Vitreoretinal SurgeryPhase 4NCT03189329
The Effect of Retrobulbar Block for Eye Surgery on Brain Oxygenation and Cognitive Functions in Elderly Patients
A Phase 4 study testing 2% lidocaine hydrochloride and 0.5% levobupivacaine in people with Vitreoretinal Surgery and Cognitive Function Abnormal, run by Cengiz KAYA at 1 site in Turkey (Türkiye).
Trial summary
The investigators measured changes in cerebral oxygen saturation (rSO2) and MMSE scores after retrobulbar block performed with levobupivacaine and lidocaine in patients undergoing vitreoretinal surgery.A total of 66 patients over the age of 60 undergoing vitreoretinal surgery with a total duration of less than 1 hour… Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Vitreoretinal Surgery, Cognitive Function Abnormal, Intraoperative Monitoring
- What is being tested?
- 2% lidocaine hydrochloride and 0.5% levobupivacaine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 66 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- Jan 2015to Jan 2016
- Phase
- Phase 4
- 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 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Undergoing vitreoretinal surgery (total duration < 60 minutes)
- The ASA (American Society of Anesthesiologists) Classification I-III
- Over the age of 60
- The patiens who had no cognitive dysfunction
Who cannot join
- Contraindication for retrobulbar block
- Preoperative systolic blood pressure of 180 mmHg, diastolic blood pressure of above 100 mmHg
- Uncontrolled diabetes
- Body mass index ≥ 30 kg/m2
- MMSE ≤ 24
- Advanced organ failure
- Hb < 9gr/dl
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Ondokuz Mayis Universitesi
Samsun, Atakum, 55139
About this study
Official title: The Effect of Retrobulbar Block on Bi-Hemispheric Cerebral Oxygen Saturation and Early Period Postoperative Cognitive Functions With Lidocaine and Levobupivacaine in Elderly Patients With Ophthalmic Surgery
The investigators measured changes in cerebral oxygen saturation (rSO2) and MMSE scores after retrobulbar block performed with levobupivacaine and lidocaine in patients undergoing vitreoretinal surgery.A total of 66 patients over the age of 60 undergoing vitreoretinal surgery with a total duration of less than 1 hour were included in this prospective, double-blinded study. The patients were randomly divided into two groups: group L (5ml, 2% lidocaine) and group LB (5ml, 0.5% levobupivacaine). Bilateral rSO2 measurements were recorded before the retrobulbar block and at 1-5 minutes post-block, during the procedure, and at 10-40 minutes post-op. MMSE was performed preoperatively and postoperatively in order to evaluate short term cognitive function. Sensory and motor block durations, pain, akinesia and conjunctival feeling scores, patient-surgeon satisfaction, and complications were also recorded.
Read the detailed description
A total of 66 patients undergoing vitreoretinal surgery (total duration < 60 minutes) using retrobulbar block, who were classified as category I-III according to the ASA (American Society of Anesthesiologists) Classification system, who were over the age of 60, and who had no cognitive dysfunction were included in the study. Exclusion criteria were as follows: contraindication for retrobulbar block, preoperative systolic blood pressure of 180 mmHg, diastolic blood pressure of above 100 mmHg, uncontrolled diabetes, body mass index ≥ 30 kg/m2, MMSE ≤ 24, advanced organ failure, or Hb < 9gr/dl.The patients were randomly divided into two groups using a sealed-envelope method:
Group L: Patients undergoing block with lidocaine (n = 33) Group LB: Patients undergoing block with levobupivacaine (n = 33) The patients did not undergo premedication in order to accommodate the postoperative MMSE evaluation. For intra-operative sedation, remifentanil (UltivaR, GlaxoSmithKline, Berntford, UK) was initiated as an infusion at a dose range of 0.05-0.1 mcg/kg/min. The mean arterial pressure and heart rate values were allowed to vary up to 20% of the preoperative values of the patients. For this purpose, the remifentanil infusion rate was increased or decreased at the determined dose interval.
