Comparison of Intratechal Levobupivacaine and Adding With Sufetanil and Fentanyl in Ceserean Section

Sponsor
Ankara City Hospital Bilkent (Other)
Overall Status
Completed
CT.gov ID
NCT02430090
Collaborator
(none)
45
3
3.9

Study Details

Study Description

Brief Summary

45 pregnant women undergoing cesarean section were enrolled in the study in november 2006 to march 2007. 2 ml of 0.5% levobupivacaine was added to 1 ml of saline in group I, 1 ml of 15 µcg of fentanyl in group II and 1 ml of 1,5 µcg sufentanil in group III by intratechal administration. Hemodynamic parameters, characteristics of sensory and motor blockade, peri-operative and postoperative visual analogue scale (VAS) pain scores, the time to the first analgesic requirement and adverse effects were recorded.

Detailed Description

45 pregnant women undergoing cesarean section were enrolled in the study in november 2006 to march 2007. Using CSE technique, 2 ml of 0.5% levobupivacaine was added to 1 ml of saline in group I, 1 ml of 15 µcg of fentanyl in group II and 1 ml of 1,5 µcg sufentanil in group III by intratechal administration. Hemodynamic parameters, characteristics of sensory and motor blockade, peri-operative and postoperative visual analogue scale (VAS) pain scores, the time to the first analgesic requirement and adverse effects were recorded.

Study Design

Study Type:
Interventional
Actual Enrollment :
45 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Comparison of Intratechal Low-Dose Levobupivacaine With Levobupivacaine-Fentanyl and Levobupivacaine-Sufentanil Combinations for Cesarean Section
Study Start Date :
Nov 1, 2006
Actual Primary Completion Date :
Mar 1, 2007
Actual Study Completion Date :
Mar 1, 2007

Arms and Interventions

Arm Intervention/Treatment
Experimental: Levobupivacaine

Levobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. Injection Surgical anaesthesia Adult: Epidural block: 50-100 mg (10-20 ml) of a 0.5% solution or 75-150 mg (10-20 ml) of a 0.75% solution. Caesarean section: 75-150 mg (15-30 ml) of a 0.5% solution. Spinal block: 15 mg (3 ml) of a 0.5% solution. Max: 150 mg/dose; 400 mg/day. Injection Peripheral nerve block Read more: http://www.ndrugs.com/?s=levobupivacaine#ixzz3Xvp0iS5T

Drug: Levobupivacaine
this used in intratechal area and for spinal anesthesia in ceserean section
Other Names:
  • chirocaine
  • Experimental: Levobupivacaine + fentanyl

    Fentanyl - Used for: Producing anesthesia for surgery and treating pain before, during, and after surgery.Fentanyl is a narcotic (opioid) analgesic. It works in the brain and nervous system to cause anesthesia and decrease pain. Indications: Adult: PO Breakthrough cancer pain As a loz: Initially, 200 mcg over 15 minutes for an episode of breakthrough pain; may repeat once after 15 minutes if needed. Not more than 4 unit doses/day. IV Adjunct to general anesth Patients w/ spontaneous resp: Initial: 50-200 mcg, w/ supplements of 50 mcg. Patients w/ assisted ventilation: Initial: 300-3,500 mcg (up to 50 mcg/kg), w/ supplements of 100-200 mcg depending on response. Read more: http://www.ndrugs.com/?s=fentanyl#ixzz3XvpAcULL

    Drug: Fentanyl
    this used in intratechal area and for spinal anesthesia in ceserean section

    Drug: Levobupivacaine
    this used in intratechal area and for spinal anesthesia in ceserean section
    Other Names:
  • chirocaine
  • Experimental: Levobupivacaine + sufentanil

