UMIN-CTR Clinical Trial

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

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Basic information

Public title

OPTIMIZED METHOD OF UNILATERAL SPINAL ANESTHESIA

Acronym

OPTIMUS

Scientific Title

OPTIMIZED METHOD OF UNILATERAL SPINAL ANESTHESIA: DOUBLE BLIND, RANDOMISED CLINICAL STUDY

Scientific Title:Acronym

OPTIMUS

Region

Asia(except Japan)


Condition

Condition

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.

Classification by specialty

Medicine in general Vascular surgery Anesthesiology
Intensive care medicine Adult

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

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.

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

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

Key secondary outcomes

Satisfaction and adherence of patients and anesthesiologists to unilateral spinal anesthesia technique.


Base

Study type

Interventional


Study design

Basic design

Parallel

Randomization

Randomized

Randomization unit

Individual

Blinding

Double blind -all involved are blinded

Control

Active

Stratification


Dynamic allocation


Institution consideration


Blocking

NO

Concealment

Numbered container method


Intervention

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Other

Interventions/Control_1

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


Interventions/Control_2

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

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

25 years-old <

Age-upper limit

65 years-old >

Gender

Male and Female

Key inclusion criteria

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.

Key exclusion criteria

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

Target sample size

133


Research contact person

Name of lead principal investigator

1st name Yernar
Middle name Dauletovich
Last name Mamyrov

Organization

Pavlodar Branch of NCJSC Semey Medical University

Division name

Department of Emergency Medicine

Zip code

140000

Address

Tolstogo str, 19-57, Pavlodar, Pavlodar region, Kazakhstan

TEL

+77077999003

Email

genius.earnico@gmail.com


Public contact

Name of contact person

1st name Yernar
Middle name Dauletovich
Last name Mamyrov

Organization

Pavlodar Branch of NCJSC Semey Medical University

Division name

Department of Emergency Medicine

Zip code

140002

Address

Toraigyrov str, 72/1, Pavlodar, Pavlodar region, Kazakhstan

TEL

+7(7182)55-28-54

Homepage URL

https://semeymedicaluniversity.kz/en/about-us/structure/branches/pavlodar-branch-of-the-university/

Email

pavlodar@nao-mus.kz


Sponsor or person

Institute

NCJSC Semey Medical University

Institute

Department

Personal name



Funding Source

Organization

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

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Pavlodar Branch of NCJSC Semey Medical University, Department of Emergency Medicine

Address

Toraigyrov str, 72/1, Pavlodar, Pavlodar region, Kazakhstan

Tel

+7(7182)55-28-54

Email

genius.earnico@gmail.com


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

1. University hospital of NCJSC SMU (Semey, Kazakhstan).
2. City hospital No.1 (Pavlodar, Kazakhstan)


Other administrative information

Date of disclosure of the study information

2022 Year 11 Month 18 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled

134

Results


Results date posted


Results Delayed

Delay expected

Results Delay Reason

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

Date of the first journal publication of results

2023 Year 02 Month 01 Day

Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

No longer recruiting

Date of protocol fixation

2018 Year 09 Month 28 Day

Date of IRB

2023 Year 02 Month 01 Day

Anticipated trial start date

2018 Year 10 Month 01 Day

Last follow-up date

2019 Year 03 Month 30 Day

Date of closure to data entry

2019 Year 06 Month 30 Day

Date trial data considered complete

2022 Year 10 Month 01 Day

Date analysis concluded

2022 Year 11 Month 01 Day


Other

Other related information



Management information

Registered date

2022 Year 11 Month 18 Day

Last modified on

2022 Year 11 Month 18 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000056422


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name