Retrobulbar block was performed with 5 ml of 2% lidocaine hydrochloride (AritmalR, Osel, Istanbul, Turkey) in Group L patients and 5ml of 0.5% levobupivacaine (ChirocaineR, Abbvie, Chicago, USA) in Group LB patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA).
Sensory and motor block onset and end times and akinesia score were recorded. The mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were recorded in the preoperative period, at minutes 1, 3, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 intra-operatively, and at 10, 20, 30, and 40 minutes postoperatively in the recovery room.
. The patients were transferred to the operating table for measurement of bilateral rSO2, and preoxygenation was performed for three minutes using 4 L/min 100% oxygen via nasal cannula. The basal oxygenation values were determined by taking the average of the last 30 s measurements. The rSO2 values were recorded at 1, 3, 5, 10, 15, 20, 25, 30th, 35, 40, 45, 50, 55, and 60 minutes after retrobulbar block, and at 10, 20, 30, and 40 minutes after the completion of the procedure.
Cognitive functions were assessed by the same technician using MMSE in the preoperative period, 40 minutes postoperatively and at 7 days after the operation (short term).Surgeon satisfaction was queried at the end of the case and patient satisfaction was questioned at the end of day.
- Being tested
- 2% lidocaine hydrochloride, 0.5% levobupivacaine
- Keywords
- NIR spectroscopy, cognitive function, eye, nerve block
- Medical subject headings
- Cognition Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
2% lidocaine hydrochlorideDrug
Retrobulbar block was performed with 5 ml of 2% lidocaine hydrochloride (AritmalR, Osel, Istanbul, Turkey) in Group L patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA)
0.5% levobupivacaineDrug
and 5ml of 0.5% levobupivacaine (ChirocaineR, Abbvie, Chicago, USA) in Group LB patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA)
| Study group | Role | What they receive |
|---|---|---|
| Group L | Active comparator | Patients undergoing block with 2% lidocaine hydrochloride Receives: Drug: 2% lidocaine hydrochloride |
| Group LB | Active comparator | Patients undergoing block with 0.5% levobupivacaine Receives: Drug: 0.5% levobupivacaine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Cerebral oxygen saturation changes (rSO2)
The NIRS device probes (INVOS-3100AR; Somanetics Inc., Troy, MI, USA) were placed at least 2 cm above the eyebrows and 3 cm away from the mid-line of the forehead, on right and left, in accordance with the instructions of manufacturer.The patient's forehead was cleaned with acetone alcohol before the sensor pads were glued, and wrapped with a bandage so that the sensors were not affected by ambient light. The patients were transferred to the operating table for measurement of bilateral rSO2, and preoxygenation was performed for three minutes using 4 L/min 100% oxygen via nasal cannula.
Measured: The rSO2 value changes were recorded from baseline up to 40 minutes after surgery
Secondary outcomes (11)
Cognitive function measurement
Cognitive functions were assessed by the same technician using the Mini Mental State Examination (MMSE) test.
Measured: Cognitive functions were assessed from baseline up to 7 days after the surgery
Sensory block onset time by the conjunctival feeling score using the cotton contact test.
The sensory block onset time was recorded as the moment when the patient did not feel a piece of cotton touching the cornea. This time was measured by the conjunctival feeling score using the cotton contact test (0: normal, 1: less sensitive, 2: complete sensory loss). Score of 2 on the scale was considered as onset time for sensory block.
Measured: The sensory block onset time was recorded at the beginning of surgery till the first 15 min
Sensory block end time by the conjunctival feeling score using the cotton contact test.
The time at which recovery of sensory block was recovered was measured by the conjunctival feeling score using the cotton contact test (0: normal, 1: less sensitive, 2: complete sensory loss). Score of 0 on the scale was considered as end time for sensory block.
Measured: The sensory block end time was recorded at the end of surgery till the first 24 h
Motor block onset time by eye movements score.
The motor block onset time was recorded as the time that the patient's eye movements score was four or less. Eye movements score was measured over three points in each of the four quadrants as follows: 3, full eye movement and 0, no movement.
