AzTrials
AzTrials

Prostatic NeoplasmNCT05566405

The Effects of Method of Anaesthesia on the Safety and Effectiveness of Radical Retropubic Prostatectomy

A study testing General Anaesthesia, Combined (Epidural and Spinal) Anaesthesia and Open Retropubic Radical Prostatectomy in people with Prostatic Neoplasm, run by Sismanoglio General Hospital at 1 site in Greece.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Prostate cancer is one of the most commonly diagnosed neoplasm in men worldwide. The gold standard of therapy is radical prostatectomy, a wide surgical excision of the neoplasm and can be performed either open, laparoscopic or robotic. Read more about this study

Who is it for?
Any age, men only
Conditions the study is for
Prostatic Neoplasm
What is being tested?
General Anaesthesia, Combined (Epidural and Spinal) Anaesthesia and Open Retropubic Radical Prostatectomy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteGreece
Study dates
27 Jul 2020to 30 Sep 2022
Phase
Interventional
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 Any age
  • Men only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosed with localised prostate cancer
  • Eligible for open retropubic radical prostatectomy

Who cannot join

  • Metastatic prostate cancer
  • History of severe heart disease
  • History of haemostasis disorders
  • History of previous pelvic surgery
  • History of lung disease

Trial locations and contacts

1 site in 1 country.

Greece1 site
  • Sismanoglio General Hospital

    Marousi, Attica, 15126

Other trials in Greece

About this study

Official title: Comparative Study of the Effects of Combined Spinal Anaesthesia and General Anaesthesia on the Safety and Effectiveness of Radical Retropubic Prostatectomy in Patients With Localised Prostate Cancer

Prostate cancer is one of the most commonly diagnosed neoplasm in men worldwide. The gold standard of therapy is radical prostatectomy, a wide surgical excision of the neoplasm and can be performed either open, laparoscopic or robotic. The open retropubic approach, still performed today, can be completed under either general anaesthesia or combined (spinal/epidural) anaesthesia without any clear guideline on which one should be preferred.

In this study the investigators aim to evaluate general anaesthesia and combined (spinal/ epidural) anaesthesia in patients undergoing open retropubic radical prostatectomy and define whether these may have an impact on the oncological outcome and safety of the procedure.

Being tested
General Anaesthesia, Combined (Epidural and Spinal) Anaesthesia, Open Retropubic Radical Prostatectomy
Medical subject headings
Prostatic Neoplasms

What participants receive

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

  • General AnaesthesiaProcedure or surgery

    All patients in the general anaesthesia group will be premedicated with intravenously administered (iv) midazolam (2mg) and fentanyl (100 mcg). Induction will be performed using intravenous propofol (2.5-3mg/kg) and lidocaine (40mg); dexamethasone 8mg, metoclopramide 10mg and omeprazole 40mg will also be administered. After successful tracheal intubation, total intravenous anaesthesia will be maintained by administering propofol (0.05 mg/kg/sec iv) and remifentanil (0.2 mcg/kg/sec iv). Pain management will be achieved by paracetamol (1g iv) and tramadol (100mg iv) whereas muscle relaxation by vecuronium (0.6 mg/kg iv).

  • Combined (Epidural and Spinal) AnaesthesiaProcedure or surgery

    Combined (epidural and spinal) anaesthesia will be performed using an epidural 18G needle and a spinal 27G needle, in the L2-L3 or L3-L4 interspace. Induction will be carried out by spinal intrathecal administration of levobupivacaine (2.6-3ml of 0.5%) and mild sedation by midazolam (5mg iv in bolus). All patients will be administered dexamethasone 8mg, metoclopramide 10mg and omeprazole 40mg iv. Maintenance will be performed 75 minutes after induction and obtained using an epidural administration of levobupivacaine (4-5ml of 0.5%).

