A 3 Months Duration Interventional Study Comparing Hemodynamic Parameters Between Bolus and Fractionated Group.

NCT ID: NCT06620614

Last Updated: 2024-10-08

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

PHASE1

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-01

Study Completion Date

2023-12-01

Brief Summary

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The goal of this study is to compare the intraoperative hemodynamic status, characteristics of block of fractionated versus single bolus dose of Hyperbaric Bupivacaine in patient undergoing Transurethral Resection of Prostate(TURP) surgery under Subarachnoid block(SAB).

Seventy-two patients aged 50 years and above belonging to American Physical status I and II are divided into two study group.

Group B will receive Injection 0.5 % hyperbaric bupivacaine 2.5 ml single bolus dose and group F will receive same concentration and volume of hyperbaric bupivacaine with two third dose initially (i.e. 1.6 ml) and remaining one third dose (i.e. 0.9 ml) after 60 seconds at the rate of 0.2ml/sec.

Detailed Description

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The aim of this study is to compare the intraoperative hemodynamic status, characteristics of block of fractionated versus single bolus dose of Hyperbaric Bupivacaine in patient undergoing TURP surgery under SAB.

Seventy-two patients aged 50 years and above belonging to American Physical status I and II undergoing transurethral resection of prostate for benign enlargement of prostate under subarachnoid block are enrolled and are divided into two groups having 36 patients in each.

Group B will receive Injection 0.5 % hyperbaric bupivacaine 2.5 ml single bolus dose and group F will receive same concentration and volume of hyperbaric bupivacaine with two third dose initially (i.e. 1.6 ml) and remaining one third dose (i.e. 0.9 ml) after 60 seconds at the rate of 0.2ml/sec.

Intraoperative mean arterial pressure (MAP), heart rate, onset of sensory and motor block, duration of sensory and motor block, and total intraoperative consumption of vasopressor are observed and compared between the groups.

Conditions

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Prostatic Hyperplasia, Benign

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

An approval from the Institutional Review Board (IRB), NAMS was taken prior to commencing the study. 72 Patients of ASA physical status I or II scheduled for Transurethral Resection of prostate under Sub-arachnoid block were enrolled in the study. . Patient's characteristics including name, gender, age, body weight, height and body mass index were recorded.

Patients were kept nil per oral as per American society of anesthesiologist guidelines prior to surgery. Study pouplation were divided into two groups:

* Bolus group
* Fractionated group
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Fractionated group arm

In this group ,participants are given 1.6 ml of Injection Heavy Bupivacaine 0.5% initially followed by 0.9ml after 60 seconds at a rate of 0.2ml/hr.

Group Type EXPERIMENTAL

0.5% Heavy Bupivacaine

Intervention Type COMBINATION_PRODUCT

There are two groups.

Bolus arm group

In this group ,participants are given Injection Heavy Bupivacaine 0.5% 2.5ml bolus at a rate of 0.2ml/hr

Group Type PLACEBO_COMPARATOR

0.5% Heavy Bupivacaine

Intervention Type COMBINATION_PRODUCT

There are two groups.

Interventions

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0.5% Heavy Bupivacaine

There are two groups.

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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26 G Quincke's needle

Eligibility Criteria

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Inclusion Criteria

* Age: 50 years and above patients undergoing TURP surgery under SAB
* American Society of Anesthesiologist's Physical Status: I and II.

Exclusion Criteria

* Patients with history of uncontrolled hypertension.
* Patients with previous history of cerebrovascular accidents.
* Patients with history of spinal deformity.
* Patients with known allergy to local anesthetics.
* Patient with Infection at site of injection.
* Patient with history of coagulopathy.
Minimum Eligible Age

50 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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National Academy of Medical Sciences, Nepal

OTHER_GOV

Sponsor Role lead

Responsible Party

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Shushma K C

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pusparaj Poudel, MD

Role: STUDY_CHAIR

Bir Hospital

Locations

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National Academy of Medical Sciences, Bir Hospital

Kathmandu, , Nepal

Site Status

Countries

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Nepal

References

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Nash J. Benign prostatic hyperplasia: prevalence and diagnosis. GM Journal. 2010;40:321-4

Reference Type BACKGROUND

Persu C, Georgescu D, Arabagiu I, Cauni V, Moldoveanu C, Geavlete P. TURP for BPH. How large is too large? J Med Life. 2010 Oct-Dec;3(4):376-80.