    Sufentanil is a synthetic opioid analgesic. Sufentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Maintenance: Additional doses of 0.5-10 mcg/kg may be given if needed. Max (total dose): 30 mcg/kg. Post-op pain Initial: 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of ≥1 hr if needed. Epidural Pain relief during labour and delivery W/ bupivacaine: 10-15 mcg w/ or w/o epinephrine. May repeat dose twice at intervals of ≥1 hr till delivery. Max (total dose): 30 mcg. Read more: http://www.ndrugs.com/?s=sufentanil#ixzz3XvqVyLzx

    Drug: Sufentanil
    this used in intratechal area and for spinal anesthesia in ceserean section
    Other Names:
  • sufenta
  • Drug: Levobupivacaine
    this used in intratechal area and for spinal anesthesia in ceserean section
    Other Names:
  • chirocaine
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Participants With Adverse Events as a Measure of Safety and Tolerability [Up to 4 months]

      The frequency and the severity (ex) of the side effects including nausea and vomiting, hypotension, pruritus, and bradycardia were recorded.

    Secondary Outcome Measures

    1. Number of Participants With Pain Scores on the Visual Analog Scale [Up to 4 months]

      Hemodynamic parameters, characteristics of sensory and motor blockade, peri-operative and postoperative visual analogue scale (VAS) pain scores, the time to the first analgesic requirement were recorded.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 45 Years
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    • pregnant women with a single live fetus aged 18-45 years old and classified as ASA I, undergoing elective cesarean section, were included the study in november 2006 to march 2007
    Exclusion Criteria:
    • Multiple pregnancies,

    • preterm labor,

    • eclampsia,

    • preeclampsia,

    • concomitant diabetes mellitus,

    • allergy to local anesthetics, fentanyl or sufentanil,

    • contraindication for regional anesthesia were the exclusion criteria.

    Contacts and Locations

    Locations

    No locations specified.

    Sponsors and Collaborators

    • Ankara City Hospital Bilkent

    Investigators

    • Principal Investigator: Müge Çakırca, Ankara Numune Training and Research hospital, Anesthesiology and Reanimation Clinic

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    Responsible Party:
    Ankara City Hospital Bilkent
    ClinicalTrials.gov Identifier:
    NCT02430090
    Other Study ID Numbers:
    • 2006-099
    First Posted:
    Apr 30, 2015
    Last Update Posted:
    Nov 19, 2021
    Last Verified:
    May 1, 2015
    Keywords provided by Ankara City Hospital Bilkent
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Arm/Group Description Levobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. Injection Surgical anaesthesia Adult: Epidural block: 50-100 mg (10-20 ml) of a 0.5% solution or 75-150 mg (10-20 ml) of a 0.75% solution. Caesarean section: 75-150 mg (15-30 ml) of a 0.5% solution. Spinal block: 15 mg (3 ml) of a 0.5% solution. Max: 150 mg/dose; 400 mg/day. Injection Peripheral nerve block Read more: http://www.ndrugs.com/?s=levobupivacaine#ixzz3Xvp0iS5T Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Fentanyl - Used for: Producing anesthesia for surgery and treating pain before, during, and after surgery.Fentanyl is a narcotic (opioid) analgesic. It works in the brain and nervous system to cause anesthesia and decrease pain. Indications: Adult: PO Breakthrough cancer pain As a loz: Initially, 200 mcg over 15 minutes for an episode of breakthrough pain; may repeat once after 15 minutes if needed. Not more than 4 unit doses/day. IV Adjunct to general anesth Patients w/ spontaneous resp: Initial: 50-200 mcg, w/ supplements of 50 mcg. Patients w/ assisted ventilation: Initial: 300-3,500 mcg (up to 50 mcg/kg), w/ supplements of 100-200 mcg depending on response. Read more: http://www.ndrugs.com/?s=fentanyl#ixzz3XvpAcULL Fentanyl: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Sufentanil is a synthetic opioid analgesic. Sufentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Maintenance: Additional doses of 0.5-10 mcg/kg may be given if needed. Max (total dose): 30 mcg/kg. Post-op pain Initial: 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of ≥1 hr if needed. Epidural Pain relief during labour and delivery W/ bupivacaine: 10-15 mcg w/ or w/o epinephrine. May repeat dose twice at intervals of ≥1 hr till delivery. Max (total dose): 30 mcg. Read more: http://www.ndrugs.com/?s=sufentanil#ixzz3XvqVyLzx Sufentanil: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section
    Period Title: Overall Study
    STARTED 15 15 15
    COMPLETED 15 15 15
    NOT COMPLETED 0 0 0

