NCT02111447

Brief Summary

Children who receive general anesthesia may become agitated (emergence delirium) in the recovery period. This occurs more often after inhalational anesthetics, particularly sevoflurane and desflurane than after propofol. However, agitation after anesthesia in children may be difficult to distinguish from pain; accordingly studies are ideally designed during MRI to obviate the contribution of pain during emergence. Airway complications have been reported after LMA and isoflurane more commonly than with IV propofol and nasal prongs. Whether the airway complications were due to the LMA or the isoflurane was unclear. Therefore, this study was designed to study the incidence of 1. agitation after sevoflurane compared with IV propofol and 2. airway complications after LMA or nasal prongs.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
6

participants targeted

Target at below P25 for phase_4

Timeline
Completed

Started Jan 2014

Shorter than P25 for phase_4

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2014

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

April 9, 2014

Completed
2 days until next milestone

First Posted

Study publicly available on registry

April 11, 2014

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
4.6 years until next milestone

Results Posted

Study results publicly available

July 23, 2019

Completed
Last Updated

July 23, 2019

Status Verified

July 1, 2019

Enrollment Period

11 months

First QC Date

April 9, 2014

Results QC Date

April 4, 2019

Last Update Submit

July 1, 2019

Conditions

Keywords

childrensevofluraneisofluranepropofolanesthesiaMRIdelirium

Outcome Measures

Primary Outcomes (1)

  • Incidence of Delirium on Emergence

    Delirium on emergence will be assessed using the PAED scale by a blinded observer in the post anesthesia period. A score \>12 constitutes a diagnosis of delirium in children. The post anesthesia period is usually \<2 hours after anesthesia.

    WIthin 2 hours of emergence from anesthesia

Secondary Outcomes (1)

  • Incidence of Airway Complications

    WIthin 2 hours of emergence from anesthesia

Study Arms (4)

Sevoflurane, propofol, Nasal oxygen

ACTIVE COMPARATOR

After securing the IV, sevoflurane will be discontinued and a propofol infusion will be started at the dose of 300 mcg/kg/min depending on the child's age and neurologic status. A bolus of propofol will not be administered. Oxygen will be delivered via nasal prongs at 2 liters per minute. The infusion rate of propofol will be decreased to 250 after 15 min and then 200 mcg/kg/min also after 15 min. Supplemental IV boluses of Propofol (0.5 mg/kg) will be administered if the child moves or if signs of light anesthesia are noticed. The propofol infusion may also be increased in response to light anesthesia.

Drug: Propofol

Sevoflurane, Propofol, LMA

ACTIVE COMPARATOR

After securing the IV, weight appropriate LMA will be inserted and sevoflurane will be discontinued and a propofol infusion will be started at the dose of 300 mcg/kg/min depending on the child's age and neurologic status. Oxygen in air will be delivered via LMA. The infusion rate of propofol will be decreased to 250 after 15 min and then 200 mcg/kg/min after another 15 min. Supplemental IV boluses of Propofol (0.5 mg/kg) will be given if the child moves or exhibits signs of light anesthesia. The propofol infusion may also be increased in response to light anesthesia.

Drug: PropofolDrug: Sevoflurane

Sevoflurane, sevoflurane, LMA

ACTIVE COMPARATOR

After securing the IV, weight appropriate LMA will be inserted and sevoflurane continued at 3% inspired concentration. Oxygen in air will be delivered via LMA at 2 lpm. The sevoflurane may be increased or decreased in 0.5% increments as needed.

Drug: Sevoflurane

Sevoflurane, isoflurane, LMA

ACTIVE COMPARATOR

After securing the IV, weight appropriate LMA will be inserted , sevoflurane will be discontinued and isoflurane will be administered at 2 % inspired concentration. Oxygen in air will be delivered via LMA at 2 lpm. Isoflurane may be increased or decreased in 0.5% increments as needed.

Drug: SevofluraneDrug: Isoflurane

Interventions

Propofol infusion with nasal oxygen

Also known as: Diprivan 1%
Sevoflurane, Propofol, LMASevoflurane, propofol, Nasal oxygen

Sevoflurane with an LMA

Also known as: Sevorane
Sevoflurane, Propofol, LMASevoflurane, isoflurane, LMASevoflurane, sevoflurane, LMA

Isoflurane with an LMA

Also known as: Forane
Sevoflurane, isoflurane, LMA

Eligibility Criteria

Age2 Years - 12 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Age 2-12yrs,
  • ASA Class I-II,
  • Fasting,
  • Unmedicated,
  • Elective MRI scan

You may not qualify if:

  • Cognitive impairment,
  • On psychotropic medications,
  • Taking multiple (\>2) antiepileptic medications,
  • Requiring endotracheal intubation for GA

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Women and Chidren's Hospital Of Buffalo

Buffalo, New York, 14222, United States

Location

MeSH Terms

Conditions

Emergence DeliriumDelirium

Interventions

PropofolSevofluraneIsoflurane

Condition Hierarchy (Ancestors)

ConfusionNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesPostoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsSigns and SymptomsNeurocognitive DisordersMental Disorders

Intervention Hierarchy (Ancestors)

PhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsMethyl EthersEthersHydrocarbons, FluorinatedHydrocarbons, Halogenated

Limitations and Caveats

none study not completed due to facility issues

Results Point of Contact

Title
Research Coordinator
Organization
GLA

Study Officials

  • Jerrold Lerman, MD

    Women And Childrens Hospital Of Buffalo

    PRINCIPAL INVESTIGATOR
  • Christopher Heard, MD

    Women And Childrens Hospital Of Buffalo

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Professor of Anesthesiology

Study Record Dates

First Submitted

April 9, 2014

First Posted

April 11, 2014

Study Start

January 1, 2014

Primary Completion

December 1, 2014

Study Completion

December 1, 2014

Last Updated

July 23, 2019

Results First Posted

July 23, 2019

Record last verified: 2019-07

Data Sharing

IPD Sharing
Will not share

Locations