Comparison Between IT Fentanyl and IV Granisetron in Prevention of Vomiting in CS Under Spinal Anesthesia

NCT ID: NCT05474001

Last Updated: 2023-04-18

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

2022-06-01

Study Completion Date

2024-01-30

Brief Summary

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Intrathecal Fentanyl Versus Intravenous Granisetron for the Prevention of Perioperative Nausea and Vomiting During Cesarean Delivery under Spinal Anesthesia

Detailed Description

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This prospective randomized control study will be held in Sohag University Hospital After approval of local ethics committee of sohag university hospital from June 2022 to December 2022, written informed consent will be taken from all patients , about advantages and possible complications of this study .

Inclusion criteria This study will include 90 Patients , physical status I or II according to ASA classification , age between ( 18 - 45 years ) undergoing cesarean delivery under spinal anesthesia.

Technique :

On arrival of patient to operative room :

1. 20G IV line ( cannula ) will be inserted .
2. Putting of patient on monitor and assessment of hemodynamics ( HR , RR , BP ) .
3. Pre anesthetic hydration by at least 1000 ml ringer lactate
4. Patient received Spinal anesthesia at level L3-L4 or L4-L5 lumbar segement .
5. during the procedure, If patient suffer from :

* brady cardia with heart rate ( HR ) less than 55 we will give atropine sulphate 0.5 mg IV .
* hypotension less than 25% of MBP of preoperative value we will give normal saline or ephedrine 5-10 mg .
6. Putting patient in the position for the operation .

Patients will be prospectively randomized divided into 3 groups :

The patients will be randomized using closed envelope method and the medications will be prepared by another anaesthologist not sharing in the study

Group ( F ) Fentanyl group : ( n = 30 ) Patients will receive 10 mg hyperbaric Bupivacaine ( 2ml ) and 20 μg (0.5 mL) fentanyl IT.

1 mL IV normal saline immediately after the placement of the spinal. Group ( G ) Granisetron group : ( n = 30 ) Patients will receive 10 mg hyperbaric Bupivacaine ( 2ml ) and 0.5 mL normal saline IT.

1 mg (1 mL) IV granisetron after spinal placement. Group ( C ) Control group : ( n = 30 ) 10 mg hyperbaric Bupivacaine ( 2ml ) IT and normal saline 0.5 ml

1 ml normal saline IV after spinal placement.

\\Data will be collected from this study : ( 1 ) : Demographic data : Age , sex , weight , height and duration of operation .

( 2 ) : intraoperative:

A- hemodynamics (HR , BP , RR , oxygen saturation before anesthesia , after induction and then :

Every 5 minutes for 1st hour Every 15 minutes for next 2 hours Then every 3 hour for 12 h post operative . B - nausea and vomiting. C - patient discomfort during anesthesia. D - itching. ( 3 ) : post operative : A - nausea and vomiting : using nausea and vomiting score. B - pain assessment using VAS : every 30 mins for 2 h , every hour for 12 h If VAS 3-5 we will give paracetamol 1g IV , more than 5 we will give ketrolac 30 mg IV C \_ total analgesic consumption D \_ itching F \_ retention of urine

Conditions

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Nausea and Vomiting, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Fentanyl group

Patients will receive 10 mg hyperbaric Bupivacaine ( 2ml ) and 20 μg (0.5 mL) fentanyl IT.

1 mL IV normal saline immediately after the placement of the spinal.

Group Type ACTIVE_COMPARATOR

Fentanyl

Intervention Type DRUG

10mg bubivacain intrathecal ( 2ml ) with 20microgram intrathecal fentanyl

Granisetron group

Patients will receive 10 mg hyperbaric Bupivacaine ( 2ml ) and 0.5 mL normal saline IT.

1 mg (1 mL) IV granisetron after spinal placement.

Group Type ACTIVE_COMPARATOR

intravenous graniseton

Intervention Type DRUG

10mg bubivacain intrathecal ( 2ml ) with 0.5 ml saline with no intrathecal fentanyl with 1mg iv granisetron

Control group

10 mg hyperbaric Bupivacaine ( 2ml ) IT and normal saline 0.5 ml

1 ml normal saline IV after spinal placement.

Group Type PLACEBO_COMPARATOR

Bupivacain

Intervention Type DRUG

10mg bubivacain intrathecal (2ml) with 0.5 ml saline with no intrathecal fentanyl

Interventions

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Fentanyl

10mg bubivacain intrathecal ( 2ml ) with 20microgram intrathecal fentanyl

Intervention Type DRUG

Bupivacain

10mg bubivacain intrathecal (2ml) with 0.5 ml saline with no intrathecal fentanyl

Intervention Type DRUG

intravenous graniseton

10mg bubivacain intrathecal ( 2ml ) with 0.5 ml saline with no intrathecal fentanyl with 1mg iv granisetron

Intervention Type DRUG

Other Intervention Names

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IT Fentanyl IT mercaine IV Grantryl

Eligibility Criteria

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Inclusion Criteria

* physical status I or II according to ASA classification with age between ( 18 - 45 years ) undergoing cesarean delivery under spinal anesthesia.

Exclusion Criteria

* patient refusal .
* Any contraindication of neuraxial block.
* Patients with physical status other than 1 and 2 according to ASA classification
* Those with history of nausea and vomiting as Parturients with a history of motion sickness, hyperemesis gravidarum , also those who received anti emetic drugs in last 2 hours of operation .
* Allergy to any of the drug included in this study .
* complicated pregnancy as placenta previa, preeclampsia and eclampsia multible pregnancy
* fetal distress
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mohamed Youssef Mohamed

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Youssef Mohamed

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Sohag University Hospital

Sohag, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Mohammed Youssef, postgarduate

Role: CONTACT

01119727670

Mostafa youssef

Role: CONTACT

01008840458

Facility Contacts

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Osama Elsherief

Role: primary

0934602963

Related Links

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https://journals.lww.com/anesthesia-analgesia/fulltext/2000/05000/intrathecal_fentanyl_is_superior_to_intravenous.30.aspx

Intrathecal Fentanyl Is Superior to Intravenous Ondansetron for the Prevention of Perioperative Nausea During Cesarean Delivery with Spinal Anesthesia

Other Identifiers

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134896646

Identifier Type: -

Identifier Source: org_study_id

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