Measured: The motor block onset time was recorded at the beginning of surgery till the first 15 min
Motor block end time by eye movements score.
The time at which recovery of motor block was recovered was measured by the eye movements score (three points in each of the four quadrants as follows: 3, full eye movement and 0, no movement). Score of 12 on the scale was considered as end time for motor block.
Measured: The motor block end time was recorded at the end of surgery till the first 24 h
The akinesia score measurement
The akinesia score was assessed between 0-12 points after 10 minutes of block application. Eye movements were measured over three points in each of the four quadrants as follows: 3, full eye movement and 0, no movement. The sum of the movement scores across all four quadrants was recorded as the akinesian score. An eye with full movement was scored as 12, and an immobile eye was scored as 0. If the akinesia score was four or less, the block was considered successful.
Measured: The akinesia score was assessed at the beginning of surgery till the first 15 min.
The mean arterial pressure (MAP) measurement
The mean arterial pressure (MAP) was recorded in the preoperative period, at minutes 1, 3, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 intra-operatively, and at 10, 20, 30, and 40 minutes postoperatively in the recovery room.
Measured: The mean arterial pressure was recorded from baseline up to 40 minutes after surgery
The heart rate (HR) measurement
The heart rate (HR) was recorded in the preoperative period, at minutes 1, 3, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 intra-operatively, and at 10, 20, 30, and 40 minutes postoperatively in the recovery room.
Measured: The heart rate (HR) was recorded from baseline up to 40 minutes after surgery
The oxygen saturation (SpO2) measurement
The oxygen saturation (SpO2) was recorded in the preoperative period, at minutes 1, 3, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 intra-operatively, and at 10, 20, 30, and 40 minutes postoperatively in the recovery room.
Measured: The oxygen saturation (SpO2) was recorded from baseline up to 40 minutes after surgery
Surgeon satisfaction
They were asked to score over 10 point scale. Surgeon satisfaction was evaluated using 10 point scale ( 0 = not satisfied at all and 10 = very satisfied)
Measured: Surgeon satisfaction was queried at the end of the surgery till the first 15 min.
Patient satisfaction
They were asked to score over 10 point scale. Patient satisfaction was evaluated using 10 point scale ( 0 = not satisfied at all and 10 = very satisfied)
Measured: Patient satisfaction was questioned 24 hours after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jun 2017
- Study startJan 2015
- Primary completionJan 2016
- Study completionJan 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (21)Papers the sponsor has linked to this study.
- Other trials for Vitreoretinal SurgeryStudies 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 4
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Investigator
- Enrolment
- 66 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cengiz KAYA
- Sponsor type
- University, hospital or other
- Collaborators
- Ondokuz Mayıs University
- Responsible party
- Sponsor-investigator, Cengiz KAYA, Ondokuz Mayıs University
- Investigators
- Cengiz Kaya, MD, Principal investigator, Ondokuz Mayıs University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03189329
- Sponsor's protocol ID
- PYO.TIP.1904.15.009
- Status last verified
- Jun 2017
- First submitted
- 10 Jun 2017
- Last updated
- 16 Jun 2017
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92. doi: 10.1001/archneur.58.12.1985.
PubMed 11735772Ripart J, Lefrant JY, Vivien B, Charavel P, Fabbro-Peray P, Jaussaud A, Dupeyron G, Eledjam JJ. Ophthalmic regional anesthesia: medial canthus episcleral (sub-tenon) anesthesia is more efficient than peribulbar anesthesia: A double-blind randomized study. Anesthesiology. 2000 May;92(5):1278-85. doi: 10.1097/00000542-200005000-00015.
PubMed 10781272BOBERG-ANS J. Experience in clinical examination of corneal sensitivity; corneal sensitivity and the naso-lacrimal reflex after retrobulbar anaesthesia. Br J Ophthalmol. 1955 Dec;39(12):705-26. doi: 10.1136/bjo.39.12.705. No abstract available.
