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CTRI Number  CTRI/2024/09/074068 [Registered on: 19/09/2024] Trial Registered Prospectively
Last Modified On: 16/09/2024
Post Graduate Thesis  Yes 
Type of Trial  Observational 
Type of Study   Follow Up Study 
Study Design  Single Arm Study 
Public Title of Study   Effect of injection speed of heavy bupivacaine in spinal anaesthesia on blood pressure, heart rate and quality of block 
Scientific Title of Study   Effect of injection speed of heavy bupivacaine in spinal anaesthesia on hemodynamic changes and quality of block 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Shivani Singh 
Designation  Junior resident 
Affiliation   
Address  Department of Anesthesia, Kasturba medical college, Manipal

Udupi
KARNATAKA
576104
India 
Phone  8588938364  
Fax    
Email  shivanimiley@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Shivani Singh 
Designation  Junior resident 
Affiliation   
Address  Department of Anesthesia, Kasturba medical college, Manipal


KARNATAKA
576104
India 
Phone  8588938364  
Fax    
Email  shivanimiley@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Shivani Singh 
Designation  Junior resident 
Affiliation   
Address  Department of Anesthesia, Kasturba medical college, Manipal


KARNATAKA
576104
India 
Phone  8588938364  
Fax    
Email  shivanimiley@gmail.com  
 
Source of Monetary or Material Support  
Kasturba medical college, Manipal, Karnataka- 576104 
 
Primary Sponsor  
Name  Shivani Singh 
Address  Kasturba medical college, Manipal, Karnataka- 576104 
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Shivani Singh  Kasturba hospital  Department of Anesthesia, Kasturba hospital, KMC Manipal, Karnataka
Udupi
KARNATAKA 
8588938364

shivanimiley@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Kasturba medical college institutional ethics committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: O||Medical and Surgical,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  NIL  NIL 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  60.00 Year(s)
Gender  Both 
Details  1. American Society of Anesthesiologists physical status I–II patients
2. Aged 18–60 years
3. Height between 155 and 165 cm
scheduled for various elective surgeries under spinal anesthesia like orthopedic surgeries, urological surgeries, surgical debridements, gynaecological procedures such as hysteroscopy, dilatation and curettage, endometrial biopsy
 
 
ExclusionCriteria 
Details  1. Hypertensive patients with uncontrolled hypertension
2. Patients with ischemic heart disease with severe cardiac dysfunction or cardiorespiratory compromise
3. Patients with large intra-abdominal mass, and ascites
4. Pregnant patients
5. Surgeries with blood loss more than 15% of patient’s estimated blood volume
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
Mean arterial pressure (MAP)  Every 2 minutes for first 10 minutes, and at every 5 minutes thereafter for 1 hour  
 
Secondary Outcome  
Outcome  TimePoints 
Time to achieve desired dermatomal blockade required for surgery   5 minutes by using modified Bromage score 
 
Target Sample Size   Total Sample Size="62"
Sample Size from India="62" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   01/10/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form
    Response - Clinical Study Report
    Response -  Analytic Code

  3. Who will be able to view these files?
    Response - Researchers who provide a methodologically sound proposal.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [shivanimiley@gmail.com].

  6. For how long will this data be available start date provided 11-09-2024 and end date provided 31-10-2025?
    Response - Immediately following publication. No end date.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

1.  After approval from the Institutional Ethics Committee, the study participants will be given the patient information sheet and will be explained about the procedure before obtaining a valid, written consent. The consenting patients will be receiving spinal anesthesia drug at the speed which will be at discretion of consultant anesthesiologist and the effect of different drug speeds will only be observed and compared. 

2. The selection of drug speed is at the discretion of consultant anesthesiologist and it is as per routine standard of care.

3. Patients will be premedicated with alprazolam 0.25 mg orally on the night before the surgery as well as pantoprazole 40 mg and metoclopramide 10 mg orally on the night before and on the morning of surgery.

4. The patient will be shifted to the operation theater, after confirming the nil per oral status. In the operation theatre, electrocardiogram, pulse oximetry and non invasive blood pressure monitors will be attached. The patency of the intravenous cannula will be checked and an intravenous access will be secured if none.

5. Baseline heart rate and blood pressure will be recorded. Patients will be then given 10 mL/kg of lactated Ringer’s solution. 

6. Patients will be positioned in the lateral decubitus position. Under strict aseptic precautions and using midline approach, dural puncture will be done at the L3-L4 interspace with 25 G Quincke Babcock needle. After confirmation of free flow of CSF, 3.2 mL of spinal drug ( 3ml of 0.5% hyperbaric bupivacaine + 60 mcg buprenorphine) will be administered. 

7. The patients will then be turned into supine position and data will be collected. Sensory block will be assessed by loss of cold sensation using cold alcohol swab. 

8. Mean arterial pressure (MAP) ( hypotension will be defined as MAP less than 25% of patient’s baseline MAP value) and HR will be measured at 2 minute intervals for the first 10 minutes and 5 minute interval thereafter for 1 hour following the spinal injection. 

9. The time to achieve maximum desired sensory blockade will be recorded. A modified Bromage score will be used for evaluation of the degree of motor block – Grade 1: Free movement of legs and feet implied no motor block, Grade 2: Just able to flex knees with free movement of feet implied partial (33%) block, Grade 3: Unable to flex knees but free movement of feet implied (66%) partial block, and Grade 4: Unable to move legs or feet implied complete paralysis.

10. Surgery will be allowed to proceed after desired dermatomal blockade is achieved 

11. If desired dermatomal blockade is not achieved, then general anesthesia will be administered to the patient and then that patient will no longer be a part of this study.

 
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