Reference Type BACKGROUND
PMID: 21254734 (View on PubMed)

Bhattacharyya S, Bisai S, Biswas H, Tiwary MK, Mallik S, Saha SM. Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block. Saudi J Anaesth. 2015 Jul-Sep;9(3):268-71. doi: 10.4103/1658-354X.158497.

Reference Type BACKGROUND
PMID: 26240544 (View on PubMed)

Gandhi M, Kabir KK, Arora KK, Tiwari K. Comparative study between fractionated and single bolus dose of local anaesthetic in elective lower segment caeserean section. Indian J Clin Anaesth. 2019;6(3):386-90

Reference Type BACKGROUND

Kararmaz A, Kaya S, Turhanoglu S, Ozyilmaz MA. Low-dose bupivacaine-fentanyl spinal anaesthesia for transurethral prostatectomy. Anaesthesia. 2003 Jun;58(6):526-30. doi: 10.1046/j.1365-2044.2003.03153.x.

Reference Type BACKGROUND
PMID: 12846615 (View on PubMed)

Beed M. Anaesthesia for gynaecological and genitourinary surgery. In: Aitkenhead A, Thompson J, Rowbotham D, Moppett I, editors. Smith and Aitkenhead's Textbook of Anaesthesia. 6 th edition. London: Churchill Livingstone/Elsevier; 2013. p. 568-77

Reference Type BACKGROUND

Puri N, Talwar A. Comparative Study of Ephedrine and Mephertermine in Treatment of Hypotension in Patients Undergoing Elective Trans Urethral Resection Prostate (TURP). Journal of Bangladesh College of Physicians and Surgeons. 2010;28(1):10-6

Reference Type BACKGROUND

Favarel-Garrigues JF, Sztark F, Petitjean ME, Thicoipe M, Lassie P, Dabadie P. Hemodynamic effects of spinal anesthesia in the elderly: single dose versus titration through a catheter. Anesth Analg. 1996 Feb;82(2):312-6. doi: 10.1097/00000539-199602000-00017.

Reference Type BACKGROUND
PMID: 8561333 (View on PubMed)

Nugroho AM, Sugiarto A, Chandra S, Lembahmanah L, Septica RI, Yuneva A. A Comparative Study of Fractionated Versus Single Dose Injection for Spinal Anesthesia During Cesarean Section in Patients with Pregnancy-Induced Hypertension. Anesth Pain Med. 2019 Feb 6;9(1):e85115. doi: 10.5812/aapm-85115. eCollection 2019 Feb.

Reference Type BACKGROUND
PMID: 30881909 (View on PubMed)

Norris MC. Neuraxial anaesthesia. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SM, Holt NF, editors. Clinical Anaesthesia. 8 thedition. New Delhi: Wolters Kluwer; 2017. p. 914-44.

Reference Type BACKGROUND

Brull R, Macfarlane AJ, Chan VW. Spinal, epidural, and caudal anaesthesia. In: Miller RD, editor. Miller's anaesthesia. 8 th edition. Philadelphia: Elsevier Saunders;2015. p. 1684-720.

Reference Type BACKGROUND

Badheka JP, Oza VP, Vyas A, Baria D, Nehra P, Babu T. Comparison of fractionated dose versus bolus dose injection in spinal anaesthesia for patients undergoing elective caesarean section: A randomised, double-blind study. Indian J Anaesth. 2017 Jan;61(1):55-60. doi: 10.4103/0019-5049.198390.

Reference Type BACKGROUND
PMID: 28216705 (View on PubMed)

Ramasali M.V., Vankaylapatti S. D., Appagalla S, Kulkarni D. K., Pasupuleti S. A Prospective Randomised Double-Blind Comparative Study of Bolus versus Fractionated Dose Injection in Spinal Anaesthesia for Pregnant Women undergoing elective Caesarean Section. Indian J Anesth Anal 2018; 5(11):1840-45

Reference Type BACKGROUND

Derakhshan P, Faiz SHR, Rahimzadeh P, Salehi R, Khaef G. A Comparison of the Effect of Fractionated and Bolus Dose Injection on Spinal Anesthesia for Lower Limb Surgery: A Randomized Clinical Trial. Anesth Pain Med. 2020 Aug 23;10(5):e102228. doi: 10.5812/aapm.102228. eCollection 2020 Oct.

Reference Type BACKGROUND
PMID: 34150559 (View on PubMed)

Kaniyil S, Priya PG, Nithinkumar MP, Sneha SR. Fractional spinal anaesthesia in high-risk elderly patients for orthopaedic surgery - Case series. Indian J Anaesth. 2023 Jul;67(7):651-654. doi: 10.4103/ija.ija_888_22. Epub 2023 Jul 14.