PubMed 13276583Wang PW, Chen ML, Huang LW, Yang W, Wu KY, Huang YF. Prenatal nonylphenol exposure, oxidative and nitrative stress, and birth outcomes: A cohort study in Taiwan. Environ Pollut. 2015 Dec;207:145-51. doi: 10.1016/j.envpol.2015.08.044. Epub 2015 Sep 12.
PubMed 26367708Tsai TC, Orav EJ, Jha AK. Patient satisfaction and quality of surgical care in US hospitals. Ann Surg. 2015 Jan;261(1):2-8. doi: 10.1097/SLA.0000000000000765.
PubMed 24887985Casati A, Fanelli G, Pietropaoli P, Proietti R, Tufano R, Montanini S; Collaborative Italian Study Group on Anaesthesia in Elderly Patients; Danelli G, Nuzzi M, Mentegazzi F, Torri G, Martani C, Spreafico E, Fierro G, Pugliese F, De Cosmo G, Aceto P, Servillo G, Monaco F. Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: a prospective cohort study. Eur J Anaesthesiol. 2007 Jan;24(1):59-65. doi: 10.1017/S0265021506001025. Epub 2006 Jul 7.
PubMed 16824246Astrup J. Energy-requiring cell functions in the ischemic brain. Their critical supply and possible inhibition in protective therapy. J Neurosurg. 1982 Apr;56(4):482-97. doi: 10.3171/jns.1982.56.4.0482. No abstract available.
PubMed 6278105Shokunbi MT, Gelb AW, Wu XM, Miller DJ. Continuous lidocaine infusion and focal feline cerebral ischemia. Stroke. 1990 Jan;21(1):107-11. doi: 10.1161/01.str.21.1.107.
PubMed 2300976Rasool N, Faroqui M, Rubinstein EH. Lidocaine accelerates neuroelectrical recovery after incomplete global ischemia in rabbits. Stroke. 1990 Jun;21(6):929-35. doi: 10.1161/01.str.21.6.929.
PubMed 2349597Haschke RH, Fink BR. Lidocaine effects on brain mitochondrial metabolism in vitro. Anesthesiology. 1975 Jun;42(6):737-40. doi: 10.1097/00000542-197506000-00018.
PubMed 1130742Baik JS, Sohn JT, Ok SH, Kim JG, Sung HJ, Park SS, Park JY, Hwang EM, Chung YK. Levobupivacaine-induced contraction of isolated rat aorta is calcium dependent. Can J Physiol Pharmacol. 2011 Jul;89(7):467-76. doi: 10.1139/y11-046. Epub 2011 Jul 21.
PubMed 21812525Sung HJ, Ok SH, Sohn JY, Son YH, Kim JK, Lee SH, Han JY, Lim DH, Shin IW, Lee HK, Chung YK, Choi MJ, Sohn JT. Vasoconstriction potency induced by aminoamide local anesthetics correlates with lipid solubility. J Biomed Biotechnol. 2012;2012:170958. doi: 10.1155/2012/170958. Epub 2012 Jun 17.
PubMed 22778542Birt DJ, Cummings GC. The efficacy and safety of 0.75% levobupivacaine vs 0.75% bupivacaine for peribulbar anaesthesia. Eye (Lond). 2003 Mar;17(2):200-6. doi: 10.1038/sj.eye.6700313.
PubMed 12640407Suehiro K, Okutai R. Duration of cerebral desaturation time during single-lung ventilation correlates with mini mental state examination score. J Anesth. 2011 Jun;25(3):345-9. doi: 10.1007/s00540-011-1136-1. Epub 2011 Apr 12.
PubMed 21484501Zhang Y, Qian Y, Bao H, Shi H, Zhou J. [Effect of Stellate Ganglion Block on Bilateral Regional Cerebral Oxygen Saturation and Postoperative Cognitive Function]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2016 Feb;33(1):132-5. Chinese.
