PainPhase 2NCT02416063
Caudal Versus Intravenous Dexmedetomidine for Caudal Analgesia in Children
A Phase 2 study testing Caudal Dexmedetomidine and Intravenous dexmedetomidine in people with Pain, run by University of Jordan.
Trial summary
The aim of this prospective randomized double-blind study was to compare the analgesic efficacy and the side effects of dexmedetomidine (1 µg.kg-1) co-administered with bupivacaine for caudal analgesia or intravenously in children undergoing infra-umbilical surgery. Read more about this study
- Who is it for?
- Ages 1 year to 6 years
- Conditions the study is for
- Pain
- What is being tested?
- Caudal Dexmedetomidine and Intravenous dexmedetomidine
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 75 participants
- Where
- No sites listed yet
- Study dates
- Jan 2014to Oct 2014
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 1 year to 6 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Patients with American Society of Anesthesiologists (ASA) - I
- Scheduled for lower abdominal and perineal surgery
- Under general anesthesia
Who cannot join
- Hypersensitivity to any local anesthetics
- Patient has history of allergy, intolerance, or reaction to dexmedetomidine
- Infections at puncture sites
- Bleeding diathesis
- Preexisting neurological disease
- Children with uncorrected cardiac lesions
- Children with heart block
About this study
Official title: Caudal Versus Intravenous Dexmedetomidine for Caudal Analgesia in Children: A Randomised Controlled Double Blind Study
The aim of this prospective randomized double-blind study was to compare the analgesic efficacy and the side effects of dexmedetomidine (1 µg.kg-1) co-administered with bupivacaine for caudal analgesia or intravenously in children undergoing infra-umbilical surgery.
Read the detailed description
Dexmedetomidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent.But which route of administration of dexmedetomidine is the most beneficial remains unknown.
The investigators performed prospective randomized double-blind study to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on postoperative analgesia after caudal bupivacaine in children undergoing infra-umbilical surgery.
75 children (ASAⅠorⅡ,aged 1-6 yr) undergoing infra-umbilical surgery were included in this study. Anesthesia was induced with sevoflurane via a facemask, followed by placement of a laryngeal mask airway. Anesthesia was maintained with sevoflurane 2-3% in oxygen-air.Then,caudal block was applied. Patients were randomly assigned in three groups. Group B-Dcau (n = 25): Caudal bupivacaine 0.25% 1ml/kg plus dexmedetomidine 1µg/kg and 10 ml normal saline i.v.;Group B-Div (n = 25): bupivacaine 0.25% 1ml/kg and dexmedetomidine 1µg/kg(10 ml)i.v.;Group B(n = 25): bupivacaine 0.25% and 10 ml normal saline intravenous
- Conditions
- Pain
- Being tested
- Caudal Dexmedetomidine, Intravenous dexmedetomidine, Placebo
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Caudal DexmedetomidineDrug
Also called dexmedetomidine, Precedex
Drug:Caudal bupivacaine 0.25% 1ml/kg
Drug: Caudal dexmedetomidine 1µg/kg
Intravenous: 10 ml normal saline
sevoflurane Induction and maintenance of anesthesia
Intravenous dexmedetomidineDrug
Also called precedex
Drug:Caudal bupivacaine 0.25% 1ml/kg.
Drug:Intravenous dexmedetomidine1 μg /kg in a total volume of 10 ml
sevoflurane Induction and maintenance of anesthesia
PlaceboDrug
Also called normal saline
Drug:Caudal bupivacaine 0.25% 1ml/kg
Intravenous: Normal saline 10 ml
sevoflurane Induction and maintenance of anesthesia
| Study group | Role | What they receive |
|---|---|---|
| caudal Dexmedetomidine | Active comparator | Drug:Caudal Bupivacaine 0.25% 1ml/kg .
Drug:caudal Dexmedetomidine 1μg /kg.