    Baseline Characteristics

    Arm/Group Title Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil Total
    Arm/Group Description Levobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. Injection Surgical anaesthesia Adult: Epidural block: 50-100 mg (10-20 ml) of a 0.5% solution or 75-150 mg (10-20 ml) of a 0.75% solution. Caesarean section: 75-150 mg (15-30 ml) of a 0.5% solution. Spinal block: 15 mg (3 ml) of a 0.5% solution. Max: 150 mg/dose; 400 mg/day. Injection Peripheral nerve block Read more: http://www.ndrugs.com/?s=levobupivacaine#ixzz3Xvp0iS5T Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Fentanyl - Used for: Producing anesthesia for surgery and treating pain before, during, and after surgery.Fentanyl is a narcotic (opioid) analgesic. It works in the brain and nervous system to cause anesthesia and decrease pain. Indications: Adult: PO Breakthrough cancer pain As a loz: Initially, 200 mcg over 15 minutes for an episode of breakthrough pain; may repeat once after 15 minutes if needed. Not more than 4 unit doses/day. IV Adjunct to general anesth Patients w/ spontaneous resp: Initial: 50-200 mcg, w/ supplements of 50 mcg. Patients w/ assisted ventilation: Initial: 300-3,500 mcg (up to 50 mcg/kg), w/ supplements of 100-200 mcg depending on response. Read more: http://www.ndrugs.com/?s=fentanyl#ixzz3XvpAcULL Fentanyl: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Sufentanil is a synthetic opioid analgesic. Sufentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Maintenance: Additional doses of 0.5-10 mcg/kg may be given if needed. Max (total dose): 30 mcg/kg. Post-op pain Initial: 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of ≥1 hr if needed. Epidural Pain relief during labour and delivery W/ bupivacaine: 10-15 mcg w/ or w/o epinephrine. May repeat dose twice at intervals of ≥1 hr till delivery. Max (total dose): 30 mcg. Read more: http://www.ndrugs.com/?s=sufentanil#ixzz3XvqVyLzx Sufentanil: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Total of all reporting groups
    Overall Participants 15 15 15 45
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    27.8
    (7.4)
    25.5
    (5.2)
    27.4
    (7.1)
    26.9
    (7.5)
    Sex: Female, Male (Count of Participants)
    Female
    15
    100%
    15
    100%
    15
    100%
    45
    100%
    Male
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    White
    15
    100%
    15
    100%
    15
    100%
    45
    100%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Region of Enrollment (participants) [Number]
    Turkey
    15
    100%
    15
    100%
    15
    100%
    45
    100%

    Outcome Measures

    1. Primary Outcome
    Title Number of Participants With Adverse Events as a Measure of Safety and Tolerability
    Description The frequency and the severity (ex) of the side effects including nausea and vomiting, hypotension, pruritus, and bradycardia were recorded.
    Time Frame Up to 4 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Arm/Group Description 2 ml of 0.5% levobupivacaine was added to 1 ml of saline in group I by intrathecal administration 2 ml of 0.5% levobupivacaine was added to 1 ml of 15 µcg of fentanyl in group II by intrathecal administration 2 ml of 0.5% levobupivacaine was added to 1 ml of 1,5 µcg sufentanil in group III by intrathecal administration
    Measure Participants 15 15 15
    Number [participants]
    5
    33.3%
    10
    66.7%
    9
    60%
    2. Secondary Outcome
    Title Number of Participants With Pain Scores on the Visual Analog Scale
    Description Hemodynamic parameters, characteristics of sensory and motor blockade, peri-operative and postoperative visual analogue scale (VAS) pain scores, the time to the first analgesic requirement were recorded.
    Time Frame Up to 4 months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description