PubMed 27382753
Study at a glance
From the registry record, last updated by the sponsor on 16 Jun 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Retrobulbar Block on Bi-Hemispheric Cerebral Oxygen Saturation and Early Period Postoperative Cognitive Functions With Lidocaine and Levobupivacaine in Elderly Patients With Ophthalmic Surgery
- ClinicalTrials.gov ID
- NCT03189329
- Acronym / sponsor ID
- PYO.TIP.1904.15.009
- Keywords
- NIR spectroscopy, cognitive function, eye, nerve block
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 66 participants (actual)
- Lead sponsor
- Cengiz KAYAUniversity, hospital or other
- Collaborators
- Ondokuz Mayıs University
- Study start
- Jan 2015 (actual)
- Primary completion
- Jan 2016 (actual)
- Study completion
- Jan 2016 (actual)
- First posted
- 16 Jun 2017 (actual)
- 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 investigators measured changes in cerebral oxygen saturation (rSO2) and MMSE scores after retrobulbar block performed with levobupivacaine and lidocaine in patients undergoing vitreoretinal surgery.A total of 66 patients over the age of 60 undergoing vitreoretinal surgery with a total duration of less than 1 hour were included in this prospective, double-blinded study. The patients were randomly divided into two groups: group L (5ml, 2% lidocaine) and group LB (5ml, 0.5% levobupivacaine). Bilateral rSO2 measurements were recorded before the retrobulbar block and at 1-5 minutes post-block, during the procedure, and at 10-40 minutes post-op. MMSE was performed preoperatively and postoperatively in order to evaluate short term cognitive function. Sensory and motor block durations, pain, akinesia and conjunctival feeling scores, patient-surgeon satisfaction, and complications were also recorded.
Detailed description
A total of 66 patients undergoing vitreoretinal surgery (total duration < 60 minutes) using retrobulbar block, who were classified as category I-III according to the ASA (American Society of Anesthesiologists) Classification system, who were over the age of 60, and who had no cognitive dysfunction were included in the study. Exclusion criteria were as follows: contraindication for retrobulbar block, preoperative systolic blood pressure of 180 mmHg, diastolic blood pressure of above 100 mmHg, uncontrolled diabetes, body mass index ≥ 30 kg/m2, MMSE ≤ 24, advanced organ failure, or Hb < 9gr/dl.The patients were randomly divided into two groups using a sealed-envelope method:
Group L: Patients undergoing block with lidocaine (n = 33) Group LB: Patients undergoing block with levobupivacaine (n = 33) The patients did not undergo premedication in order to accommodate the postoperative MMSE evaluation. For intra-operative sedation, remifentanil (UltivaR, GlaxoSmithKline, Berntford, UK) was initiated as an infusion at a dose range of 0.05-0.1 mcg/kg/min. The mean arterial pressure and heart rate values were allowed to vary up to 20% of the preoperative values of the patients. For this purpose, the remifentanil infusion rate was increased or decreased at the determined dose interval.
Retrobulbar block was performed with 5 ml of 2% lidocaine hydrochloride (AritmalR, Osel, Istanbul, Turkey) in Group L patients and 5ml of 0.5% levobupivacaine (ChirocaineR, Abbvie, Chicago, USA) in Group LB patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA).
Sensory and motor block onset and end times and akinesia score were recorded. The mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were recorded in the preoperative period, at minutes 1, 3, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 intra-operatively, and at 10, 20, 30, and 40 minutes postoperatively in the recovery room.
. The patients were transferred to the operating table for measurement of bilateral rSO2, and preoxygenation was performed for three minutes using 4 L/min 100% oxygen via nasal cannula. The basal oxygenation values were determined by taking the average of the last 30 s measurements. The rSO2 values were recorded at 1, 3, 5, 10, 15, 20, 25, 30th, 35, 40, 45, 50, 55, and 60 minutes after retrobulbar block, and at 10, 20, 30, and 40 minutes after the completion of the procedure.
