Thoracic Spinal Versus Epidural Anesthesia for Nephrectomy in Obstructive/Restrictive Lung Disease Patients

NCT ID: NCT03324490

Last Updated: 2019-07-23

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

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-01

Study Completion Date

2018-06-01

Brief Summary

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Patients with respiratory disease have an increased risk of developing complications perioperatively. The use of regional anesthesia decreases this risk with better postoperative outcome. The aim of this study is to compare the safety and efficacy of thoracic spinal versus thoracic epidural anesthesia for open nephrectomy in patients with obstructive/restrictive lung disease.

Detailed Description

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Conditions

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Nephrectomy Lung Diseases Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Using computer \& sealed envelope randomization, patients are assigned to receive either thoracic spinal anesthesia \[TSA group: n=30\] or thoracic epidural anesthesia \[TEA group: n=30\].
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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TSA group

Thoracic Spinal Anesthesia; Bupivacaine 0.5% (hyperbaric) 7.5mg, Fentanyl 25 µg \& Dexmedetomidine 5 µg by intrathecal injection

Group Type ACTIVE_COMPARATOR

Thoracic Spinal Anesthesia

Intervention Type PROCEDURE

Spinal anesthesia will be performed for patients of the TSA group at the T7-T8 intervertebral space, using a 27 G pencil point needle with an introducer (Braun Melsungen, Melsungen, Germany).

When correct placement is confirmed by the free flow of clear CSF, 1.5 ml of hyperbaric Bupivacaine 0.5% (7.5 mg) in addition to 0.5 ml Fentanyl (25 μg) \& 5 μg dexmedetomidine will be injected.

Bupivacaine 0.5% (hyperbaric)

Intervention Type DRUG

Neuro-axially injected

Fentanyl

Intervention Type DRUG

Neuro-axially injected

Dexmedetomidine

Intervention Type DRUG

Neuro-axially injected

TEA group

Thoracic Epidural Anesthesia; Bupivacaine 0.5% (isobaric) 25-50 mg \& Fentanyl 10-20 µg by epidural injection

Group Type ACTIVE_COMPARATOR

Thoracic Epidural Anesthesia

Intervention Type PROCEDURE

Epidural anesthesia will be performed for patients of the TEA group at the T7-T8 intervertebral space, using the "Prefix Custom Epidural Anesthesia Tray" with an 18 G Tuohy epidural needle \& a 20 G epidural catheter.

Patients will initially receive 5-10 ml of a mixed preparation of 0.5% isobaric Bupivacaine with 2 μg Fentanyl per ml volume as a bolus dose via the epidural catheter, this will be followed by a continuous infusion of 5-10 ml/hr started 1 hour after the bolus dose \& continued throughout the procedure.

Bupivacaine 0.5% (isobaric)

Intervention Type DRUG

Neuro-axially injected

Fentanyl

Intervention Type DRUG

Neuro-axially injected

Interventions

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Thoracic Spinal Anesthesia

Spinal anesthesia will be performed for patients of the TSA group at the T7-T8 intervertebral space, using a 27 G pencil point needle with an introducer (Braun Melsungen, Melsungen, Germany).

When correct placement is confirmed by the free flow of clear CSF, 1.5 ml of hyperbaric Bupivacaine 0.5% (7.5 mg) in addition to 0.5 ml Fentanyl (25 μg) \& 5 μg dexmedetomidine will be injected.

Intervention Type PROCEDURE

Thoracic Epidural Anesthesia

Epidural anesthesia will be performed for patients of the TEA group at the T7-T8 intervertebral space, using the "Prefix Custom Epidural Anesthesia Tray" with an 18 G Tuohy epidural needle \& a 20 G epidural catheter.

Patients will initially receive 5-10 ml of a mixed preparation of 0.5% isobaric Bupivacaine with 2 μg Fentanyl per ml volume as a bolus dose via the epidural catheter, this will be followed by a continuous infusion of 5-10 ml/hr started 1 hour after the bolus dose \& continued throughout the procedure.

Intervention Type PROCEDURE

Bupivacaine 0.5% (hyperbaric)

Neuro-axially injected

Intervention Type DRUG

Bupivacaine 0.5% (isobaric)

Neuro-axially injected

Intervention Type DRUG

Fentanyl

Neuro-axially injected

Intervention Type DRUG

Dexmedetomidine

Neuro-axially injected

Intervention Type DRUG

Other Intervention Names

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Heavy Marcaine Marcaine

Eligibility Criteria

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Inclusion Criteria

* ASA class II or III
* Mild to moderate obstructive or restrictive lung disease
* Open nephrectomy candidate patients

Exclusion Criteria

* Any condition contra-indicating regional anesthesia
* Allergic to any of the drugs used during the procedure
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nazmy Edward Seif

OTHER

Sponsor Role lead

Responsible Party

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Nazmy Edward Seif

Clinical Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Nazmy E Seif, MD

Role: STUDY_CHAIR

Kasr Al-Ainy Hospital, Cairo University

Ahmed M El-Badawy, MD

Role: STUDY_DIRECTOR

Kasr Al-Ainy Hospital, Cairo University

Locations

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Kasr Al-Ainy Hospital, Cairo University

Cairo, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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TSEANORLDP60

Identifier Type: -

Identifier Source: org_study_id

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