Anaesthetist-controlled versus patient-maintained effect-site targeted propofol sedation during elective primary lower-limb arthroplasty performed under spinal anaesthesia (ACCEPTS): study protocol for a parallel-group randomised comparison trial

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Hewson, DW, Worcester, F ORCID: https://orcid.org/0000-0003-4616-6842, Sprinks, J ORCID: https://orcid.org/0000-0003-3781-5484, Smith, MD, Buchanan, H, Breedon, P ORCID: https://orcid.org/0000-0002-1006-0942, Hardman, JG and Bedforth, NM, 2019. Anaesthetist-controlled versus patient-maintained effect-site targeted propofol sedation during elective primary lower-limb arthroplasty performed under spinal anaesthesia (ACCEPTS): study protocol for a parallel-group randomised comparison trial. Trials, 20: 129. ISSN 1745-6215

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Official URL: http://doi.org/10.1186/s13063-019-3228-4

Abstract

Background: The clinical efficacy of effect-site targeted patient-maintained propofol sedation (PMPS) compared to anaesthetist-controlled propofol sedation (ACPS) for patients undergoing awake joint replacement surgery is currently unknown. There is no commercially available medical device capable of delivering PMPS so we have designed and built such a device. We plan a clinical trial to compare PMPS to ACPS and to collect data relating to the safety of our prototype device in delivering sedation.

Methods: The trial is an open-label, randomised, controlled superiority trial recruiting adults who are undergoing elective primary lower-limb arthroplasty with sedation by propofol infusion by effect-site targeting into two equal-sized parallel arms: PMPS and ACPS. The primary research objective is to compare the body-weight-normalised rate of propofol consumption when sedation for surgery on adults undergoing elective primary lower-limb arthroplasty under spinal anaesthesia is patient-maintained versus when it is anaesthetist-controlled. The study primary null hypothesis is that there is no difference in the rate of propofol consumption when sedation is patient-maintained versus anaesthetist-controlled.

Discussion: This is the first trial to test the superiority of effect-site-targeted patient-maintained propofol sedation versus anaesthetist-controlled propofol sedation in terms of total propofol consumption during the sedation period. The results of this trial will help inform clinicians and device manufacturers of the clinical efficacy and safety of patient-maintained propofol sedation applied to a common operative setting.

Trial registration: International Standard Randomised Controlled Trial Number Registry, ISRCTN29129799. Prospectively registered on 12 June 2018.

Item Type:	Journal article
Publication Title:	Trials
Creators:	Hewson, D.W., Worcester, F., Sprinks, J., Smith, M.D., Buchanan, H., Breedon, P., Hardman, J.G. and Bedforth, N.M.
Publisher:	BMC (BioMed Central)
Date:	13 February 2019
Volume:	20
ISSN:	1745-6215
Identifiers:	Number Type 10.1186/s13063-019-3228-4 DOI
Rights:	© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Divisions:	Schools > School of Architecture, Design and the Built Environment
Record created by:	Jill Tomkinson
Date Added:	04 Mar 2019 12:04
Last Modified:	04 Mar 2019 12:04
URI:	https://irep.ntu.ac.uk/id/eprint/35888