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Trial registered on ANZCTR
Registration number
ACTRN12625000299404p
Ethics application status
Submitted, not yet approved
Date submitted
2/04/2025
Date registered
15/04/2025
Date last updated
22/06/2025
Date data sharing statement initially provided
15/04/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Plasma concentrations and outcomes of an optimised intraoperative lidocaine infusion regimen in patients with obesity
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Scientific title
Plasma concentrations and outcomes of an optimised intraoperative lidocaine infusion regimen in patients with obesity during laparoscopic abdominal surgery
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Secondary ID [1]
314068
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None
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Universal Trial Number (UTN)
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Trial acronym
LIIDO: Lidocaine Intraoperative Infusion Dose Optimisation in obesity
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity
336815
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Condition category
Condition code
Diet and Nutrition
333310
333310
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0
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Obesity
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Surgery
333311
333311
0
0
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Other surgery
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Anaesthesiology
333309
333309
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
An intravenous lidocaine infusion regimen will be administered in patients with BMI >30kg/m2 having elective laparoscopic abdominal surgery. A regimen dosed according to lean body weight of of 2mg/kg bolus over 20 minutes commencing prior to skin incision, followed by 3mg/kg/hour for 80 mins then reduced to 2mg/kg/hour until completion of the surgery will be delivered and documented by the treating anaesthetist.
Intravenous lignocaine infusions are widely regarded as a valuable adjunct to laparoscopic abdominal surgical procedures however their use in this population group, with the current level of evidence, is entirely dependant on anaesthetist preference. As such in some cases intravenous lignocaine infusions would be used regardless but in some cases they will be utilised specifically for the purposes of the study.
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Intervention code [1]
330644
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Plasma GX concentrations (secondary active metabolite of lidocaine)
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Assessment method [1]
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Total and unbound concentrations measured by liquid chromatography mass spectrometry
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Timepoint [1]
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Baseline prior to infusion starting (T0); at the completion of the 20-minute loading dose (T20), 5 minutes after completion of loading dose (T25); then at 60, and 100 minutes (T60; T100) during the infusion. A sample will be taken at 180 minutes after the regimen is commenced (T180) (following reduction of the infusion rate). Samples will also be taken at the time of discontinuation of infusion (TE); and then 10, 60 and 180 minutes after discontinuation of the infusion (TE10, TE60, TE180). Final samples at 6 and 24 hours (TP6, TP24).
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Primary outcome [2]
340887
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Plasma lidocaine concentrations
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Assessment method [2]
340887
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Total and unbound concentrations measured by liquid chromatography mass spectrometry
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Timepoint [2]
340887
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Baseline prior to infusion starting (T0); at the completion of the 20-minute loading dose (T20), 5 minutes after completion of loading dose (T25); then at 60, and 100 minutes (T60; T100) during the infusion. A sample will be taken at 180 minutes after the regimen is commenced (T180) (following reduction of the infusion rate). Samples will also be taken at the time of discontinuation of infusion (TE); and then 10, 60 and 180 minutes after discontinuation of the infusion (TE10, TE60, TE180). Final samples at 6 and 24 hours (TP6, TP24).
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Primary outcome [3]
340888
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Plasma MEGX concentrations (primary active metabolite of lidocaine)
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Assessment method [3]
340888
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Total and unbound concentrations measured by liquid chromatography mass spectrometry
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Timepoint [3]
340888
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Baseline prior to infusion starting (T0); at the completion of the 20-minute loading dose (T20), 5 minutes after completion of loading dose (T25); then at 60, and 100 minutes (T60; T100) during the infusion. A sample will be taken at 180 minutes after the regimen is commenced (T180) (following reduction of the infusion rate). Samples will also be taken at the time of discontinuation of infusion (TE); and then 10, 60 and 180 minutes after discontinuation of the infusion (TE10, TE60, TE180). Final samples at 6 and 24 hours (TP6, TP24).
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Secondary outcome [1]
445959
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Post-operative nausea and vomiting (PONV)
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Assessment method [1]
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Dichotomous yes/no Review of medical records, use of antiemetics, type, dose, route.
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Timepoint [1]
445959
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PACU, 24 h
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Secondary outcome [2]
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Feasibility of delivering standardised anaesthesia and lidocaine protocol
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Assessment method [2]
445357
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Audit of anaesthetic records. Adherence to protocols. Descriptive statistics.
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Timepoint [2]
445357
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Intraoperative.
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Secondary outcome [3]
445957
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Pain assessment
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Assessment method [3]
445957
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Pain scores: numerical rating scale 0-10, rest and movement Functional activity score: A, B, C
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Timepoint [3]
445957
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In post-anaesthetic care unit (PACU), at 24h
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Secondary outcome [4]
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Opioid use
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Assessment method [4]
445958
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Anaesthesia and medication records of opioid medications used, dose and route. Converted to oral morphine equivalents.
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Timepoint [4]
445958
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Intraoperative, PACU, first 24 hours, 48 hours.
