose was compared among the groups.

Conditions

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Intubation Complication Blood Pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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0 mg/kg of oxycodone

Intervention: patients receive 10 ml of normal saline without oxycodone through intravenous route before intubation.

Group Type OTHER

saline

Intervention Type DRUG

different dosage of IV oxycodone was given before intubation

0.05 mg/kg of oxycodone

Intervention: patients receive 10 ml of fluid with 0.05 mg/kg of oxycodone in normal saline through intravenous route before intubation.

Group Type OTHER

0.05 mg/kg of oxycodone

Intervention Type DRUG

different dosage of IV oxycodone was given before intubation

0.1 mg/kg of oxycodone

Intervention: patients receive 10 ml of fluid with 0.1 mg/kg of oxycodone in normal saline through intravenous route before intubation.

Group Type OTHER

0.1 mg/kg of oxycodone

Intervention Type DRUG

different dosage of IV oxycodone was given before intubation

0.15 mg/kg of oxycodone

Intervention: patients receive 10 ml of fluid with 0.15 mg/kg of oxycodone in normal saline through intravenous route before intubation.

Group Type OTHER

0.15 mg/kg of oxycodone

Intervention Type DRUG

different dosage of IV oxycodone was given before intubation

0.2 mg/kg of oxycodone

Intervention: patients receive 10 ml of fluid with 0.2 mg/kg of oxycodone in normal saline through intravenous route before intubation.

Group Type OTHER

0.2 mg/kg of oxycodone

Intervention Type DRUG

different dosage of IV oxycodone was given before intubation

Interventions

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saline

different dosage of IV oxycodone was given before intubation

Intervention Type DRUG

0.05 mg/kg of oxycodone

different dosage of IV oxycodone was given before intubation

Intervention Type DRUG

0.1 mg/kg of oxycodone

different dosage of IV oxycodone was given before intubation

Intervention Type DRUG

0.15 mg/kg of oxycodone

different dosage of IV oxycodone was given before intubation

Intervention Type DRUG

0.2 mg/kg of oxycodone

different dosage of IV oxycodone was given before intubation

Intervention Type DRUG

Other Intervention Names

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OxyNorm OxyNorm OxyNorm OxyNorm

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiologists (ASA) class 1

Exclusion Criteria

* ASA class over 2
* expected difficult intubation
* intubation time over 30 seconds
* intubation trial was more than once
Minimum Eligible Age

20 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chung-Ang University

OTHER

Sponsor Role collaborator

Yong-Hee Park

OTHER

Sponsor Role lead

Responsible Party

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Yong-Hee Park

Assistant professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Young-Cheol Woo, Ph.D.

Role: STUDY_DIRECTOR

Chung-Ang University Hosptial, Chung-Ang University College of Medicine

Locations

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Department of Anesthesiology and Pain Medicine : Chung-Aung University Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Sawano Y, Miyazaki M, Shimada H, Kadoi Y. Optimal fentanyl dosage for attenuating systemic hemodynamic changes, hormone release and cardiac output changes during the induction of anesthesia in patients with and without hypertension: a prospective, randomized, double-blinded study. J Anesth. 2013 Aug;27(4):505-11. doi: 10.1007/s00540-012-1552-x. Epub 2013 Jan 12.

Reference Type BACKGROUND
PMID: 23314694 (View on PubMed)

Russell WJ, Morris RG, Frewin DB, Drew SE. Changes in plasma catecholamine concentrations during endotracheal intubation. Br J Anaesth. 1981 Aug;53(8):837-9. doi: 10.1093/bja/53.8.837.

Reference Type BACKGROUND
PMID: 7272146 (View on PubMed)

Other Identifiers

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C2014115(1311)

Identifier Type: -

Identifier Source: org_study_id

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