Intravenous :10 ml normal saline
Anesthesia was induced and maintained with sevoflurane Receives: Drug: Caudal Dexmedetomidine |
| Intravenous Dexmedetomidine | Active comparator | Drug:Caudal bupivacaine 0.25% 1ml/kg
Drug: Intravenous dexmedetomidine 1µg/kg in a 10 ml volume normal saline
Anesthesia was induced and maintained with sevoflurane Receives: Drug: Intravenous dexmedetomidine |
| Placebo | Placebo comparator | Caudal: bupivacaine 0.25% 1ml/kg .
Intravenous: 10 ml Normal saline
Anesthesia was induced and maintained with sevoflurane Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to first analgesic requirement
Time to first rescue medication. The time from end of surgery to the first requirement of postoperative analgesia,pain score ≥4
Measured: 24 hours
Secondary outcomes (7)
Postoperative behaviour scores
behaviour score was recorded throughout the post-anesthesia care unit stay at 15-minute time intervals.
Measured: 2 hours
Sevoflurane concentration
Sevoflurane concentration required to maintain Bispectral Index (BIS) monitor reading between 40 and 60
Measured: 1 hour
Blood pressure Perioperative blood pressure readings
Perioperative blood pressure readings
Measured: 2 hours
Heart Rate
Perioperative heart rate readings
Measured: 2 hours
the incidence of emergence agitation
Participants will be followed for the duration of PACU stay, an expected average of 2 hours
Measured: 2 hours
Postoperative pain scores
postoperative pain score will be assessed over 24 hours
Measured: 24 hours
Side effects
side effects including nausea, vomiting and urinary retention and lower limb weakness
Measured: 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Apr 2015 (estimated)
- Study startJan 2014
- Primary completionOct 2014
- Study completionOct 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 75 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Jordan
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Khaled Radian Al-zaben, University of Jordan
- Investigators
- khaled R Al-zaben, Principal investigator, University of Jordan
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02416063
- Sponsor's protocol ID
- Faculty of medicine-JU
- Status last verified
- Apr 2015
- First submitted
- 12 Mar 2015
- Last updated
- 14 Apr 2015
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Zhang C, Hu J, Liu X, Yan J. Effects of intravenous dexmedetomidine on emergence agitation in children under sevoflurane anesthesia: a meta-analysis of randomized controlled trials. PLoS One. 2014 Jun 16;9(6):e99718. doi: 10.1371/journal.pone.0099718. eCollection 2014.
PubMed 24932765Guler G, Akin A, Tosun Z, Ors S, Esmaoglu A, Boyaci A. Single-dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy. Paediatr Anaesth. 2005 Sep;15(9):762-6. doi: 10.1111/j.1460-9592.2004.01541.x.
PubMed 16101707Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Oweidi AS, Abu-Halaweh SA, Abu-Ali HM, Saleem MM. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery. Eur J Anaesthesiol. 2010 Mar;27(3):247-52. doi: 10.1097/EJA.0b013e32833522bf.
PubMed 19952754Kim NY, Kim SY, Yoon HJ, Kil HK. Effect of dexmedetomidine on sevoflurane requirements and emergence agitation in children undergoing ambulatory surgery. Yonsei Med J. 2014 Jan;55(1):209-15. doi: 10.3349/ymj.2014.55.1.209.
PubMed 24339309She YJ, Xie GT, Tan YH, Kuang XH, Yu GF, Lian GH, Song XR. A prospective study comparing the onset and analgesic efficacy of different concentrations of levobupivacaine with/without dexmedetomidine in young children undergoing caudal blockade. J Clin Anesth. 2015 Feb;27(1):17-22. doi: 10.1016/j.jclinane.2014.09.005. Epub 2014 Nov 21.