Reference Type BACKGROUND
PMID: 37601939 (View on PubMed)

Tiwari K, Masar R. Comparison Between Fractionated and Single Bolus Dose of Local Anaesthetic (Bupivacaine 0.5% Heavy) in Elective Lower Segment Caeserean Section. Int. J. Health Clin. Res. 2020; 3(6):36-42

Reference Type BACKGROUND

Srivastava N, Ahluwalia P, Jheetay GS, Singh G. Bolus dose versus fractionated dose injection of hyperbaric bupivacaine in spinal anaesthesia among adult patients undergoing lower limb surgery: A prospective study. Indian J Clin Anaesth. 2020;7(2):238-44

Reference Type BACKGROUND

Hossain MM, Biswas B, Mohanta PK, Hassan MM, Basu P, Islam F. Comparison between fractionated dose with bolus dose in Spinal Anaesthesia for haemodynamic stability and duration of analgesia in patients undergoing elective Lower Segment Caesarean Section (LSCS). Mediscope. 2020 Sep 29;7(2):95-102

Reference Type BACKGROUND

Sowmya NL. Comparison of Fractionated versus Bolus Dose Injection of Drug in Spinal Anaesthesia for Lower Limb Surgeries. Int. J. Sci. Res. 2020;Vol 9

Reference Type BACKGROUND

Mahbuba S, Chy MM, Naz S, Begum M, Jahan SS, Sheikh ZA. Comparison of sensory and motor block outcome of fractionated versus single bolus dose administration of hyperbaric bupivacaine in elective cesarean section. Medico Research Chronicles. 2021 ;8(4):317-24

Reference Type BACKGROUND

Related Links

Access external resources that provide additional context or updates about the study.

https://pavilionhealthtoday.com/gm/benign-prostatic-hyperplasia-prevalence-and-diagnosis/

This study describes about prevalence of benign prostatic hyperlasia in elderly male.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019067/

This article describes about TURP for Benign Prostatic Hyperplasia

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478818/

This article describes about comparision between saddle and subarachnoid block in TURP surgery.

https://pubmed.ncbi.nlm.nih.gov/12846615/

This article describes about Low-dose bupivacaine-fentanyl spinal anaesthesia for transurethral prostatectomy.

https://www.banglajol.info/index.php/JBCPS/article/view/4638

This study describes about comparison of Ephedrine and Mephertermine in Treatment of Hypotension in Patients Undergoing Elective Trans Urethral Resection Prostate (TURP).

https://pubmed.ncbi.nlm.nih.gov/8561333/

This study describes about Hemodynamic effects of spinal anesthesia in the elderly: single dose versus titration through a catheter.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413406/

This study describes about comparision of fractionated versus single dose injection for spinal anesthesia during cesarean section in patients with pregnancy-induced hypertension

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296809/

This study compares between fractionated dose versus bolus dose injection in spinal anaesthesia for patients undergoing elective caesarean section:

https://rfppl.co.in/view_abstract.php?jid=24&art_id=8119

This study compares between Bolus versus Fractionated Dose Injection in Spinal Anaesthesia for Pregnant Women undergoing elective Caesarean Section

https://pubmed.ncbi.nlm.nih.gov/34150559/

This study compares between Fractionated and Bolus Dose Injection on Spinal Anesthesia for Lower Limb Surgery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10436721/

This study compares between Fractional spinal anaesthesia in high-risk elderly patients for orthopaedic surgery

https://core.ac.uk/download/pdf/335018765.pdf

This study compares between Fractionated and Single Bolus Dose of Local Anaesthetic (Bupivacaine 0.5% Heavy) in Elective Lower Segment Caeserean Section

https://pdfs.semanticscholar.org/b3c5/beacd5a02cc5619d71b2774a16a01d0399fa.pdf

This study compares between fractionated dose with bolus dose in Spinal Anaesthesia for haemodynamic stability and duration of analgesia in patients undergoing elective Lower Segment Caesarean Section

https://www.ijsr.net/archive/v9i1/ART20204456.pdf

This study compares between Fractionated versus Bolus Dose Injection of Drug in Spinal Anaesthesia for Lower Limb Surgeries

https://medrech.com/index.php/medrech/article/view/520

This study compares between sensory and motor block outcome of fractionated versus single bolus dose administration of hyperbaric bupivacaine in elective cesarean section

Other Identifiers

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187/2079/80

Identifier Type: -

Identifier Source: org_study_id

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