Unique ID issued by UMIN | UMIN000049554 |
---|---|
Receipt number | R000056422 |
Scientific Title | OPTIMIZED METHOD OF UNILATERAL SPINAL ANESTHESIA: DOUBLE BLIND, RANDOMISED CLINICAL STUDY |
Date of disclosure of the study information | 2022/11/18 |
Last modified on | 2022/11/18 15:52:32 |
OPTIMIZED METHOD OF UNILATERAL SPINAL ANESTHESIA
OPTIMUS
OPTIMIZED METHOD OF UNILATERAL SPINAL ANESTHESIA: DOUBLE BLIND, RANDOMISED CLINICAL STUDY
OPTIMUS
Asia(except Japan) |
Our study, which is a clinically controlled, multicenter, double-blind, equally randomized, parallel-group study, that was conducted in Kazakhstan, was conducted after the approval of the ethics committee (Protocol No. 1, dated 28.09.2018).
The study was carried out in two centers, in particular, at the NCJSC SMU University Hospital of NCJSC SMU in Semey, Kazakhstan, which is the regional center of the Abay region with a population of about 650,000 people. The second center for conducting the study was the City Hospital No.1 of Pavlodar, Kazakhstan, which is also a regional center with a population of 750,000 people.
Medicine in general | Vascular surgery | Anesthesiology |
Intensive care medicine | Adult |
Others
NO
1. reduce the rate of complications related to spinal puncture.
2. increase the quality of anesthesia and, respectively, patient satisfaction.
3. simplify USpA and reduce the number of unsuccessful punctures by using electrical nerve stimulation.
Safety,Efficacy
1. UsPA + ENS reduces the incidence of unwanted puncture complications, namely Postdural Punture Headache (PDPH), nausea, vomiting, number of puncture attempts.
2. improves the quality of anesthesia, namely: patient satisfaction according to Visual Analogue Scale (VAS), Lateralisation of anesthesia, Adequacy of anesthesia
Satisfaction and adherence of patients and anesthesiologists to unilateral spinal anesthesia technique.
Interventional
Parallel
Randomized
Individual
Double blind -all involved are blinded
Active
NO
Numbered container method
2
Treatment
Other |
For main group Unilateral Spinal Anesthesia with electrical nerve stimulation were performed (USpA+ENS technique description):
1. I/V Infusion of 8 ml/kg of crystalloids preoperatively.
2. Laying the patient in a lateral decubitus position of the upcoming operation side .
3. Local skin anesthesia 4-5 ml of 0.5% solution of Novocaine solution
4. Puncture of the epidural space with resistance loss test (level L2-L3, L3-L4 Stimuplex 21-22G needle 50 mm long connected to a neurostimulator).
5. Through the needle, the current is supplied with a power of 4 MA, a frequency of 2 Hz, a pulse duration of 0.1 ms, until the Dura is punctured, but not more than 30 seconds.
6. Passing through the needle for neurostimulation, the usual spinal needle size 29G - 90 mm with a Quincke cut to puncture the dura.
7. Immediately after the dura puncture, the current is transmitted along the inner wall of the needle for neurostimulation to the spinal needle and reaches the subarachnoid space.
8. The anesthesiologist observed the action of electric current visually - muscle contractions of the interested or both limbs for 5-10 seconds.
9. The patient felt irritated by the electric current and immediately reported verbally to the anesthesiologist in 5-10 seconds.
10. Checking the free flow of CSF through the spinal needle for 5-10 seconds. Turning the bevel of the needle caudally.
11. Slow, within 100-120 seconds, the introduction of 7.5 mg of LA - Bupivacaine-Spinal.
12. Remove the needle, apply an aseptic dressing, exposure for 15-20 minutes on the lateral decubitus position
For control group usual Unilateral Spinal Anesthesia were performed (Usual USpA technique description):
1. I/V Infusion of 8 ml/kg of crystalloids preoperatively.
2. Laying the patient in a lateral decubitus position of the upcoming operation side .
3. Local skin anesthesia 4-5 ml of 0.5% solution of Novocaine solution
4. Puncture of the subarachnoid space (level L2-L3, L3-L4 Spinal needle 27G with intoducer is used).
5. Checking the free flow of CSF through the spinal needle for 5-10 seconds. Turning the bevel of the needle caudally.
6. Slow, within 100-120 seconds, the introduction of 7.5 mg of LA - Bupivacaine-Spinal.
7. Remove the needle, apply an aseptic dressing, exposure for 15-20 minutes on the lateral decubitus position
25 | years-old | < |
65 | years-old | > |
Male and Female
1. patients with upcoming operations for varicose veins of the lower extremities, mainly saphenectomy and crossectomy with CEAP clinical classes from C2 to C4.
2. age from 25 to 65;
3. anesthetic risk according to ASA-I-IV class;
4. signed informed consent of the patient.
1. refusal to participate in the study;
2. risk according to ASA V class;
3. coagulopathy of various ethiologies;
4.acute cardiac and / or respiratory failure;
5. hypovolemia;
6. intolerance to local anesthetics;
7. skin and soft tissues infection in the area of the proposed puncture;
8. peripheral neuropathy;
9. cognitive/psychiatric disorders or alcohol/drug dependence causing inability to adhere to the study protocol
10. patient's refusal from regional anesthesia
133
1st name | Yernar |
Middle name | Dauletovich |
Last name | Mamyrov |
Pavlodar Branch of NCJSC Semey Medical University
Department of Emergency Medicine
140000
Tolstogo str, 19-57, Pavlodar, Pavlodar region, Kazakhstan
+77077999003
genius.earnico@gmail.com
1st name | Yernar |
Middle name | Dauletovich |
Last name | Mamyrov |
Pavlodar Branch of NCJSC Semey Medical University
Department of Emergency Medicine
140002
Toraigyrov str, 72/1, Pavlodar, Pavlodar region, Kazakhstan
+7(7182)55-28-54
https://semeymedicaluniversity.kz/en/about-us/structure/branches/pavlodar-branch-of-the-university/
pavlodar@nao-mus.kz
NCJSC Semey Medical University
There is no funding source for this study, the study is carried out in frames of PhD doctoral study program, with the use of materials and conditions of NSJSC SMU and Pavlodar city hospital No.1
Self funding
Pavlodar Branch of NCJSC Semey Medical University, Department of Emergency Medicine
Toraigyrov str, 72/1, Pavlodar, Pavlodar region, Kazakhstan
+7(7182)55-28-54
genius.earnico@gmail.com
NO
1. University hospital of NCJSC SMU (Semey, Kazakhstan).
2. City hospital No.1 (Pavlodar, Kazakhstan)
2022 | Year | 11 | Month | 18 | Day |
Unpublished
134
Delay expected |
Because of late preparation of Original article for publication in Peer viewed journal, as a cause of that in the period from the end of 2019 to the beginning of 2022, our team was involved in the fight against COVID-19 in our country. Most of the staff of Department of Emergency Medicine are the Anesthesiologists and Intensive care physicians. That's why by the order of the local health department, we were directed to treat patients with COVID-19
2023 | Year | 02 | Month | 01 | Day |
No longer recruiting
2018 | Year | 09 | Month | 28 | Day |
2023 | Year | 02 | Month | 01 | Day |
2018 | Year | 10 | Month | 01 | Day |
2019 | Year | 03 | Month | 30 | Day |
2019 | Year | 06 | Month | 30 | Day |
2022 | Year | 10 | Month | 01 | Day |
2022 | Year | 11 | Month | 01 | Day |
2022 | Year | 11 | Month | 18 | Day |
2022 | Year | 11 | Month | 18 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000056422
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