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Coronary Heart DiseasePhase 4NCT02727712

Studies of Application of Combined General Anesthesia and Bilateral TPVB in OPCABG

A Phase 4 study testing bilateral thoracic paravertebral block, Transesophageal Echocardiography(TEE) and Lung protection measure during the surgery(Dräger Primus) in people with Coronary Heart Disease, run by Xiangya Hospital of Central South University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study intends to compare the combination of general anesthesia (GA) and single-shot bilateral thoracic paravertebral block (TPVB) by ropivacaine in the patients undergoing off-pump coronary artery bypass surgery ( OPCAB) with traditional general anesthesia (GA) perioperative management of patients, committed to… Read more about this study

Who is it for?
Ages 35 to 80 years
Conditions the study is for
Coronary Heart Disease
What is being tested?
bilateral thoracic paravertebral block, Transesophageal Echocardiography(TEE) and Lung protection measure during the surgery(Dräger Primus)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteChina
Study dates
Apr 2016to Dec 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 35 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Heart function grade II - III (Using the cardiac function classification method formulated by American Heart Disease Institute)
  • The in - hospital was treated with off pump coronary artery bypass grafting(CABG) operation and general anesthesia.
  • Had a good cognition, and signed the informed consent.
  • Aged between 35 and 80.
  • The age, clinical examination and other generally situation of the two groups of patients had no statistical significance.
  • no merger of valvular disease left ventricular ejection fraction > 40%, do not need intraaortic balloon counterpulsation support, without spinal deformity, no vertebral side clearance space-occupying lesions

Who cannot join

  • Combined with other blood coagulation dysfunction, serious brain, liver and kidney dysfunction, endocrine system diseases and serious infectious disease.
  • Patients with severe mental disorders cannot cooperate with the treatment.
  • Emergency operation
  • Have taboo of Echocardiography and pulmonary catheterization by echocardiography.
  • Allergic to Local anesthetics drug.
  • Suspected or had alcohol, drug abuse history.
  • Spinal or paravertebral lesions.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Xiangya Hospital of Central South University

    Changsha, Hunan, 410078

Other trials in China

About this study

Official title: Studies of Application of Combined General Anesthesia and Bilateral Thoracic Paravertebral Block by Ropivacaine in Patients Undergoing Off-pump Coronary Artery Bridge Graft - a Random Double Blind Controlled Study

This study intends to compare the combination of general anesthesia (GA) and single-shot bilateral thoracic paravertebral block (TPVB) by ropivacaine in the patients undergoing off-pump coronary artery bypass surgery ( OPCAB) with traditional general anesthesia (GA) perioperative management of patients, committed to reducing patient's physical and psychological stress by surgical trauma, achieve the purpose of fast recovery, in order to establish an more effective perioperative management during off-pump coronary artery bypass surgery, improve patients' satisfaction and to accelerate postoperative rehabilitation safely.

Read the detailed description

This study intends to compare the combination of general anesthesia (GA) and single-shot bilateral thoracic paravertebral block (TPVB) by ropivacaine in the patients undergoing off-pump coronary artery bypass surgery ( OPCAB) with traditional general anesthesia (GA) perioperative management of patients, committed to reducing patient's physical and psychological stress by surgical trauma, achieve the purpose of fast recovery, in order to establish an more effective perioperative management during off-pump coronary artery bypass surgery, improve patients' satisfaction and to accelerate postoperative rehabilitation safely. Patients included in the study (approximately 60 cases) will be randomly divided into PVB(T2/3+T5/6)+GA experimental group (A), PVB(T3/4)+GA experimental group (B)the conventional GA control group (C). All groups received the preoperative preparation, anesthesia and postoperative treatment according to the traditional manner, the group A of patients has been received bilateral thoracic paravertebral block (TPVB T2/3+T5/6) by ropivacaine(0.3%,10ml*4), group B will received bilateral thoracic paravertebral block (TPVB T3/4)by ropivacaine(0.3%,20ml*2).,while the group C will received the conventional general anesthesia management without block.