  • Open Retropubic Radical ProstatectomyProcedure or surgery

    All patients will undergo a nerve-sparing open retropubic radical prostatectomy

Study groups in NCT05566405
Study groupRoleWhat they receive
General AnaesthesiaActive comparatorPatients undergoing open retropubic radical prostatectomy under general anaesthesia
Receives: Procedure: General Anaesthesia; Procedure: Open Retropubic Radical Prostatectomy
Combined (Epidural and Spinal) AnaesthesiaActive comparatorPatients undergoing open retropubic radical prostatectomy under combined (epidural and spinal) anaesthesia
Receives: Procedure: Combined (Epidural and Spinal) Anaesthesia; Procedure: Open Retropubic Radical Prostatectomy

What is being measured

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

  1. Blood Pressure Change

    Measurement of patients systolic and diastolic blood pressure during the operation and post-operatively for 72 hours.

    Measured: Peri-operatively

  2. Heart Rate Change

    Measurement of patients Heart Rate during the operation and post-operatively for 72 hours.

    Measured: Peri-operatively

  3. Surgical APGAR Score

    Calculation of the Surgical APGAR score for each patient during surgery. The lower the score, on a scale of 1-10, the worst the prognosis of the patient.

    SAS is calculated using three variables:

    • Estimated blood loss (on a 0-3 scale, 0 points >1000 ml, 1 point 601-1000ml, 2 points 101-600 ml, 3 points <100ml)
    • Lowest mean arterial pressure (on a 0-3 scale, 0 points <40 mmHg, 1 point 40-54 mmHg, 2 points 55-69 mmHg, 3 points >70 mmHg)
    • Lowest heart rate (on a 0-4 scale, 0 points >85 bpm, 1 points 76-85 bpm, 2 points 66-75 bmp, 3 points 56-65 bmp, 4 points <55 bmp) during surgery.

    Measured: Peri-operatively

  4. Blood Loss During Surgery

    Measured from suction contents intra-operatively in ml

    Measured: Peri-operatively

  5. Haemoglobin Change

    Haemoglobin measurement before the operation and at 12-, 24- and 48-hours post-operatively, in g/dL

    Measured: Peri-operatively

  6. Operation Time

    Time required for:

    • Induction of anaesthesia
    • Completion of the operation
    • Post-operative time until the patient is successfully transferred to the recovery room

    Measured: Peri-operatively

  7. Pain Assessed by the VAS Scale

    Measured using a pain Visual Analogue Scale (VAS) at 6-, 24- and 48-hours after the operation.

    VAS is a self-reporting pain scale based on a 0 to 10-point system, with each point measuring 10mm on a linear line. Every patient was asked to indicate his pain levels from "No Pain" (equals 0) to "Worst Pain Imaginable" (equals 10).

    Measured: Peri-operatively

  8. Complication Rate

    Complications related to the procedure:

    • Intraoperative bleeding
    • Post-operative bleeding
    • Bowel perforation
    • Cardiovascular
    • Respiratory

    Complications related to the anaesthesia technique performed:

    • Post-operative headache
    • Nausea and vomiting
    • Any signs of potential nerve damage (manifested as inability to gain leg motility)

    Measured: Peri-operatively and up to 1 year after the operation

  9. Change From Baseline PSA Levels at 6-months

    Measurement of Prostatic Specific Antigen (PSA) levels at 6 to establish a PSA nadir value

    Measured: 6 months post-operative

  10. Change from 6-month PSA Levels at 12-months

    Measurement of Prostatic Specific Antigen (PSA) levels at 12 post-operation to detect any biochemical recurrence

    Measured: 12 months post-operative

Secondary outcomes (4)
  1. Change from Baseline Erectile Function after Radical Prostatectomy

    Measured using the International Index of Erectile Function (IIEF-5) questionnaires pre-operatively and at 3-, 6- and 12-months post-surgery.

    The test is composed of 5 questions with 5 points for each question. Patients are evaluated accordingly:

    • Score 22 or more = No Erectile Disfunction
    • Score 17-21 = Mild Erectile Disfunction
    • Score 12-16 = Mild to moderate Erectile Disfunction
    • Score 8-11 = Moderate Erectile Disfunction
    • Score 7 or less = Severe Erectile Disfunction

    Results will be:

    • Analysed and compared to evaluate any potential difference of the two methods of anaesthesia, on post-operational erectile function
    • Analysed comparing pre-operation with post-operation questioners overall, to evaluate erectile disfunction after radical prostatectomy regardless of method of anaesthesia.

