Efficacy and Safety of Sevofran in Patients Scheduled for Elective Surgery Under General Anesthesia

General Anesthesia Clinical Trial

Official title:

A Multi-center, Open-Label, Randomized, Active-controlled, Parallel, Phase 4 Clinical Trial to Assess the Efficacy and Safety of Sevofran in Patients Scheduled for Elective Surgery Under General Anesthesia

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01096212
• Other study ID #: Asan Medical Center_sevofran_1
• Status: Completed
• Phase: Phase 4
• First received: March 29, 2010
• Last updated: March 30, 2010
• Start date: September 2008
• Est. completion date: March 2010

Study information

• Verified date: March 2010
• Source: Asan Medical Center
• Contact: n/a
• Is FDA regulated: No
• Health authority: Korea: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

Sevoflurane is currently being used in more than 100 countries worldwide with an estimated 100 million operations having been performed using sevoflurane as a general anesthetic. After the expiry of the patent on sevoflurane as a pharmaceutical drug, a generic product (Sevofran®; Hana pharmacy, Co. Ltd, Seoul, Korea) has been launched. The aims of this study were to investigate the efficacy (mean minimum alveolar concentration), recovery characteristics (time to recovery of consciousness (ROC) and recovery, and BIS values at ROC and orientation), and safety (incidence and severity of adverse events) of generic sevoflurane in patients undergoing elective surgery.

Description:

Patients were randomly allocated to experimental group (generic sevoflurane) and active comparator group (original sevoflurane). Once in the operating room, patients were monitored with electrocardiography, non invasive blood pressure, pulse oximetry (Datex-Ohmeda S/5, Planar Systems, Inc., Beaverton, OR, USA) and BIS (Aspect 2000, Aspect Medical Systems, Inc., Newton, MA, USA).

Anesthesia was induced with fentanyl (2 μg/kg) and propofol (2mg/kg). When patients were unconscious, original or generic sevoflurane was administered. Tracheal intubation was facilitated by administering rocuronium 0.6 mg/kg. The lungs of the patients were then ventilated with oxygen in air (1:2), and the ventilation rate was adjusted to maintain the end-tidal carbon dioxide partial pressure between 35 and 45 mmHg. The concentrations of carbon dioxide, sevoflurane, and oxygen were measured continuously using an infrared anesthetic gas analyzer (Datex-Ohmeda S/5, Planar Systems, Inc., Beaverton, OR, USA), which was calibrated before anesthesia for each patient using a standard gas mixture.

The inspired concentration of sevoflurane was adjusted to maintain BIS values < 60 and stable haemodynamics (systolic arterial pressure (SAP) > 80 mmHg and heart rate (HR) > 45 beats/min). Also, it was titrated to prevent signs of inadequate anesthesia (sweating, facial flushing, movement and swallowing, HR > 90 beats/min without evidence of hypovolemia, and a 15 mmHg increase in SAP, compared with baseline SAP). Fentanyl 1 μg/kg was given if needed to resolve of signs of inadequate anesthesia.

Concentration of compound A, formaldehyde, and methadone were measured at preset interval:

30, 60, 90, 120, 150, 180 min after administration of sevoflurane. Blood and urine samples were taken at preset interval for analyzing concentration of inorganic fluoride: 1 hr after administration of sevoflurane and every 2 hr during maintenance of anesthesia.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 178
• Est. completion date: March 2010
• Est. primary completion date: September 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 19 Years and older

Eligibility

Inclusion Criteria:

• Patients scheduled for elective surgery under general anesthesia

• American Society Anesthesiologists Physical Status (ASA PS) 1 or 2

• Aged 19 years or above

Exclusion Criteria:

• ASA PS 3 or above

• aged under 19 years

• Contraindications against the use of sevoflurane

• Abnormal laboratory finding with clinical significance

• Evidence of pregnancy

• History of alcohol or drug abuse

• Hemoglobin < 11 mg/dl

• Neurological or psychiatric disease

• Unable or unwilling to give informed consent

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• General Anesthesia
• Generic Drugs
• Sevoflurane

Intervention

Drug:
• original sevoflurane
Sevoflurane content: 99.9985%, compound A: 4.6 ppm, water content (sample was opened, sealed and stored for 2 weeks): 0.072% w/v
• generic sevoflurane
Sevoflurane content: 99.99%, compound A: 3.8 ppm, water content (sample was opened, sealed and stored for 2 weeks) : 0.044% w/v

Locations

Country	Name	City	State
Korea, Republic of	Asan Medical Center	Seoul
Korea, Republic of	Sanggye-Paik Hospital	Seoul

Sponsors (2)

Lead Sponsor	Collaborator
Asan Medical Center	National Clinical Research Coordination Center, Seoul, Korea

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Comparison of mean minimum alveolar concentration between original and generic sevoflurane	Minimum alveolar concentration was determined by end-tidal sevoflurane concentrations. Mean MAC was calculated as following equation,; Mean MAC = (MAC * hour) / (maintenance time from administration of hypnotic agent (propofol) for acquring loss of consciousness to extubation)	During mainenance of anesthesia under general anesthesia	No
Secondary	Comparison of secondary efficacy and safety endpoints between two inhalation agents	Secondary efficacy and safety characteristics include following items.; Anesthesia exposure: MAC * hour [Time frame: maintenanane period of anesthesia]; Bispectral index, BIS [Time frame: time to recovery of consciousnessn, time to recovery of orientation]; Adverse event [Time frame: maintenanane period of anesthesia]; Incidence and severity of postopertive nausea and vomiting [Time frame: 24 hours postoperatively]; Concentrations of compound A, formaldehyde, methanol [Time frame: 30, 60, 90, 120, 150, 180 min after sevoflurane administration]	During maintenance of anesthesia under general anesthesia	Yes