NCT02463929

Brief Summary

The purpose of this study is to investigate the effect of diphenhydramine on the prevention of sevoflurane induced emergence delirium/ agitation in pediatrics. The Investigators hypothesis is that it reduce the incidence of sevoflurane induced emergence delirium/ agitation.

Trial Health

100
On Track

Trial Health Score

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

Enrollment
50

participants targeted

Target at P25-P50 for phase_4

Timeline
Completed

Started Apr 2014

Shorter than P25 for phase_4

Status
completed

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

April 1, 2014

Completed
2 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2014

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2014

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

May 18, 2015

Completed
17 days until next milestone

First Posted

Study publicly available on registry

June 4, 2015

Completed
Last Updated

June 4, 2015

Status Verified

June 1, 2015

Enrollment Period

2 months

First QC Date

May 18, 2015

Last Update Submit

June 2, 2015

Conditions

Keywords

Diphenhydramineemergence agitationpediatric anesthesiaPAEDSWithdrawal

Outcome Measures

Primary Outcomes (1)

  • Incidence of sevoflurane induced post anesthesia agitation

    10 minutes post extubation

Secondary Outcomes (8)

  • Amount of rescue Ketamine used

    1 minute post extubation, at emergence, 15 minute post extubation

  • Significant adverse events

    1 minute post extubation, at emergence, 15 minute post extubation

  • Mean Pediatric Emergence Agitation and Delirium Score (PAEDS)

    1 minute post extubation

  • Mean Pediatric Emergence Agitation and Delirium Score (PAEDS)

    at emergence

  • Mean Pediatric Emergence Agitation and Delirium Score (PAEDS)

    15 minute post extubation

  • +3 more secondary outcomes

Study Arms (2)

diphenhydramine

EXPERIMENTAL

Subject sedated with sevoflurane, and given bilateral extraoral infraorbital block with 0,125% bupivacaine. Subject injected 0,5mg/kg diphenhydramine intravenously, 15 minutes prior to discontinuation of sevoflurane. If subject develop agitation, 0,1 mg/kg ketamine is administered

Drug: DiphenhydramineDrug: KetamineDrug: SevofluraneDrug: Bupivacaine

control

PLACEBO COMPARATOR

Subject sedated with sevoflurane, and given bilateral extraoral infraorbital block with 0,125% bupivacaine. Subject injected 0,5cc/kg normal saline intravenously, 15 minutes prior to discontinuation of sevoflurane. If subject develop agitation, 0,1 mg/kg ketamine is administered

Drug: normal salineDrug: KetamineDrug: SevofluraneDrug: Bupivacaine

Interventions

Intravenous Injection

diphenhydramine

Intravenous Injection

Also known as: NaCl 0,9%
control

Ketamine 0,1 mg/kg intravenously used as rescue tranquilizer if the subject becomes agitated, repeated dose of 0,05 mg/kg every minute can be given if the agitation does not resolve, maximum ketamine dose for tranquilizer 0,25 mg/kg to prevent deep sedation

controldiphenhydramine

Sevoflurane as single sedation agent for general anesthesia in both arm. 8% Sevoflurane in 100% oxygen used as induction agent, and 2% sevoflurane in 50% oxygen used as maintenance agent

controldiphenhydramine

Bilateral extraoral infraorbital nerve block with 0,125% Bupivacaine as analgetic for operation and post operation.

controldiphenhydramine

Eligibility Criteria

Age2 Months - 24 Months
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • ASA I or 2
  • no cardiovascular, respiratory or neurologic congenital anomalies
  • no allergic reactions, or any contraindication to drugs used in this trial ever documented

You may not qualify if:

  • congenital anomalies recognized/diagnosed during trial procedures
  • hemmorhage \> 15% EBV
  • shock or other major anesthesia or surgical complications during trial procedures (hipoxia, atelectasis, unintended disconection of ETT or IV line)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (6)

  • Varughese AM, Rampersad SE, Whitney GM, Flick RP, Anton B, Heitmiller ES. Quality and safety in pediatric anesthesia. Anesth Analg. 2013 Dec;117(6):1408-18. doi: 10.1213/ANE.0b013e318294fb4a.

    PMID: 24257392BACKGROUND
  • Cohen IT, Finkel JC, Hannallah RS, Hummer KA, Patel KM. The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children. Anesth Analg. 2002 May;94(5):1178-81, table of contents. doi: 10.1097/00000539-200205000-00023.

    PMID: 11973185BACKGROUND
  • Koner O, Ture H, Mercan A, Menda F, Sozubir S. Effects of hydroxyzine-midazolam premedication on sevoflurane-induced paediatric emergence agitation: a prospective randomised clinical trial. Eur J Anaesthesiol. 2011 Sep;28(9):640-5. doi: 10.1097/EJA.0b013e328344db1a.

    PMID: 21822077BACKGROUND
  • Abdallah C, Hannallah R. Premedication of the child undergoing surgery. Middle East J Anaesthesiol. 2011 Jun;21(2):165-74. No abstract available.

    PMID: 22435268BACKGROUND
  • Aouad MT, Nasr VG. Emergence agitation in children: an update. Curr Opin Anaesthesiol. 2005 Dec;18(6):614-9. doi: 10.1097/01.aco.0000188420.84763.35.

    PMID: 16534301BACKGROUND
  • Simons FE, Simons KJ. Clinical pharmacology of H1-antihistamines. Clin Allergy Immunol. 2002;17:141-78. No abstract available.

    PMID: 12113216BACKGROUND

MeSH Terms

Conditions

Emergence Delirium

Interventions

DiphenhydramineSaline SolutionKetamineSevofluraneBupivacaine

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

EthylaminesAminesOrganic ChemicalsBenzhydryl CompoundsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsCrystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical PreparationsCyclohexanesCycloparaffinsHydrocarbons, AlicyclicMethyl EthersEthersHydrocarbons, FluorinatedHydrocarbons, HalogenatedAnilidesAmidesAniline Compounds

Study Officials

  • Johan Mr Arifin, dr

    Universitas Diponegoro

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Doctor

Study Record Dates

First Submitted

May 18, 2015

First Posted

June 4, 2015

Study Start

April 1, 2014

Primary Completion

June 1, 2014

Study Completion

July 1, 2014

Last Updated

June 4, 2015

Record last verified: 2015-06