CTRI Number |
CTRI/2021/10/037492 [Registered on: 22/10/2021] Trial Registered Prospectively |
Last Modified On: |
29/10/2021 |
Post Graduate Thesis |
No |
Type of Trial |
Interventional |
Type of Study
|
Drug |
Study Design |
Randomized, Parallel Group, Placebo Controlled Trial |
Public Title of Study
|
A clinical trial to study the effect of nebulized lignocaine and ketamine in reducing incidence of
postoperative sore throat |
Scientific Title of Study
|
Comparison of the effects of nebulized Ketamine and nebulized Lignocaine in
decreasing incidence of post-operative sore throat : A randomized control
prospective study |
Trial Acronym |
ketlo |
Secondary IDs if Any
|
Secondary ID |
Identifier |
NIL |
NIL |
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
Name |
Dr Deepali Valecha |
Designation |
Assistant Professor |
Affiliation |
Mahatma Gandhi Memorial Medical College, Indore |
Address |
Department of Anaesthesiology, Maharaja Yeshwant Rao Hospital and Mahatma Gandhi Memorial Medical College
Indore MADHYA PRADESH 452001 India |
Phone |
|
Fax |
|
Email |
deepalisidhwani@gmail.com |
|
Details of Contact Person Scientific Query
|
Name |
Swapnil Kumar Barasker |
Designation |
Assistant Professor |
Affiliation |
Sri Aurobindo Medical College and PG Institute |
Address |
Department of Anaesthesiology and Critical Care, Sri Aurobindo
Medical College and PG Institute, Indore Ujjain State Highway, Near MR 10 Crossing
Indore MADHYA PRADESH 453111 India |
Phone |
|
Fax |
|
Email |
swapnilkbarasker@gmail.com |
|
Details of Contact Person Public Query
|
Name |
Swapnil Kumar Barasker |
Designation |
Assistant Professor |
Affiliation |
Sri Aurobindo Medical College and PG Institute |
Address |
Department of Anaesthesiology and Critical Care, Sri Aurobindo
Medical College and PG Institute, Indore Ujjain State Highway, Near MR 10 Crossing
MADHYA PRADESH 453111 India |
Phone |
|
Fax |
|
Email |
swapnilkbarasker@gmail.com |
|
Source of Monetary or Material Support
|
Department of Anaesthesiology, MGM Medical college and MY hospital Indore |
|
Primary Sponsor
|
Name |
Department of Anaesthesiology |
Address |
MY hospital & MGM college Indore |
Type of Sponsor |
Government medical college |
|
Details of Secondary Sponsor
|
|
Countries of Recruitment
|
India |
Sites of Study
|
No of Sites = 1 |
Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
Deepali Valecha |
Ground floor OT Comlex, Department of Anaesthesiology, Maharaja Yeshwant Rao Hospital |
MY hospital road, CRP line Indore MADHYA PRADESH |
9424405405
deepalisidhwani@gmail.com |
|
Details of Ethics Committee
|
No of Ethics Committees= 1 |
Name of Committee |
Approval Status |
Ethics and scientific review Committe, MGM college and MY hospital Indore |
Approved |
|
Regulatory Clearance Status from DCGI
|
|
Health Condition / Problems Studied
|
Health Type |
Condition |
Patients |
(1) ICD-10 Condition: O||Medical and Surgical, |
|
Intervention / Comparator Agent
|
Type |
Name |
Details |
Intervention |
ketamine 50 mg |
Group K will recieve ketamine 50 mg (1.0 ml + 4.0 ml of the saline) nebulization
15 min prior to induction in pre
op room.
|
Intervention |
lignocaine 4% nebulization |
Group L will receive lignocaine 4% nebulization( 2ml lignocaine 4% + 3ml saline) 15 min prior to induction in pre
op room.
