Transurethral Resection of ProstateEarly Phase 1NCT05351489
Effect of Two Different Doses of Intrathecal Dexmedetomidine as Adjuvant in Elderly Patients Undergoing HoLEP
A Early Phase 1 study testing Dexmedetomidine in people with Transurethral Resection of Prostate, run by Mansoura University at 1 site in Egypt.
Trial summary
Transurethral resection of the prostate (TURP) is the most common Surgical intervention for elderly patients with benign prostatic hyperplasia. Spinal anesthesia is the technique of choice in TURP.Intrathecal (IT)adjuvants prolong the duration of spinal anesthesia and postoperative analgesia there by reducing the… Read more about this study
- Who is it for?
- Ages 60 to 85 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Transurethral Resection of Prostate
- What is being tested?
- Dexmedetomidine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 70 participants
- Where
- 1 siteEgypt
- Study dates
- 30 May 2022to 31 Dec 2024
- Phase
- Early Phase 1
- 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 to 85 years
- Men only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Elderly patients undergoing transurtheral resection of Prostate.
- American Society of Anesthesiologists (ASA) physical status I/II
Who cannot join
- Any contraindication to subarachnoid block.
- On chronic analgesic therapy.
- Patients refuse to contribute in the study.
- Cognitive impairment.
- Not able to understand numerical rating pain scale (NRS). 6.-Significant comorbid conditions like uncontrolled hypertension, congestive heart failure myocardial infarction in the past 6 months..
Trial locations and contacts
1 site in 1 country.
Egypt1 site
Urology and nephrology center
Al Mansurah, Dakahlia Governorate, 050
About this study
Official title: Effect of Two Different Doses of Intrathecal Dexmedetomidine as Adjuvant Combined With Hyperbaric Bupivacaine in Elderly Patients Undergoing Transurethral Resection of Prostate: A Prospective, Randomized Study
Transurethral resection of the prostate (TURP) is the most common Surgical intervention for elderly patients with benign prostatic hyperplasia. Spinal anesthesia is the technique of choice in TURP.Intrathecal (IT)adjuvants prolong the duration of spinal anesthesia and postoperative analgesia there by reducing the requirement of postoperative supplement analgesics .The incorporation of adjuvants also lowers the overall dose of local anesthetic and associated side effects .
The extended analgesic efficacy of intratheacal dexmedetomidine in the postoperative period has been shown in a few clinical studies . These authors have studied different doses (2 - 10 μg) of intrathecal dexametomedine and compared it with various other adjuvants like clonidine, fentanyl, midazolam, buprenorphine, etc., with varying results . The existing studies comparing different doses of intratheacal dexmedetomidine are few. Moreover none of these studies have stressed the dose-response relationship between different doses of intratheacal dexmedetomidine and differential analgesia (DA) defined as the time difference from the offset of motor blockade to the first analgesic requirement on numerical rating scale more than4.
Read the detailed description
The study hypothesis is that there may be a dose dependent prolongation of dexametomedine with escalating doses of intrathecal dexmedetomidine.In this study we tried to find out the optimum safe dose of dexametomedine that used as adjuvant with bupivacaine for patient undergoing transuretheral reseaction of large sized prostate.
The aim of the current study is to To elucidate the dose-response relationship between intrathecal dexametomedine with different doses and subarachnoid block characteristics, particularly the duration of analgesia and differential analgesia. Considering the dose dependent action of intrathecal dexametomedine, the authors could hypotheize that the higher dose of dexametomedine (10 μg) used as adjuvant with bupivacaine will result in better efficacy profile with further prolongation of sensory motor blockade in elderly patient undergoing transurethral resecation of large sized prostate if compared with dexametomedine (5 μg).
After obtaining approval from Mansoura Faculty of Medicine Institutional Research Board about This study which will be a double blinded, prospective, randomized, trial. This study will be carried out in the Urology and Nephrology center of Mansoura university (MUCH). An informed written consent will be obtained from all patient.
This study will be conducted on 70 patients 55- 85 years of age, American Society of Anesthesiologists (ASA) physical status I/II scheduled for transurethral reasection of prostate .
The study subjects will be randomly assigned to one of two equal groups (dexmedetomidine5 μg group and dexmedetomidine 10 μg group ) using computer generrated randomization members Dexmedetomidine 5 μg group (D5 group ): Patients will receive 2 mL heavy bupivacaine 0. 5% and Dexmedetomidine 5 μg dexmedetomidine 10 μg group (D10 group ): Patients will receive 2 mL heavy bupivacaine 0. 5% and Dexmedetomidine 10 μg All patients will be subjected to preoperative assessment that includes thorough clinical examination, radiological and laboratory workup. Laboratory investigations will include complete blood count (CBC), serum electrolytes, arterial blood gas, urine analysis, coagulation survey, blood glucose level, liver and renal function tests. ECG, transthoracic echocardiography and chest x-ray will be done.
