Best Hypnotic Drug Choice for Rapid Sequence Induction in the Operating Room

NCT ID: NCT06733129

Last Updated: 2025-12-02

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

1218 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-14

Study Completion Date

2027-04-30

Brief Summary

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The best hypnotic choice to optimize the balance between good intubation condition quality and hemodynamic stability during RSI performed in the operating theatre remained to be investigated.

Therefore, a randomized study evaluating the efficacy of propofol, ketamine, and a combination of both is appropriate. So, we designed the HyPnotiKs randomized controlled study to investigate the efficacy of these hypnotic drugs in patients undergoing RSI in the operating theatre. The primary endpoint will be the successful tracheal intubation at the first attempt without major arterial hypotension event.

Detailed Description

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Conditions

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Rapid Sequence Induction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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KETOFOL

Ketofol: combination of Ketamine and Propofol : consecutive direct IV injection of Ketamine 1 mg/kg and Propofol 1 mg/kg after completing pre-oxygenation

Group Type EXPERIMENTAL

combination of Ketamine and Propofol

Intervention Type DRUG

combination of Ketamine and Propofol described above: consecutive direct IV injection of Ketamine 1 mg/kg and Propofol 1 mg/kg (adjusted body weight if BMI \> 30). Dilution are not necessary.

KETAMINE

direct IV injection at dosage of 2 mg/kg after completing pre-oxygenation

Group Type EXPERIMENTAL

direct IV injection

Intervention Type DRUG

direct IV injection at dosage of 2 mg/kg (adjusted body weight if BMI \> 30) after completing pre-oxygenation

PROPOFOL

direct IV injection at dosage of 2 mg/kg after completing pre-oxygenation.

Group Type ACTIVE_COMPARATOR

direct IV injection

Intervention Type DRUG

direct IV injection at dosage of 2 mg/kg (adjusted body weight if BMI \> 30) after completing pre-oxygenation

Interventions

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combination of Ketamine and Propofol

combination of Ketamine and Propofol described above: consecutive direct IV injection of Ketamine 1 mg/kg and Propofol 1 mg/kg (adjusted body weight if BMI \> 30). Dilution are not necessary.

Intervention Type DRUG

direct IV injection

direct IV injection at dosage of 2 mg/kg (adjusted body weight if BMI \> 30) after completing pre-oxygenation

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* age between 18 - 80 years' old
* female\* and male

* ≥ 1 risk factor of aspiration of gastric contents defined as
* preoperative fasting period of less than 6 hours,
* occlusive syndrome, functional ileus, vomiting episode within the last 12 hours,
* orthopaedic trauma within the last 12 hours,
* medical history of symptomatic gastroesophageal reflux or hiatus, hernia or gastroparesis or dysautonomia or gastroesophageal surgery with sphincter dysfunction)
* patient requiring orotracheal intubation during general anaesthesia in the operating room.
* patient or his/her next of kin written informed consent or emergency procedure
* failure to discontinue GLP1 analogue as recommended (exenatide, liraglutide, albiglutide, taspoglutide, lixisenatide)

Exclusion Criteria

* predicted impossible tracheal intubation (≥ 1 of the following criteria: patient with known intubation complications, Mallampati score IV, Thyromental Distance ≤ 4.0 cm, Mouth Opening \< 3 cm, Sternomental Distance \< 12.5 cm, significant modification of the airway due to congenital, cancer, trauma or burning lesions (non-exhaustive list)) \[30\]
* preoperative arterial hypotension (MAP \< 65 mmHg or under catecholamine)
* preoperative respiratory distress syndrome (SpO2 \< 90% in room air)
* contraindications to the use of ketamine and/or propofol and/or NMB:

* allergy to the active substance or to one of the excipients or to soy or peanuts,
* porphyria
* intracranial hypertension
* uncontrolled arterial hypertension (systolic arterial pressure \> 180 mmHg)
* personal or family history of known malignant hyperthermia, congenital muscular dystrophy, myasthenia, a known congenital deficit in plasma pseudocholinesterase
* pregnancy or breast-feeding woman
* patients under court protection or guardianship
* absence of insurance covering health costs
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chr Angers

Angers, , France

Site Status RECRUITING

CHRU de Brest Hôpital Cavale Blanche

Brest, , France

Site Status RECRUITING

Ch Louis Pasteur

Chartres, , France

Site Status NOT_YET_RECRUITING

CHU Dijon

Dijon, , France

Site Status RECRUITING

CHU Grenoble Alpes

Grenoble, , France

Site Status NOT_YET_RECRUITING

CHD Vendée

La Roche-sur-Yon, , France

Site Status RECRUITING

APHP Bicêtre

Le Kremlin-Bicêtre, , France

Site Status NOT_YET_RECRUITING

CH Le Mans

Le Mans, , France

Site Status RECRUITING

CHU Lille Hopital Salengro

Lille, , France

Site Status RECRUITING

CHU Lille Hôpital Claude Huriez

Lille, , France

Site Status RECRUITING

CHU Lyon Hôpital Sud

Lyon, , France

Site Status NOT_YET_RECRUITING

HCL Lyon Croix-Rousse

Lyon, , France

Site Status NOT_YET_RECRUITING

Chu Nantes (Laennec)

Nantes, , France

Site Status RECRUITING

Chu Nantes

Nantes, , France

Site Status RECRUITING

APHP St-Antoine

Paris, , France

Site Status NOT_YET_RECRUITING

APHP Tenon

Paris, , France

Site Status NOT_YET_RECRUITING

CHU Poitiers

Poitiers, , France

Site Status RECRUITING

Hopital Foch

Suresnes, , France

Site Status RECRUITING

CHU Toulouse Hôpital Purpan

Toulouse, , France

Site Status NOT_YET_RECRUITING

CHU Toulouse Hôpital Rangueil

Toulouse, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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Nicolas GRILLOT, MD

Role: CONTACT

02 53 48 22 24 ext. +33

Facility Contacts

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Sigismond LASOCKI

Role: primary

02 41 35 36 35 ext. +33

Anais CAILLARD

Role: primary

02 98 34 76 23 ext. +33

Nidhal CHEBBI

Role: primary

Pierre-Grégoire GUINOT

Role: primary

03 80 28 15 54 ext. +33

Pierre BOUZAT

Role: primary

04 76 76 72 53 ext. +33

Mathieu OUDOT

Role: primary

02 51 44 62 37 ext. +33

Samy FIGUEIREDO

Role: primary

01 45 21 34 41 ext. +33

Laurent BLANCHET

Role: primary

02 43 43 28 40 ext. +33

Nathalie BRUNEAU

Role: primary

03 20 44 59 62 ext. +33

Cédric CIRENEI

Role: primary

03 20 44 59 62 ext. +33

Jean-Stephane DAVID

Role: primary

04 72 11 73 11 ext. +33

Alice BLET

Role: primary

04 72 07 12 39

Xavier AMBROSI

Role: primary

02 53 48 27 85 ext. +33

Nicolas GRILLOT, MD

Role: primary

02 53 48 22 24 ext. +33

Franck VERDON

Role: primary

01 71 97 70 70 ext. +33

Franck VERDONK

Role: primary

01 71 97 70 70 ext. +33

Quentin SAINT GENIS

Role: primary

05 49 44 38 95 ext. +33

Morgan LE GUEN

Role: primary

Maxime POMMIER

Role: primary

05 61 77 23 88 ext. +33

Francois LABASTE

Role: primary

05 61 32 28 22 ext. +33

Other Identifiers

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RC24_0389

Identifier Type: -

Identifier Source: org_study_id

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