Being tested
bilateral thoracic paravertebral block, Transesophageal Echocardiography(TEE), Lung protection measure during the surgery(Dräger Primus), Anesthesia drugs during the surgery, thoracic paravertebral block
Keywords
coronary artery bypass graft, thoracic paravertebral block
Medical subject headings
Coronary Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • bilateral thoracic paravertebral blockProcedure or surgery

    group A under TPVB((TPVB T2/3+T5/6) by ropivacaine(0.3%,10ml*4)program

  • Transesophageal Echocardiography(TEE)Device

    1. Apply Transesophageal Echocardiography(TEE)after anesthesia induction and draw 400ml autologous blood (Haemonetics®)used for the postoperative transfusion;
    2. Goal-directed fluid management
  • Lung protection measure during the surgery(Dräger Primus)Device

    Protective ventilation strategy(Low tidal volume about 6~7ml/kg, joint use of PEEP)

  • Anesthesia drugs during the surgeryDrug

    1. Bilateral thoracic paravertebral block before induction of anesthesia;
    2. Fast channel anesthesia • Induction use Sufentanil 0.5~1ug/kg, Vecuronium for Injection 0.15mg/kg and Etomidate 0.2~0.6mg/kg; ②. Maintain use Sufentanil Hydrochloride for Injection 0.01~0.04ug/kg•min, Sevoflurane 0.5~1.5MAC(minimum alveolar concentration) and Infusing Dexmedetomidine which load dose 0.5μg/kg in 10min then changed into 0.5-1.0μg/kg•h,Vecuronium 0.06~0.12mg/kg•h; ③. Intravenous hydromorphone Hydrochloride Injection 0.15mg/kg before surgery over.
  • thoracic paravertebral blockProcedure or surgery

    group B under(TPVB T3/4)by ropivacaine(0.3%,20ml*2)program

Study groups in NCT02727712
Study groupRoleWhat they receive
TPVB T2/3+T5/6+GAExperimentalthe group A of patients has been received bilateral thoracic paravertebral block (TPVB T2/3+T5/6) by ropivacaine(0.3%,10ml*4), before general anesthesia management
Receives: Procedure: bilateral thoracic paravertebral block; Device: Transesophageal Echocardiography(TEE); Device: Lung protection measure during the surgery(Dräger Primus); Drug: Anesthesia drugs during the surgery
TPVB T3/4+GAExperimentalthe group Bof patients has been received bilateral thoracic paravertebral block (TPVB 3/4) by ropivacaine(0.3%,10ml*4), before general anesthesia management Device: The use of Transesophageal Echocardiography(TEE)、STAT PROFILE® and Haemonetics® during the surgery
Receives: Device: Transesophageal Echocardiography(TEE); Device: Lung protection measure during the surgery(Dräger Primus); Drug: Anesthesia drugs during the surgery; Procedure: thoracic paravertebral block
GAPlacebo comparatorgroup C under control (without TPVB)program Device: The use of Transesophageal Echocardiography(TEE)、STAT PROFILE® and Haemonetics® during the surgery
Receives: Device: Transesophageal Echocardiography(TEE); Device: Lung protection measure during the surgery(Dräger Primus); Drug: Anesthesia drugs during the surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Fasting blood glucose

    1day before and 4days after operation

    Measured: baseline and 4 days

  2. Blood Lactic Acid

    1day before and 4days after operation

    Measured: baseline and 4 days

  3. Creatine kinase isoenzymes

    1day before and 4days after operation

    Measured: baseline and 4 days

  4. Myoglobin

    1day before and 4days after operation

    Measured: baseline and 4 days

  5. Troponin I

    1day before and 4days after operation

    Measured: baseline and 4 days

  6. White Blood Cell

    1day before and 4days after operation

    Measured: baseline and 4 days

  7. C-reactive protein

    1day before and 4days after operation

    Measured: baseline and 4 days

  8. N-terminal B-type natriuretic peptide(NT-proBNP)

    1day before and 4days after operation

    Measured: baseline and 4 days

Secondary outcomes (14)
  1. Perioperative major adverse events

    Measured: From pre-surgery to discharge, up to 4 weeks

  2. Perioperative use of vasoactive drug species

    Measured: From pre-surgery to discharge, up to 4 weeks

  3. Vasoactive drugs Support Hours

    Measured: From the start of drugs to stop them, up to 4 weeks

  4. Time after deactivation of vasoactive drugs

    Measured: From the end of surgery to the deactivation of vasoactive drugs, up to 4 weeks