All patient will be hospitalized at least a day before surgery and will be kept nil per os for 8 hours.Before the procedure the investigator will measure and record baseline heart rate (HR) and mean arterial pressure (MAP) will be assessed by noninvasive blood pressure monitoring, as well as arterial oxygen saturation, then all participants will be received 10 mL/kg of crystalloid (Ringer's solution) in the supine position on arrival to the operating room, and finally divided into two groups using block randomization: SA will be performed with a 22-25-gauge Quincke needle at the L3/L4 or L4/L5intervertebral space The first group (dexmedetomidine5 μg group) will be received 2mL (10 mg) of heavy bupivacaine plus 5 μg of dexmedetomidine intrathecally in 1 ml insulin syringe the second (dexmedetomidine 10 μg group),will be received 2 mL (10 mg) of heavy bupivacaine plus 10 μg dexmedetomidine in 1 ml insulin syringe.
The duration of analegesia will be investigated.Also,Total dose of analgesic requirements 24 hrs postoperative),Intra operative heart rate and blood pressure every 15 min till the end of surgery,Postoperative blood pressure and heat rate at 2,4,6,12 and 24 hour ,Onset of sensory block after spinal anesthesia (minute),Onset of motor block after spinal anesthesia (minute),Time to achieve sensory block at T8 or higher dermatome (using pin prick test every 1 minute) (minute),Time to achieve sensory block level at T12 and L1 dermatomes and spinal anesthesia wearing off (minute),Dose of vasopressors required
,Visual analog scale Immediately Recovery and 2,4,6 and 12 hours after operation Differenrtial analgesia (time difference from the offset of motor blockade to the first analgesic required ).Postoperative complications (nausea, vomiting, pruritis, hypotension and shivering )will be recorded.
- Conditions
- Transurethral Resection of Prostate
- Being tested
- Dexmedetomidine
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DexmedetomidineDrug
Also called Group (D 5):Patients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with dexmedetomidine 5 μg dexmedetomidine ., Group (D10):Patients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with dexmedetomidine 10 μg dexmedetomidine
Patients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with either dexmedetomidine 5 μg or10 μg dexmedetomidine .
| Study group | Role | What they receive |
|---|---|---|
| Dexmedetomidine 5 μg group (D5 group ) | Experimental | Dexmedetomidine 5 μg group (D5 group ): Patients will receive 2 mL heavy bupivacaine 0.5% and Dexmedetomidine 5 μg intrathecal. Receives: Drug: Dexmedetomidine |
| Dexmedetomidine 10 μg group (D10 group ) | Active comparator | dexmedetomidine 10 μg group (D10 group ): Patients will receive 2 mL heavy bupivacaine 0.5% and Dexmedetomidine 10 μg intrathecal . Receives: Drug: Dexmedetomidine |
What is being measured
The primary outcome is the main question the study is designed to answer.
The duration of analgesia
Duration of spinal analgesia till analgesic rescue.
Measured: perioperative time for 24 hours
Secondary outcomes (6)
Total dose of analgesic requirements .
Record the total analgesic rescue to allow visual analogue score less than3
Measured: perioperative time for 24 hours
Hemodynamic stability perioperatively.
Intra operative systolic and diastolic arterial blood pressure every 15 min till the end of surgery.Postoperative systolic and diastolic arterial blood pressure at 2,4,6,12 and 24 hour
Measured: perioperative time for 24 hours
Onset of sensory block after spinal anesthesia .
Onset of sensory loss after spinal anesthesia in minutes.
Measured: Immediate after spinal anesthesia
Dose of vasopressors required
Dose of ephedrine or norepinephrine used to counteract any hypotension.
Measured: perioperative time for two hours postoperatively
Perioperative hypotension
Record number of patients with any drop of systolic blood pressure below 90 mmHg
Measured: Perioperative time for 24 hours postoperatively
Differential analgesia
Record the time difference from the offset of motor blockade to the first analgesic required
Measured: Perioperative time for 24 hours.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Apr 2022
- Study start30 May 2022
- Primary completion30 Oct 2023
- Study completion31 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Transurethral Resection of ProstateStudies of the same condition, open and under way.
- More trials run by Mansoura UniversityThe sponsor's other registered studies.