PubMed 25468576Schnabel A, Reichl SU, Poepping DM, Kranke P, Pogatzki-Zahn EM, Zahn PK. Efficacy and safety of intraoperative dexmedetomidine for acute postoperative pain in children: a meta-analysis of randomized controlled trials. Paediatr Anaesth. 2013 Feb;23(2):170-9. doi: 10.1111/pan.12030. Epub 2012 Oct 9.
PubMed 23043461Fares KM, Othman AH, Alieldin NH. Efficacy and safety of dexmedetomidine added to caudal bupivacaine in pediatric major abdominal cancer surgery. Pain Physician. 2014 Sep-Oct;17(5):393-400.
PubMed 25247897
Study at a glance
From the registry record, last updated by the sponsor on 14 Apr 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Caudal Versus Intravenous Dexmedetomidine for Caudal Analgesia in Children: A Randomised Controlled Double Blind Study
- ClinicalTrials.gov ID
- NCT02416063
- Acronym / sponsor ID
- Faculty of medicine-JU
- Conditions
- Pain
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 75 participants (actual)
- Lead sponsor
- University of JordanUniversity, hospital or other
- Study start
- Jan 2014
- Primary completion
- Oct 2014 (actual)
- Study completion
- Oct 2014 (actual)
- First posted
- 14 Apr 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this prospective randomized double-blind study was to compare the analgesic efficacy and the side effects of dexmedetomidine (1 µg.kg-1) co-administered with bupivacaine for caudal analgesia or intravenously in children undergoing infra-umbilical surgery.
Detailed description
Dexmedetomidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent.But which route of administration of dexmedetomidine is the most beneficial remains unknown.
The investigators performed prospective randomized double-blind study to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on postoperative analgesia after caudal bupivacaine in children undergoing infra-umbilical surgery.
75 children (ASAⅠorⅡ,aged 1-6 yr) undergoing infra-umbilical surgery were included in this study. Anesthesia was induced with sevoflurane via a facemask, followed by placement of a laryngeal mask airway. Anesthesia was maintained with sevoflurane 2-3% in oxygen-air.Then,caudal block was applied. Patients were randomly assigned in three groups. Group B-Dcau (n = 25): Caudal bupivacaine 0.25% 1ml/kg plus dexmedetomidine 1µg/kg and 10 ml normal saline i.v.;Group B-Div (n = 25): bupivacaine 0.25% 1ml/kg and dexmedetomidine 1µg/kg(10 ml)i.v.;Group B(n = 25): bupivacaine 0.25% and 10 ml normal saline intravenous
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| caudal Dexmedetomidine | Active comparator | Drug: Caudal DexmedetomidineDrug:Caudal Bupivacaine 0.25% 1ml/kg . Drug:caudal Dexmedetomidine 1μg /kg. Intravenous :10 ml normal saline Anesthesia was induced and maintained with sevoflurane |
| Intravenous Dexmedetomidine | Active comparator | Drug: Intravenous dexmedetomidineDrug:Caudal bupivacaine 0.25% 1ml/kg Drug: Intravenous dexmedetomidine 1µg/kg in a 10 ml volume normal saline Anesthesia was induced and maintained with sevoflurane |
| Placebo | Placebo comparator | Drug: PlaceboCaudal: bupivacaine 0.25% 1ml/kg . Intravenous: 10 ml Normal saline Anesthesia was induced and maintained with sevoflurane |
Who may qualify
- Ages
- 1 year to 6 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Patients with American Society of Anesthesiologists (ASA) - I
- Scheduled for lower abdominal and perineal surgery
- Under general anesthesia
Key exclusion criteria (7 listed)
- Hypersensitivity to any local anesthetics
- Patient has history of allergy, intolerance, or reaction to dexmedetomidine
- Infections at puncture sites
- Bleeding diathesis