  5. Postoperative tracheal tube time

    Measured: From the end of surgery to the removal of tracheal tube, up to 4 weeks

  6. Duration of mechanical ventilation after surgery

    Measured: From the end of surgery to the recovery of spontaneous breathing, up to 4 weeks

  7. The time after the ICU until discharge

    Measured: From leaving the ICU to discharge from hospital, up to 4 weeks

  8. Length of ICU stay

    Measured: From ICU admission to discharge from ICU, up to 4 weeks

  9. Recovery time

    Measured: From the end of surgery to recover, up to 4 weeks

  10. Time to first bowel movement

    Measured: From the end of surgery to first bowel movement, up to 2 weeks

  11. Postoperative to normal eating time

    Measured: From the end of surgery to normal eating, up to 2 weeks

  12. The total length of hospital stay

    Measured: From admission to discharge, up to 5 weeks

  13. Visual analog pain score

    Measured: From the end of surgery, up to 48 hours

  14. Ramsay score

    Measured: From the end of surgery, up to 48 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Apr 2016 (estimated)
  2. Study startApr 2016
  3. Primary completionSep 2016 (estimated)
  4. Study completionDec 2016 (estimated)

Resources

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02727712
Sponsor's protocol ID
20160131
Status last verified
Mar 2016
First submitted
22 Feb 2016
Last updated
5 Apr 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes

Publications

  • Olivier JF, Bracco D, Nguyen P, Le N, Noiseux N, Hemmerling T; Perioperative Cardiac Surgery Research Group (PeriCARG). A novel approach for pain management in cardiac surgery via median sternotomy: bilateral single-shot paravertebral blocks. Heart Surg Forum. 2007;10(5):E357-62. doi: 10.1532/HSF98.20071082.

    PubMed 17855198
  • Ganapathy S, Murkin JM, Boyd DW, Dobkowski W, Morgan J. Continuous percutaneous paravertebral block for minimally invasive cardiac surgery. J Cardiothorac Vasc Anesth. 1999 Oct;13(5):594-6. doi: 10.1016/s1053-0770(99)90015-0. No abstract available.

    PubMed 10527232
  • Mehta Y, Arora D, Sharma KK, Mishra Y, Wasir H, Trehan N. Comparison of continuous thoracic epidural and paravertebral block for postoperative analgesia after robotic-assisted coronary artery bypass surgery. Ann Card Anaesth. 2008 Jul-Dec;11(2):91-6. doi: 10.4103/0971-9784.41576.

    PubMed 18603748
  • Dhole S, Mehta Y, Saxena H, Juneja R, Trehan N. Comparison of continuous thoracic epidural and paravertebral blocks for postoperative analgesia after minimally invasive direct coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2001 Jun;15(3):288-92. doi: 10.1053/jcan.2001.23271.

    PubMed 11426357

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing bilateral thoracic paravertebral block, Transesophageal Echocardiography(TEE) and Lung protection measure during the surgery(Dräger Primus) in people with Coronary Heart Disease, run by Xiangya Hospital of Central South University at 1 site in China.

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 6 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: status not confirmed, as of the sponsor's last update on 5 Apr 2016. 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 China. 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. 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 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact e Wang, phD (+86 731 84327413, ewang324@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Fasting blood glucose (time frame: baseline and 4 days). The study lists 8 primary outcomes in all. 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 NCT02727712, which also lists 4 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 5 Apr 2016.

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