- 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
- Early Phase 1
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 70 participants (actual)
Sponsor and investigators
- Lead sponsor
- Mansoura University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mahmoud Mahmoud Othman, Mansoura University
- Investigators
- Mahmoud M Othman, MD, Principal investigator, Department of anesthesia ,Urology and nephrology center ,Faculty of medicine,Mansoura universityTaha R Elashmawy, BCH, Study chair, Department of anesthesia ,Urology and nephrology center ,Faculty of medicine,Mansoura university
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05351489
- Sponsor's protocol ID
- MS.22.04.157
- Status last verified
- May 2025
- First submitted
- 17 Apr 2022
- Last updated
- 9 May 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 9 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Two Different Doses of Intrathecal Dexmedetomidine as Adjuvant Combined With Hyperbaric Bupivacaine in Elderly Patients Undergoing Transurethral Resection of Prostate: A Prospective, Randomized Study
- ClinicalTrials.gov ID
- NCT05351489
- Acronym / sponsor ID
- MS.22.04.157
- Conditions
- Transurethral Resection of Prostate
- Phase
- Early Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 70 participants (actual)
- Lead sponsor
- Mansoura UniversityUniversity, hospital or other
- Study start
- 30 May 2022 (actual)
- Primary completion
- 30 Oct 2023 (actual)
- Study completion
- 31 Dec 2024 (actual)
- First posted
- 28 Apr 2022 (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.
Transurethral resection of the prostate (TURP) is the most common Surgical intervention for elderly patients with benign prostatic hyperplasia. Spinal anesthesia is the technique of choice in TURP.Intrathecal (IT)adjuvants prolong the duration of spinal anesthesia and postoperative analgesia there by reducing the requirement of postoperative supplement analgesics .The incorporation of adjuvants also lowers the overall dose of local anesthetic and associated side effects .
The extended analgesic efficacy of intratheacal dexmedetomidine in the postoperative period has been shown in a few clinical studies . These authors have studied different doses (2 - 10 μg) of intrathecal dexametomedine and compared it with various other adjuvants like clonidine, fentanyl, midazolam, buprenorphine, etc., with varying results . The existing studies comparing different doses of intratheacal dexmedetomidine are few. Moreover none of these studies have stressed the dose-response relationship between different doses of intratheacal dexmedetomidine and differential analgesia (DA) defined as the time difference from the offset of motor blockade to the first analgesic requirement on numerical rating scale more than4.
Detailed description
The study hypothesis is that there may be a dose dependent prolongation of dexametomedine with escalating doses of intrathecal dexmedetomidine.In this study we tried to find out the optimum safe dose of dexametomedine that used as adjuvant with bupivacaine for patient undergoing transuretheral reseaction of large sized prostate.
The aim of the current study is to To elucidate the dose-response relationship between intrathecal dexametomedine with different doses and subarachnoid block characteristics, particularly the duration of analgesia and differential analgesia. Considering the dose dependent action of intrathecal dexametomedine, the authors could hypotheize that the higher dose of dexametomedine (10 μg) used as adjuvant with bupivacaine will result in better efficacy profile with further prolongation of sensory motor blockade in elderly patient undergoing transurethral resecation of large sized prostate if compared with dexametomedine (5 μg).
After obtaining approval from Mansoura Faculty of Medicine Institutional Research Board about This study which will be a double blinded, prospective, randomized, trial. This study will be carried out in the Urology and Nephrology center of Mansoura university (MUCH). An informed written consent will be obtained from all patient.
This study will be conducted on 70 patients 55- 85 years of age, American Society of Anesthesiologists (ASA) physical status I/II scheduled for transurethral reasection of prostate .
The study subjects will be randomly assigned to one of two equal groups (dexmedetomidine5 μg group and dexmedetomidine 10 μg group ) using computer generrated randomization members Dexmedetomidine 5 μg group (D5 group ): Patients will receive 2 mL heavy bupivacaine 0. 5% and Dexmedetomidine 5 μg dexmedetomidine 10 μg group (D10 group ): Patients will receive 2 mL heavy bupivacaine 0. 5% and Dexmedetomidine 10 μg All patients will be subjected to preoperative assessment that includes thorough clinical examination, radiological and laboratory workup. Laboratory investigations will include complete blood count (CBC), serum electrolytes, arterial blood gas, urine analysis, coagulation survey, blood glucose level, liver and renal function tests. ECG, transthoracic echocardiography and chest x-ray will be done.
