Comparison of Hypertonic Saline and Mannitol on Brain Relaxation During Supratentorial Tumors Resection

NCT ID: NCT04314674

Last Updated: 2020-03-19

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-04-30

Study Completion Date

2022-12-31

Brief Summary

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Hyperosmotic agents are used to decrease intracranial pressure. The aim of the study is to compare the effects of continuous 3% hypertonic saline (HS), bolus HS and 20% mannitol on intraoperative brain relaxation in patients with raised intracranial pressure during surgery for supratentorial tumors.

Detailed Description

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After obtaining approval from the ethics committee and informed consent, a total of 90 patients aged 18-70 years, conscious (GCS\>13) and American Society of Anesthesiologists (ASA) class I-III, who had intracranial shift \>0.5 cm or glioblastoma multiforme or metastatic tumor and who were scheduled for supratentorial mass resection under elective conditions, will be included in the present prospective, randomized, double-blind and placebo-controlled study. Patients with heart failure, kidney insufficiency, diabetes insipidus, electrolyte imbalance and who are unconscious will be excluded from the study.

The patients will randomized into 3 groups:

Group 1: %3 HS bolus 3 mL.kg-1 Group 2: %3 HS infusion 20 ml/h Group 3: %20 mannitol 0,6 gr.kg-1 After head fixation, all patients will be administered with HS or mannitol (over 20 minutes). Arterial blood gas (ABG) analysis (Cobas b 221 blood gas analyzer, Roche®, Basel, Switzerland) will be made at 30 minute,2,4,6,8. hours. Blood sodium, potassium, chlorine, base excess, lactate levels and blood osmolarity will be recorded in each time intervals. The brain relaxation scale will be recorded at the time of dura opening.

Conditions

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Brain Tumor - Metastatic Brain Tumor, Adult: Glioblastoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group 1: %3 HS bolus 3 mL.kg-1 Group 2: %3 HS infusion 20 ml/h Group 3: %20 mannitol 0,6 gr.kg-1
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
All the patients, the anesthesiologist who will evaluate the postoperative cranial CT will be blind to study group

Study Groups

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%3 HS bolus 3 mL.kg-1

After the head fixation 3 mL.kg-1 %3 hypertonic saline will be administered over the 20 min intravenously.

Group Type ACTIVE_COMPARATOR

%3 HS bolus

Intervention Type DRUG

After head fixation %3 HS bolus 3 ml/kg will be administered

%3 HS infusion 20 ml/h

After the head fixation 3% hypertonic saline at 20 ml/h infusion rate will be administered during the operation

Group Type ACTIVE_COMPARATOR

%3 HS infusion 20 ml/h

Intervention Type DRUG

After head fixation %3 HS 20 ml/h infusion will be administered

%20 mannitol 0,6 gr.kg-1

After the head fixation %20 mannitol 0,6 gr.kg-1 will be administered over the 20 min intravenously.

Group Type ACTIVE_COMPARATOR

20% mannitol

Intervention Type DRUG

After head fixation %20 mannitol 0.6 ml/kg will be administered

Interventions

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%3 HS bolus

After head fixation %3 HS bolus 3 ml/kg will be administered

Intervention Type DRUG

%3 HS infusion 20 ml/h

After head fixation %3 HS 20 ml/h infusion will be administered

Intervention Type DRUG

20% mannitol

After head fixation %20 mannitol 0.6 ml/kg will be administered

Intervention Type DRUG

Other Intervention Names

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Group 1 Group 2 Group 3

Eligibility Criteria

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Inclusion Criteria

* Elective supratentorial tumor resection
* Glioblastoma multiforme
* Metastatic tumor
* Intracranial shift \>0.5 cm
* GCS\>13

Exclusion Criteria

* Renal failure
* Heart failure
* Electrolyte imbalance
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Istanbul University

OTHER

Sponsor Role lead

Responsible Party

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Eren Fatma Akcil

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yusuf Tunali

Role: STUDY_DIRECTOR

Professor of the department

Central Contacts

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Eren F Akcil

Role: CONTACT

00905327992399

References

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Quentin C, Charbonneau S, Moumdjian R, Lallo A, Bouthilier A, Fournier-Gosselin MP, Bojanowski M, Ruel M, Sylvestre MP, Girard F. A comparison of two doses of mannitol on brain relaxation during supratentorial brain tumor craniotomy: a randomized trial. Anesth Analg. 2013 Apr;116(4):862-8. doi: 10.1213/ANE.0b013e318282dc70. Epub 2013 Jan 25.

Reference Type BACKGROUND
PMID: 23354336 (View on PubMed)

Dostal P, Dostalova V, Schreiberova J, Tyll T, Habalova J, Cerny V, Rehak S, Cesak T. A comparison of equivolume, equiosmolar solutions of hypertonic saline and mannitol for brain relaxation in patients undergoing elective intracranial tumor surgery: a randomized clinical trial. J Neurosurg Anesthesiol. 2015 Jan;27(1):51-6. doi: 10.1097/ANA.0000000000000091.

Reference Type BACKGROUND
PMID: 25036870 (View on PubMed)

Hernandez-Palazon J, Fuentes-Garcia D, Domenech-Asensi P, Piqueras-Perez C, Falcon-Arana L, Burguillos-Lopez S. A comparison of equivolume, equiosmolar solutions of hypertonic saline and mannitol for brain relaxation during elective supratentorial craniotomy. Br J Neurosurg. 2016;30(1):70-5. doi: 10.3109/02688697.2015.1109061. Epub 2015 Nov 16.

Reference Type BACKGROUND
PMID: 26571037 (View on PubMed)

Other Identifiers

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Neuroanesthesia Cerrahpasa

Identifier Type: -

Identifier Source: org_study_id

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