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Comparing two different doses of bupivacaine in epidural volume extension

Completed
Conditions
male patients undergoing Orthopedic lower limb surgery
Registration Number
CTRI/2016/12/007606
Lead Sponsor
University College of Medical Sciences and Guru Teg Bahadur Hospital
Brief Summary

This trial is a comparison of two diffrent doses of plain bupivacaine (5m and 8mg) for epidural volume extension induced sensory block augumentation. It aiims to evaluate whether the intrathecal dose affects the efficacy of epidural volume extension. We will determine and compare, in patients undergoing orthopaedic surgery for lower limb,the maximum sensory block level achieved with or without epidural volume extension, following intrathecal injection of 5 mg Plain bupivacaine (along with 25μg fentanyl). The same will be done for 8mg of intrathecal plain bupivacaine. Combined spinal epidural anesthesia will be performed according to standrad practice. Epidural volume extension will be performed by injecting 10ml normal saline in epidural space

The comparison of Smax with or without epidural volume extension following either intrathecal dose i.e., between groups PE5 and PNE5; and between PE8 and PNE8; as well as that of ∆Smax with either dose of intrathecal bupivacaine; will be done using Mann Whitney-U test. For other comparisons, appropriate statistical tests will be applied as required. A p-value <0.05 will be considered statistically significant.

Sample size was determined using two-sided, two-sample t-test for comparing means at a power of 80% and α error of 5%. Taking previously reported standard deviation of 1 dermatome in the maximum sensory block level after 5 mg and 8 mg intrathecal plain bupivacaine in patients undergoing lower limb surgery, 17 patient would be required in each group to detect a difference of 1 dermatome following epidural volume extension. Adding another 10% for possible withdrawals due to various reasons such as failure of block, and 15% for the maximum sensory level being non-parametric in distribution, at least 21 patients would be required in each group.

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
Male
Target Recruitment
84
Inclusion Criteria

ASA status I or II with body weight between 50-70 kg and height of 150-180 cm undergoing lower limb surgery using combined spinal epidural technique.

Exclusion Criteria

Patients with diabetes mellitus, history of spinal disease or coagulation abnormalities, skin infection at site of injection and other contraindications to combined spinal epidural anesthesia including hypersensitivity to local anesthetics.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The maximum sensory block level (Smax) achievedThe sensory blockade will be assessed every 3 min till there is no further increase in 3 consecutive readings. This level of sensory blockade will be designated as maximum level of sensory block (Smax).
Secondary Outcome Measures
NameTimeMethod
The increase in maximum sensory block level caused by epidural volume extensionThe sensory blockade will be assessed every 3 min till there is no further increase in 3 consecutive readings. This level of sensory blockade will be designated as maximum level of sensory block (Smax).

Trial Locations

Locations (1)

University College of Medical Sciences and Guru Teg Bahadur Hospital

🇮🇳

East, DELHI, India

University College of Medical Sciences and Guru Teg Bahadur Hospital
🇮🇳East, DELHI, India
Dr Asha Tyagi
Principal investigator
9868333713
drashatyagi@gmail.com

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