    Adverse Events

    Time Frame
    Adverse Event Reporting Description
    Arm/Group Title Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Arm/Group Description Levobupivacaine, a local anesthetic agent, is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. Injection Surgical anaesthesia Adult: Epidural block: 50-100 mg (10-20 ml) of a 0.5% solution or 75-150 mg (10-20 ml) of a 0.75% solution. Caesarean section: 75-150 mg (15-30 ml) of a 0.5% solution. Spinal block: 15 mg (3 ml) of a 0.5% solution. Max: 150 mg/dose; 400 mg/day. Injection Peripheral nerve block Read more: http://www.ndrugs.com/?s=levobupivacaine#ixzz3Xvp0iS5T Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Fentanyl - Used for: Producing anesthesia for surgery and treating pain before, during, and after surgery.Fentanyl is a narcotic (opioid) analgesic. It works in the brain and nervous system to cause anesthesia and decrease pain. Indications: Adult: PO Breakthrough cancer pain As a loz: Initially, 200 mcg over 15 minutes for an episode of breakthrough pain; may repeat once after 15 minutes if needed. Not more than 4 unit doses/day. IV Adjunct to general anesth Patients w/ spontaneous resp: Initial: 50-200 mcg, w/ supplements of 50 mcg. Patients w/ assisted ventilation: Initial: 300-3,500 mcg (up to 50 mcg/kg), w/ supplements of 100-200 mcg depending on response. Read more: http://www.ndrugs.com/?s=fentanyl#ixzz3XvpAcULL Fentanyl: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section Sufentanil is a synthetic opioid analgesic. Sufentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Maintenance: Additional doses of 0.5-10 mcg/kg may be given if needed. Max (total dose): 30 mcg/kg. Post-op pain Initial: 30-60 mcg. Additional doses of up to 25 mcg may be given at intervals of ≥1 hr if needed. Epidural Pain relief during labour and delivery W/ bupivacaine: 10-15 mcg w/ or w/o epinephrine. May repeat dose twice at intervals of ≥1 hr till delivery. Max (total dose): 30 mcg. Read more: http://www.ndrugs.com/?s=sufentanil#ixzz3XvqVyLzx Sufentanil: this used in intratechal area and for spinal anesthesia in ceserean section Levobupivacaine: this used in intratechal area and for spinal anesthesia in ceserean section
    All Cause Mortality
    Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN) / (NaN)
    Serious Adverse Events
    Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/15 (0%) 0/15 (0%) 0/15 (0%)
    Other (Not Including Serious) Adverse Events
    Levobupivacaine Levobupivacaine + Fentanyl Levobupivacaine + Sufentanil
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 5/15 (33.3%) 10/15 (66.7%) 12/15 (80%)
    Cardiac disorders
    bradicardia 0/15 (0%) 0 1/15 (6.7%) 1 2/15 (13.3%) 2
    General disorders
    vomiting 0/15 (0%) 0 2/15 (13.3%) 2 0/15 (0%) 0
    hypotension 5/15 (33.3%) 5 10/15 (66.7%) 10 9/15 (60%) 9
    nausea 1/15 (6.7%) 1 9/15 (60%) 9 8/15 (53.3%) 8

    Limitations/Caveats

    A limitation of this study is that the baricity of the local anaesthetic could have been affected as the fentanyl and sufentanil were diluted within a mixture. Using these opiods in undiluted form in future studies would remove this limitation.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Dr. Müge Çakırca
    Organization Ankara Numune Training and Research Hospital
    Phone +905054433177
    Email mugeturkoglu81@hotmail.com
    Responsible Party:
    Ankara City Hospital Bilkent
    ClinicalTrials.gov Identifier:
    NCT02430090
    Other Study ID Numbers:
    • 2006-099
    First Posted:
    Apr 30, 2015
    Last Update Posted:
    Nov 19, 2021
    Last Verified:
    May 1, 2015