    Measured: Up to 1 year after the operation

  2. Post-operative Urinary Incontinence

    Measured using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form at 12 months post-surgery.

    The Questionnaire is consisted of 4 questions:

    • Frequency "How often do you leak urine?" on a scale of 0 (never) to 5 (all the time)
    • Amount of leakage "How much urine do you leak?" on a scale to 0 (none) to 3 (a large amount)
    • Overall impact on quality of life "How much does it interfere with your life?" on a scale of 0 (not at all) to 10 (a great deal)
    • Timing of leakage "When does urine leak?"

    Measured: 1 year after the operation

  3. Total Hospital Stay

    Days until patient discharge from the hospital.

    Measured: Peri-operative

  4. Patient Satisfaction Assessed by the Short Assessment of Patient Satisfaction (SAPS) Questionnaire

    Satisfaction, using the Short Assessment of Patient Satisfaction (SAPS) Questionnaire, is measured in a scale of 0 to 28, with 0 to 10 equals to "Very Dissatisfied", 11-18 equals to "Dissatisfied", 19-26 equals to "Satisfied" and 27-28 equals to "Very Satisfied"

    Measured: Peri-operative

Timeline

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

  1. First posted4 Oct 2022
  2. Study start27 Jul 2020
  3. Primary completion31 Aug 2022
  4. Study completion30 Sep 2022

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05566405
Sponsor's protocol ID
PN 20511/14.10.2020
Status last verified
Oct 2022
First submitted
27 Sep 2022
Last updated
4 Oct 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Available from the corresponding author on reasonable request.

Publications

  • Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708. Epub 2022 Jan 12.

    PubMed 35020204
  • Hatzinger M, Hubmann R, Moll F, Sohn M. [The history of prostate cancer from the beginning to DaVinci]. Aktuelle Urol. 2012 Jul;43(4):228-30. doi: 10.1055/s-0032-1324651. German.

    PubMed 23035261
  • Lepor H. A review of surgical techniques for radical prostatectomy. Rev Urol. 2005;7 Suppl 2(Suppl 2):S11-7.

    PubMed 16985892
  • Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ. An Apgar score for surgery. J Am Coll Surg. 2007 Feb;204(2):201-8. doi: 10.1016/j.jamcollsurg.2006.11.011. Epub 2006 Dec 27.

    PubMed 17254923
  • Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi: 10.5435/JAAOSGlobal-D-17-00088. eCollection 2018 Mar.

    PubMed 30211382
  • Hinkelbein J, Lamperti M, Akeson J, Santos J, Costa J, De Robertis E, Longrois D, Novak-Jankovic V, Petrini F, Struys MMRF, Veyckemans F, Fuchs-Buder T, Fitzgerald R. European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults. Eur J Anaesthesiol. 2018 Jan;35(1):6-24. doi: 10.1097/EJA.0000000000000683.

    PubMed 28877145
  • Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-30. doi: 10.1002/nau.20041.

    PubMed 15227649
  • Hawthorne G, Sansoni J, Hayes L, Marosszeky N, Sansoni E. Measuring patient satisfaction with health care treatment using the Short Assessment of Patient Satisfaction measure delivered superior and robust satisfaction estimates. J Clin Epidemiol. 2014 May;67(5):527-37. doi: 10.1016/j.jclinepi.2013.12.010.

    PubMed 24698296

Questions about this trial

What is this clinical trial studying?

A study testing General Anaesthesia, Combined (Epidural and Spinal) Anaesthesia and Open Retropubic Radical Prostatectomy in people with Prostatic Neoplasm, run by Sismanoglio General Hospital at 1 site in Greece.

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 4 Oct 2022. 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 Greece. 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.

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?

Blood Pressure Change (time frame: Peri-operatively). The study lists 10 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 NCT05566405, which also lists 8 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 4 Oct 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in