Cognitive functions were assessed by the same technician using MMSE in the preoperative period, 40 minutes postoperatively and at 7 days after the operation (short term).Surgeon satisfaction was queried at the end of the case and patient satisfaction was questioned at the end of day.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group L | Active comparator | Drug: 2% lidocaine hydrochloridePatients undergoing block with 2% lidocaine hydrochloride |
| Group LB | Active comparator | Drug: 0.5% levobupivacainePatients undergoing block with 0.5% levobupivacaine |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Undergoing vitreoretinal surgery (total duration < 60 minutes)
- The ASA (American Society of Anesthesiologists) Classification I-III
- Over the age of 60
- The patiens who had no cognitive dysfunction
Key exclusion criteria (7 listed)
- Contraindication for retrobulbar block
- Preoperative systolic blood pressure of 180 mmHg, diastolic blood pressure of above 100 mmHg
- Uncontrolled diabetes
- Body mass index ≥ 30 kg/m2
- MMSE ≤ 24
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 |
|---|---|---|
| 2% lidocaine hydrochlorideRetrobulbar block was performed with 5 ml of 2% lidocaine hydrochloride (AritmalR, Osel, Istanbul, Turkey) in Group L patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA) | Drug | Group L |
| 0.5% levobupivacaineand 5ml of 0.5% levobupivacaine (ChirocaineR, Abbvie, Chicago, USA) in Group LB patients. The block was performed by the same practitioner (fourth year assistant of Ophthalmology Department) using inferotemporal approach as described by Sanderson using 27 gage disposable needles (Atkinson Retrobulbar NeedleR, Asico, USA) | Drug | Group LB |
Primary outcome
Cerebral oxygen saturation changes (rSO2)
Time frame: The rSO2 value changes were recorded from baseline up to 40 minutes after surgery
The NIRS device probes (INVOS-3100AR; Somanetics Inc., Troy, MI, USA) were placed at least 2 cm above the eyebrows and 3 cm away from the mid-line of the forehead, on right and left, in accordance with the instructions of manufacturer.The patient's forehead was cleaned with acetone alcohol before the sensor pads were glued, and wrapped with a bandage so that the sensors were not affected by ambient light. The patients were transferred to the operating table for measurement of bilateral rSO2, and preoxygenation was performed for three minutes using 4 L/min 100% oxygen via nasal cannula.
11 secondary outcomes
Cognitive function measurement
Time frame: Cognitive functions were assessed from baseline up to 7 days after the surgery
Sensory block onset time by the conjunctival feeling score using the cotton contact test.
Time frame: The sensory block onset time was recorded at the beginning of surgery till the first 15 min
Sensory block end time by the conjunctival feeling score using the cotton contact test.
Time frame: The sensory block end time was recorded at the end of surgery till the first 24 h
Motor block onset time by eye movements score.
Time frame: The motor block onset time was recorded at the beginning of surgery till the first 15 min
Motor block end time by eye movements score.
Time frame: The motor block end time was recorded at the end of surgery till the first 24 h
The akinesia score measurement
Time frame: The akinesia score was assessed at the beginning of surgery till the first 15 min.
The mean arterial pressure (MAP) measurement
Time frame: The mean arterial pressure was recorded from baseline up to 40 minutes after surgery
The heart rate (HR) measurement
Time frame: The heart rate (HR) was recorded from baseline up to 40 minutes after surgery
The oxygen saturation (SpO2) measurement
Time frame: The oxygen saturation (SpO2) was recorded from baseline up to 40 minutes after surgery
Surgeon satisfaction
Time frame: Surgeon satisfaction was queried at the end of the surgery till the first 15 min.
Patient satisfaction
Time frame: Patient satisfaction was questioned 24 hours after surgery
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 16 Jun 2017.
- Background: PubMed 11735772Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92. doi: 10.1001/archneur.58.12.1985.
- Background: PubMed 10781272Ripart J, Lefrant JY, Vivien B, Charavel P, Fabbro-Peray P, Jaussaud A, Dupeyron G, Eledjam JJ. Ophthalmic regional anesthesia: medial canthus episcleral (sub-tenon) anesthesia is more efficient than peribulbar anesthesia: A double-blind randomized study. Anesthesiology. 2000 May;92(5):1278-85. doi: 10.1097/00000542-200005000-00015.
