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A 3 Months Duration Interventional Study Comparing Hemodynamic Parameters Between Bolus and Fractionated Group.

Phase 1
Completed
Conditions
Prostatic Hyperplasia, Benign
Interventions
Combination Product: 0.5% Heavy Bupivacaine
Registration Number
NCT06620614
Lead Sponsor
National Academy of Medical Sciences, Nepal
Brief Summary

The goal of this study is to compare the intraoperative hemodynamic status, characteristics of block of fractionated versus single bolus dose of Hyperbaric Bupivacaine in patient undergoing Transurethral Resection of Prostate(TURP) surgery under Subarachnoid block(SAB).

Seventy-two patients aged 50 years and above belonging to American Physical status I and II are divided into two study group.

Group B will receive Injection 0.5 % hyperbaric bupivacaine 2.5 ml single bolus dose and group F will receive same concentration and volume of hyperbaric bupivacaine with two third dose initially (i.e. 1.6 ml) and remaining one third dose (i.e. 0.9 ml) after 60 seconds at the rate of 0.2ml/sec.

Detailed Description

The aim of this study is to compare the intraoperative hemodynamic status, characteristics of block of fractionated versus single bolus dose of Hyperbaric Bupivacaine in patient undergoing TURP surgery under SAB.

Seventy-two patients aged 50 years and above belonging to American Physical status I and II undergoing transurethral resection of prostate for benign enlargement of prostate under subarachnoid block are enrolled and are divided into two groups having 36 patients in each.

Group B will receive Injection 0.5 % hyperbaric bupivacaine 2.5 ml single bolus dose and group F will receive same concentration and volume of hyperbaric bupivacaine with two third dose initially (i.e. 1.6 ml) and remaining one third dose (i.e. 0.9 ml) after 60 seconds at the rate of 0.2ml/sec.

Intraoperative mean arterial pressure (MAP), heart rate, onset of sensory and motor block, duration of sensory and motor block, and total intraoperative consumption of vasopressor are observed and compared between the groups.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
72
Inclusion Criteria
  • Age: 50 years and above patients undergoing TURP surgery under SAB
  • American Society of Anesthesiologist's Physical Status: I and II.
Exclusion Criteria
  • Patients with history of uncontrolled hypertension.
  • Patients with previous history of cerebrovascular accidents.
  • Patients with history of spinal deformity.
  • Patients with known allergy to local anesthetics.
  • Patient with Infection at site of injection.
  • Patient with history of coagulopathy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fractionated group arm0.5% Heavy BupivacaineIn this group ,participants are given 1.6 ml of Injection Heavy Bupivacaine 0.5% initially followed by 0.9ml after 60 seconds at a rate of 0.2ml/hr.
Bolus arm group0.5% Heavy BupivacaineIn this group ,participants are given Injection Heavy Bupivacaine 0.5% 2.5ml bolus at a rate of 0.2ml/hr
Primary Outcome Measures
NameTimeMethod
Comparision of mean arterial pressure(MAP) in both participants with subarachnoid blockThroughout study completion,an average of 3 months

Hypotension was defined when mean arterial pressure (MAP) decreased ≤20% from baseline.

Comparision of heart rate in both participants with subarachnoid blockThroughout study completion,an average of 3 months

Bradycardia was defined when heart rate is less than 60 beats per minute.

Comparision of total consumption of vasopressors used during intraoperative period between the groups.Throughout study completion,an average of 3 months

Injection Mephentermine 6mg iv was given for hypotension

Secondary Outcome Measures
NameTimeMethod
Comparision of time for onset of sensory between the groups.Throughout study completion,an average of 3 months.

Sensory block was assessed by loss of sensation to pinprick with blunted tip needle bilaterally in the dermatomal levels. It was tested every 3 min until achievement of maximum sensory block i.e. till T10 level

Comparision of time for onset of motor block between the groupsThroughout study completion,an average of 3 months.

Time required to reach Modified Bromage scale =3, where Bromage 0= no motor block ,Bromage 3= complete block of motor limb

Comparision of the time of regression of sensory block between two groups.Throughout study completion,an average of 3 months

Loss of pinprick sensation every 30 minutes postoperatively until it reached the S2 segment

Comparision of the time of regression motor block between two groups.Throughout study completion,an average of 3 months.

Assessed every 30 minutes postoperatively Time required to reach Modified Bromage scale =0, where Bromage 0= no motor block ,Bromage 3= complete block of motor limb.

Comparision of adverse effects like nausea, vomiting and shivering between the groupsThroughout study completion,an average of 3 months.

Side effects managed according to hospital protocol

Trial Locations

Locations (1)

National Academy of Medical Sciences, Bir Hospital

🇳🇵

Kathmandu, Nepal

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