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Secondary outcome [5]
445356
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Intraoperative anaesthesia details
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Assessment method [5]
445356
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Audit of anaesthetic records. Medications and amounts delivered. Descriptive statistics.
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Timepoint [5]
445356
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Intraoperative.
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Secondary outcome [6]
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Respiratory complications (e.g. desaturation, aspiration, respiratory failure)
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Assessment method [6]
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Review of medical records
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Timepoint [6]
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PACU, 24 hr
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Secondary outcome [7]
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Bowel recovery and ileus
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Assessment method [7]
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Review of medical records, documented postoperative ileus
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Timepoint [7]
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Post-operative
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Secondary outcome [8]
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Hospital length of stay (days)
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Assessment method [8]
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Review of medical record
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Timepoint [8]
445966
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Post-operative
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Secondary outcome [9]
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PACU length of stay (minutes)
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Assessment method [9]
445964
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Review PACU record
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Timepoint [9]
445964
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In PACU
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Secondary outcome [10]
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Adverse events (including suspected local anaesthetic toxicity)
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Assessment method [10]
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Reported events, review of records
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Timepoint [10]
445967
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Intraoperative, PACU, post-operative
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Secondary outcome [11]
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Quality of recovery
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Assessment method [11]
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QoR-15 Questionnaire
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Timepoint [11]
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At 24 hours
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Eligibility
Key inclusion criteria
BMI greater than or equal to 30 kg/m2
Elective laparoscopic abdominal surgery, expected > 90 mins duration, positioned with one arm available for venous sampling
Informed consent
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Minimum age
18
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Known or suspected allergy or contraindication to lidocaine or other amide local anaesthetics, including patients with porphyria and methaemaglobinaemia
Acute or chronic renal disease (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2)
Acute or chronic liver disease (based on laboratory reference range values)
Congestive cardiac failure or cardiac conduction abnormalities (e.g. heart block, bundle branch block, prolonged QT interval, Wolf Parkinson White Syndrome, or channelopathy (e.g. Brugada Syndrome)
Pregnancy
History of seizure disorder
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
An open-label plasma pharmacokinetic study of an intraoperative intravenous lidocaine infusions regimen in patients with obesity. Detailed phamacokinetic analysis of the total and unbound lidocaine, MEGX and GX concentrations using existing validated liquid chromatography mass spectrometry methodology. Analysis of alpha-1-acid glycoprotein and influence on protein binding as well as analysis of covariates (e.g. BMI, albumin).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/02/2026
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Actual
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Date of last participant enrolment
Anticipated
2/02/2027
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Actual
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Date of last data collection
Anticipated
2/08/2027
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
27671
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
43846
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4029 - Herston
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Funding & Sponsors
Funding source category [1]
318574
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Hospital
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Name [1]
318574
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Royal Brisbane and Women's Hospital
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Address [1]
318574
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Country [1]
318574
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Australia
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Primary sponsor type
Hospital
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Name
Department of Anaesthesia Royal Brisbane and Women's Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
320973
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None
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Name [1]
320973
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Address [1]
320973
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Country [1]
320973
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
317174
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Metro North Health Human Research Ethics Committee A
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Ethics committee address [1]
317174
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https://metronorth.health.qld.gov.au/research/ethics-and-governance/human-research-ethics-committee
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Ethics committee country [1]
317174
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Australia
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Date submitted for ethics approval [1]
317174
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05/06/2025
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Approval date [1]
317174
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Ethics approval number [1]
317174
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Summary
Brief summary
Intravenous lidocaine infusions have demonstrated benefits for improving analgesia and recovery after laparoscopic abdominal surgery. However, there are inconsistencies regarding the dosing of lidocaine infusions with concerns for safety and efficacy, particularly when using a weight-based protocol in patients with obesity. It is likely that current dosing regimen result in sub-therapeutic levels in patients. This study aims to prospectively evaluate a proposed optimised regimen to determine if it achieves targeted concentrations. We will also assess the feasibility of administering a standardised anaesthesia protocol and collecting a range of patient-focused outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
140246
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Dr Angela Tognolini
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Address
140246
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RBWH Anaesthetic Department Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029
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Country
140246
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Australia
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Phone
140246
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+61 7 36467154
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Fax
140246
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Email
140246
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[email protected]
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Contact person for public queries
Name
140247
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Ms Christine Woods
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Address
140247
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RBWH Anaesthetic Department Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029
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Country
140247
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Australia
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Phone
140247
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+61 7 36467154
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Fax
140247
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Email
140247
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[email protected]
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Contact person for scientific queries
Name
140248
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Angela Tognolini
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Address
140248
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RBWH Anaesthetic Department Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029
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Country
140248
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Australia
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Phone
140248
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+61 7 36467154
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Fax
140248
0
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Email
140248
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment:
This is a pharmacokinetic study for lidocaine infusions in the obese population as such the collected data is deidentified and pooled making each individual patient's data on its own irrelevant to the overall outcome.
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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