- Background: PubMed 13276583BOBERG-ANS J. Experience in clinical examination of corneal sensitivity; corneal sensitivity and the naso-lacrimal reflex after retrobulbar anaesthesia. Br J Ophthalmol. 1955 Dec;39(12):705-26. doi: 10.1136/bjo.39.12.705. No abstract available.
- Background: PubMed 26367708Wang PW, Chen ML, Huang LW, Yang W, Wu KY, Huang YF. Prenatal nonylphenol exposure, oxidative and nitrative stress, and birth outcomes: A cohort study in Taiwan. Environ Pollut. 2015 Dec;207:145-51. doi: 10.1016/j.envpol.2015.08.044. Epub 2015 Sep 12.
- Background: PubMed 24887985Tsai TC, Orav EJ, Jha AK. Patient satisfaction and quality of surgical care in US hospitals. Ann Surg. 2015 Jan;261(1):2-8. doi: 10.1097/SLA.0000000000000765.
- Background: PubMed 16824246Casati A, Fanelli G, Pietropaoli P, Proietti R, Tufano R, Montanini S; Collaborative Italian Study Group on Anaesthesia in Elderly Patients; Danelli G, Nuzzi M, Mentegazzi F, Torri G, Martani C, Spreafico E, Fierro G, Pugliese F, De Cosmo G, Aceto P, Servillo G, Monaco F. Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: a prospective cohort study. Eur J Anaesthesiol. 2007 Jan;24(1):59-65. doi: 10.1017/S0265021506001025. Epub 2006 Jul 7.
- Results publication: PubMed 6278105Astrup J. Energy-requiring cell functions in the ischemic brain. Their critical supply and possible inhibition in protective therapy. J Neurosurg. 1982 Apr;56(4):482-97. doi: 10.3171/jns.1982.56.4.0482. No abstract available.
- Results publication: PubMed 2300976Shokunbi MT, Gelb AW, Wu XM, Miller DJ. Continuous lidocaine infusion and focal feline cerebral ischemia. Stroke. 1990 Jan;21(1):107-11. doi: 10.1161/01.str.21.1.107.
- Results publication: PubMed 2349597Rasool N, Faroqui M, Rubinstein EH. Lidocaine accelerates neuroelectrical recovery after incomplete global ischemia in rabbits. Stroke. 1990 Jun;21(6):929-35. doi: 10.1161/01.str.21.6.929.
- Results publication: PubMed 1130742Haschke RH, Fink BR. Lidocaine effects on brain mitochondrial metabolism in vitro. Anesthesiology. 1975 Jun;42(6):737-40. doi: 10.1097/00000542-197506000-00018.
- Results publication: PubMed 21812525Baik JS, Sohn JT, Ok SH, Kim JG, Sung HJ, Park SS, Park JY, Hwang EM, Chung YK. Levobupivacaine-induced contraction of isolated rat aorta is calcium dependent. Can J Physiol Pharmacol. 2011 Jul;89(7):467-76. doi: 10.1139/y11-046. Epub 2011 Jul 21.
- Results publication: PubMed 22778542Sung HJ, Ok SH, Sohn JY, Son YH, Kim JK, Lee SH, Han JY, Lim DH, Shin IW, Lee HK, Chung YK, Choi MJ, Sohn JT. Vasoconstriction potency induced by aminoamide local anesthetics correlates with lipid solubility. J Biomed Biotechnol. 2012;2012:170958. doi: 10.1155/2012/170958. Epub 2012 Jun 17.
- Individual participant dataSharing planned: No
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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.
Cengiz Kaya, MD principal investigator
Ondokuz Mayıs University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing 2% lidocaine hydrochloride and 0.5% levobupivacaine in people with Vitreoretinal Surgery and Cognitive Function Abnormal, run by Cengiz KAYA at 1 site in Turkey (Türkiye).
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 4 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 16 Jun 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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?
Cerebral oxygen saturation changes (rSO2) (time frame: The rSO2 value changes were recorded from baseline up to 40 minutes after surgery). 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 NCT03189329, which also lists 21 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 16 Jun 2017.