All patient will be hospitalized at least a day before surgery and will be kept nil per os for 8 hours.Before the procedure the investigator will measure and record baseline heart rate (HR) and mean arterial pressure (MAP) will be assessed by noninvasive blood pressure monitoring, as well as arterial oxygen saturation, then all participants will be received 10 mL/kg of crystalloid (Ringer's solution) in the supine position on arrival to the operating room, and finally divided into two groups using block randomization: SA will be performed with a 22-25-gauge Quincke needle at the L3/L4 or L4/L5intervertebral space The first group (dexmedetomidine5 μg group) will be received 2mL (10 mg) of heavy bupivacaine plus 5 μg of dexmedetomidine intrathecally in 1 ml insulin syringe the second (dexmedetomidine 10 μg group),will be received 2 mL (10 mg) of heavy bupivacaine plus 10 μg dexmedetomidine in 1 ml insulin syringe.
The duration of analegesia will be investigated.Also,Total dose of analgesic requirements 24 hrs postoperative),Intra operative heart rate and blood pressure every 15 min till the end of surgery,Postoperative blood pressure and heat rate at 2,4,6,12 and 24 hour ,Onset of sensory block after spinal anesthesia (minute),Onset of motor block after spinal anesthesia (minute),Time to achieve sensory block at T8 or higher dermatome (using pin prick test every 1 minute) (minute),Time to achieve sensory block level at T12 and L1 dermatomes and spinal anesthesia wearing off (minute),Dose of vasopressors required
,Visual analog scale Immediately Recovery and 2,4,6 and 12 hours after operation Differenrtial analgesia (time difference from the offset of motor blockade to the first analgesic required ).Postoperative complications (nausea, vomiting, pruritis, hypotension and shivering )will be recorded.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dexmedetomidine 5 μg group (D5 group ) | Experimental | Drug: DexmedetomidineDexmedetomidine 5 μg group (D5 group ): Patients will receive 2 mL heavy bupivacaine 0.5% and Dexmedetomidine 5 μg intrathecal. |
| Dexmedetomidine 10 μg group (D10 group ) | Active comparator | Drug: Dexmedetomidinedexmedetomidine 10 μg group (D10 group ): Patients will receive 2 mL heavy bupivacaine 0.5% and Dexmedetomidine 10 μg intrathecal . |
Who may qualify
- Ages
- 60 to 85 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Elderly patients undergoing transurtheral resection of Prostate.
- American Society of Anesthesiologists (ASA) physical status I/II
Key exclusion criteria (5 listed)
- Any contraindication to subarachnoid block.
- On chronic analgesic therapy.
- Patients refuse to contribute in the study.
- Cognitive impairment.
- Not able to understand numerical rating pain scale (NRS). 6.-Significant comorbid conditions like uncontrolled hypertension, congestive heart failure myocardial infarction in the past 6 months..
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 |
|---|---|---|
| DexmedetomidineAlso: Group (D 5):Patients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with dexmedetomidine 5 μg dexmedetomidine ., Group (D10):Patients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with dexmedetomidine 10 μg dexmedetomidinePatients will receive intrathecal 2 mL heavy bupivacaine 0. 5% together with either dexmedetomidine 5 μg or10 μg dexmedetomidine . | Drug | Dexmedetomidine 10 μg group (D10 group ), Dexmedetomidine 5 μg group (D5 group ) |
Primary outcome
The duration of analgesia
Time frame: perioperative time for 24 hours
Duration of spinal analgesia till analgesic rescue.
6 secondary outcomes
Total dose of analgesic requirements .
Time frame: perioperative time for 24 hours
Hemodynamic stability perioperatively.
Time frame: perioperative time for 24 hours
Onset of sensory block after spinal anesthesia .
Time frame: Immediate after spinal anesthesia
Dose of vasopressors required
Time frame: perioperative time for two hours postoperatively
Perioperative hypotension
Time frame: Perioperative time for 24 hours postoperatively
Differential analgesia
Time frame: Perioperative time for 24 hours.
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 9 May 2025.
- Individual participant dataSharing planned: Yes
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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.
Mahmoud M Othman, MD principal investigator
Department of anesthesia ,Urology and nephrology center ,Faculty of medicine,Mansoura university
Taha R Elashmawy, BCH study chair
Department of anesthesia ,Urology and nephrology center ,Faculty of medicine,Mansoura university
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Early Phase 1 study testing Dexmedetomidine in people with Transurethral Resection of Prostate, run by Mansoura University at 1 site in Egypt.
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 2 inclusion and 5 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 9 May 2025. 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 Egypt. 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?
Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.
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?
The duration of analgesia (time frame: perioperative time for 24 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 9 May 2025.