- Preexisting neurological disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Caudal DexmedetomidineAlso: dexmedetomidine, PrecedexDrug:Caudal bupivacaine 0.25% 1ml/kg Drug: Caudal dexmedetomidine 1µg/kg Intravenous: 10 ml normal saline sevoflurane Induction and maintenance of anesthesia | Drug | caudal Dexmedetomidine |
| Intravenous dexmedetomidineAlso: precedexDrug:Caudal bupivacaine 0.25% 1ml/kg. Drug:Intravenous dexmedetomidine1 μg /kg in a total volume of 10 ml sevoflurane Induction and maintenance of anesthesia | Drug | Intravenous Dexmedetomidine |
| PlaceboAlso: normal salineDrug:Caudal bupivacaine 0.25% 1ml/kg Intravenous: Normal saline 10 ml sevoflurane Induction and maintenance of anesthesia | Drug | Placebo |
Primary outcome
Time to first analgesic requirement
Time frame: 24 hours
Time to first rescue medication. The time from end of surgery to the first requirement of postoperative analgesia,pain score ≥4
7 secondary outcomes
Postoperative behaviour scores
Time frame: 2 hours
Sevoflurane concentration
Time frame: 1 hour
Blood pressure Perioperative blood pressure readings
Time frame: 2 hours
Heart Rate
Time frame: 2 hours
the incidence of emergence agitation
Time frame: 2 hours
Postoperative pain scores
Time frame: 24 hours
Side effects
Time frame: 24 hours
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Apr 2015.
- Background: PubMed 24932765Zhang C, Hu J, Liu X, Yan J. Effects of intravenous dexmedetomidine on emergence agitation in children under sevoflurane anesthesia: a meta-analysis of randomized controlled trials. PLoS One. 2014 Jun 16;9(6):e99718. doi: 10.1371/journal.pone.0099718. eCollection 2014.
- Background: PubMed 16101707Guler G, Akin A, Tosun Z, Ors S, Esmaoglu A, Boyaci A. Single-dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy. Paediatr Anaesth. 2005 Sep;15(9):762-6. doi: 10.1111/j.1460-9592.2004.01541.x.
- Background: PubMed 19952754Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Oweidi AS, Abu-Halaweh SA, Abu-Ali HM, Saleem MM. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery. Eur J Anaesthesiol. 2010 Mar;27(3):247-52. doi: 10.1097/EJA.0b013e32833522bf.
- Background: PubMed 24339309Kim NY, Kim SY, Yoon HJ, Kil HK. Effect of dexmedetomidine on sevoflurane requirements and emergence agitation in children undergoing ambulatory surgery. Yonsei Med J. 2014 Jan;55(1):209-15. doi: 10.3349/ymj.2014.55.1.209.
- Background: PubMed 25468576She YJ, Xie GT, Tan YH, Kuang XH, Yu GF, Lian GH, Song XR. A prospective study comparing the onset and analgesic efficacy of different concentrations of levobupivacaine with/without dexmedetomidine in young children undergoing caudal blockade. J Clin Anesth. 2015 Feb;27(1):17-22. doi: 10.1016/j.jclinane.2014.09.005. Epub 2014 Nov 21.
- Background: PubMed 23043461Schnabel A, Reichl SU, Poepping DM, Kranke P, Pogatzki-Zahn EM, Zahn PK. Efficacy and safety of intraoperative dexmedetomidine for acute postoperative pain in children: a meta-analysis of randomized controlled trials. Paediatr Anaesth. 2013 Feb;23(2):170-9. doi: 10.1111/pan.12030. Epub 2012 Oct 9.
- Background: PubMed 25247897Fares KM, Othman AH, Alieldin NH. Efficacy and safety of dexmedetomidine added to caudal bupivacaine in pediatric major abdominal cancer surgery. Pain Physician. 2014 Sep-Oct;17(5):393-400.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
khaled R Al-zaben principal investigator
University of Jordan
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Caudal Dexmedetomidine and Intravenous dexmedetomidine in people with Pain, run by University of Jordan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Apr 2015. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to first analgesic requirement (time frame: 24 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02416063, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2015.