|
Comparator Agent |
saline nebulization |
Group C will recieve 5ml saline nebulization - 15 min prior to induction in pre
op room. |
|
Inclusion Criteria
|
Age From |
18.00 Year(s) |
Age To |
60.00 Year(s) |
Gender |
Both |
Details |
Patients with American Society of Anesthesiologists (ASA) class I or class II physical
status. |
|
ExclusionCriteria |
Details |
1. Patient refusal ,
2. Pateints with ASA physical status III & IV,
3. History of allergic reactions to local anaesthetics or ketamine,
4. Patient with anticipated difficult intubation,
5. Duration of intubation more than 30s or more than 1 attempt of intubation,
6. Patients undergoing oral, head and neck surgeries,
7. Duration of surgery> 2hr |
|
Method of Generating Random Sequence
|
Coin toss, Lottery, toss of dice, shuffling cards etc |
Method of Concealment
|
Sequentially numbered, sealed, opaque envelopes |
Blinding/Masking
|
Participant, Investigator and Outcome Assessor Blinded |
Primary Outcome
|
Outcome |
TimePoints |
Incidence and severity of sore throat in first 24
hours of post operative period |
Sore throat monitoring and grading will be done
at 0,1, 2, 4, 8, 12, 16 and 24 hours post-extubation by
an anaesthetist not aware of the group of patients |
|
Secondary Outcome
|
Outcome |
TimePoints |
To report any complication or side effect due to nebulization of lignocaine and ketamine if seen |
Monitoring will be done at 0, 2, 4, 8, 12, and 24
hours post-extubation by an anaesthetist. |
|
Target Sample Size
|
Total Sample Size="120" Sample Size from India="120"
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)
|
25/10/2021 |
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="0" Months="6" Days="0" |
Recruitment Status of Trial (Global)
Modification(s)
|
Not Applicable |
Recruitment Status of Trial (India) |
Open to Recruitment |
Publication Details
|
nil |
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - NO
|
Brief Summary
|
IntroductionPost-operative sore throat (POST) occurs in 21-65% of patients receiving general anaesthesia (GA) with tracheal intubation. (1,2) Post operative sore throat is an unavoidable complication of general anaesthesia. Localised trauma to the mucosa during laryngoscopy and intubation leads to aseptic inflammation of the pharyngeal mucosa leading to post-operative sore throat. It may lead to minor throat irritation, debilitating pain, inability to swallow and may even cause temporary voice changes.(3) Many non-pharmacological and pharmacological methods have been tried to reduce the incidence and severity of post-operative sore throat. Using a small sized endotracheal tube, gentle laryngoscopy and intubation, maintaining cuff pressures not more than 18-20cmH2O, and local anaesthetics, steroids, NSAIDs, benzydamine gargle, ketamine gargle are some of the methods used. Ketamine, a phencyclidine derivative, has been used as a gargle or nebulization in the attenuation of post-operative sore throat by its action on peripheral NMDA receptors.4,5,6. Nebulization of lignocaine can achieve highly effective anesthesia from the oral cavity up to trachea for intubation. Here in our study we want to compare the effects of nebulized ketamine and nebulized lignocaine in reducing incidence of post operative sorethroat in pateints undergoing Elective surgeries under general anaesthesia in supine position. Methodology The present study will be conducted after receiving approval by the Institutional Ethics Committee of our hospital and written informed consent will be taken from patients. Patients will be randomly allocated in three groups by chit method. Group K ( n=40), Group L ( n= 40) and Group C (n=40). The chits will be opened by the Anaesthesiologist who is not a part of study, and nebulisation solution will be prepared according to group allocation. Group L will receive lignocaine 4% nebulization( 2ml lignocaine 4% + 3ml saline) and Group K will receive ketamine 50 mg (1.0 ml + 4.0 ml of the saline) nebulization and Group C will receive 5ml saline nebulization - 15 min prior to induction in pre op room. Patients will be blinded to the study drug used. HR, MAP, SPO2 will be recorded during nebulization. A uniform anaesthetic technique will be used to induce General anaesthesia facilitating intubation using vecuronium as muscle relaxant in both the groups. The intra-operative monitoring will include continuous electrocardiography, noninvasive blood pressure, pulse oximetry , and end-tidal carbon dioxide. At the completion of surgery, with the patient adequately anaesthetised, the oropharynx will be gently suctioned using gentle suction catheter. Extubation will be done after reversal on return of spontaneous ventilation. Patients will be assessed post operatively for sore throat using a four point scale. POST was graded on a four-point scale (0-3) (7) 0 = no sore throat 1 = mild sore throat (complains of sore throat only on asking) 2 = moderate sore throat (complains of sore throat on his/her own) 3 = severe sore throat (change of voice or hoarseness, associated with throat pain). Other side-effects, if any will be noted. IV tramadol 50mg 8hrly used for post operative pain. SORE THROAT SCORE
SORE THROAT SCORE
|
0 HR
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1 hr
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2 HR
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4 HR
|
8 HR
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12 HR
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16 HR
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24 hr
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GROUP K
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GROUP L
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GROUP C
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References: 1. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88:582–4. [PubMed: 12066737] 2. Loeser EA, Bennett GM, Orr DL, Stanley TH. Reduction of postoperative sore throat with new endotracheal tube cuffs. Anesthesiology. 1980;52:257–9. [PubMed: 7369513] 3. Zuccherelli L. Post operative upper airway problems – Review article. SAAJA. 2003(9):12-6. 4. Patel MP, Patel HH, Roth DM. general anesthetics and therapeutic gases. In: Goodman and Gilman’s The pharmacological basis of therapeutics. 12th edition. Edited by Brunton LL, Chabner BA, Knollman BC 2011; chapter 19: 502-539 5. Stoelting RK, Hillier SC. Intravenous sedatives and hypnotics, In: Pharmacology and Physiology in Anaesthetic Practice. 5th edition. Edited by Stoelting RK, Hillier SC 2014; chapter 5: 186-93. 6. Vuyk J, Sitsen E, Reekers M. Intravenous anesthetics. In: Miller’s Anesthesia. 8th ed. Edited by Miller RD, Eriksson LI, Fleisher LA:Philadelphia, Elsevier. 2015, 845-848. 7. Canbay O, Celebi N, Sahin A, Celiker V , Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth. 2008;100:490–3. [PubMed: 18310675] |