ChiCTR2500115824 版本V1.0 版本创建时间2025/12/31 15:02:03 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2500115824 

最近更新日期:

Date of Last Refreshed on:

2025-12-31 15:01:59 

注册时间:

Date of Registration:

2025-12-31 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

环泊酚联合瑞芬太尼滴定麻醉对老年腹腔镜腹部手术患者围术期低血压的影响:一项随机对照研究

Public title:

Effect of Titrated Administration of Ciprofol Combined with Remifentanil on Perioperative Hypotension in Elderly Patients Undergoing Laparoscopic Abdominal Surgery: A Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

环泊酚联合瑞芬太尼滴定麻醉对老年腹腔镜腹部手术患者围术期低血压的影响:一项随机对照研究

Scientific title:

Effect of Titrated Administration of Ciprofol Combined with Remifentanil on Perioperative Hypotension in Elderly Patients Undergoing Laparoscopic Abdominal Surgery: A Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

白虹 

研究负责人:

靳三庆 

Applicant:

Bai Hong 

Study leader:

Jin Sanqing 

申请注册联系人电话:

Applicant telephone:

+86 134 8025 0519

研究负责人电话:

Study leader's telephone:

+86 137 1936 6863

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

bhong@mail.sysu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

sanqingjin@hotmail.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国广东省广州市天河区员村二横路19号

研究负责人通讯地址:

中国广东省广州市天河区员村二横路19号

Applicant address:

19 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

Study leader's address:

19 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

申请注册联系人邮政编码:

Applicant postcode:

510655

研究负责人邮政编码:

Study leader's postcode:

510655

申请人所在单位:

中山大学附属第六医院

Applicant's institution:

The Sixth Affiliated Hospital of Sun Yat-sen University

研究负责人所在单位:

中山大学附属第六医院

Affiliation of the Leader:

The Sixth Affiliated Hospital of Sun Yat-sen University

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025ZSLYEC-415

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中山大学附属第六医院伦理委员会

Name of the ethic committee:

Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-07-30 00:00:00

伦理委员会联系人:

吴倩

Contact Name of the ethic committee:

Wu Qian

伦理委员会联系地址:

中国广东省广州市天河区员村二横路19号

Contact Address of the ethic committee:

No. 19, Yuancun 2nd Cross Road, Tianhe District, Guangzhou, Guangdong, China.

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 20 3837 9764

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

中山大学附属第六医院

Primary sponsor:

The Sixth Affiliated Hospital of Sun Yat-sen University

研究实施负责(组长)单位地址:

中国广东省广州市天河区员村二横路19号

Primary sponsor's address:

19 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东

市(区县):

Country:

China

Province:

Guangdong

City:

单位(医院):

中山大学附属第六医院

具体地址:

中国广东省广州市天河区员村二横路19号

Institution
hospital:

The Sixth Affiliated Hospital of Sun Yat-sen University

Address:

19 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

经费或物资来源:

自筹

Source(s) of funding:

Self-funded

Target disease:

Perioperative hypotension in elderly patients undergoing laparoscopic abdominal surgery

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

明确采用滴定麻醉进行全麻诱导和维持的患者是否较常规麻醉者围术期低血压的发病率更低。  

Objectives of Study:

The incidence of hypotension, defined as a mean arterial pressure (MAP) <65 mmHg, compared between the two groups.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1. 年龄 >= 65岁,拟行择期腹腔镜下腹部手术 2. ASA 1-3级 3. 需要开放有创血压监测者

Inclusion criteria

1. Age >= 65 years old, scheduled for elective laparoscopic abdominal surgery 2. ASA grade 1-3 3. Requiring invasive arterial blood pressure monitoring

排除标准:

1. 当前正参与其他可能影响本研究干预或观察结果的临床试验者予以排除; 2. 合并严重肝肾疾病(GFR<=30ml/min/1.73m2, 或者需要肾脏替代治疗;肝功能Child评分C级); 3. 患者有严重的未控制的高血压(术前SBP>=180mmHg,或者DBP>=110mmHg); 4. 合并严重精神疾病(如精神分裂症)、癫痫或帕金森病,重度认知或智力障碍,严重视听障碍影响评估者,或长期嗜酒、使用镇静/镇痛药物者。 5. 既往对本研究所用药物过敏者; 6. 手术开始前需要静脉持续使用血管收缩剂者及术中因外科手术原因需要对患者血压进行长时间调控及干预者。 7. 预计失血量>总血量的15%。 8. 手术时长预计<60min或>6h。 9. 预计术后住院时间<72h。

Exclusion criteria:

1. Patients currently participating in other clinical trials that may affect the interventions or observations of this study will be excluded. 2. Those with severe liver or kidney disease (GFR<= 30 ml/min/1.73m2 or requiring renal replacement therapy; Child-Pugh class C for liver function); 3. Patients with severe uncontrolled hypertension (preoperative SBP >= 180 mmHg or DBP >= 110 mmHg); 4. Patients with severe mental disorders (such as schizophrenia), epilepsy, or Parkinson’s disease, severe cognitive or intellectual impairment, severe visual or hearing impairments affecting assessment, or long-term alcohol abuse or use of sedative/analgesic medications; 5. Patients with a history of allergy to the drugs used in this study; 6. Patients requiring continuous intravenous vasoconstrictors before the start of surgery, or those whose blood pressure needs prolonged regulation and intervention during surgery due to surgical reasons; 7. Expected blood loss > 15% of total blood volume; 8. Expected surgical duration < 60 minutes or > 6 hours; 9. Expected postoperative hospital stay < 72 hours.

研究实施时间:

Study execute time:

From 2026-01-07 00:00:00 To 2026-01-07 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-01-07 00:00:00 To 2026-01-07 00:00:00  

干预措施:

Interventions:

组别:

滴定组

样本量:

250

Group:

Titrated group

Sample size:

干预措施:

麻醉诱导以环泊酚 3mg/kg*h 速度持续泵注,瑞芬太尼 1.2ug/kg 直到患者意识消失,即 OAA/S 评分达 1 分,之后将维持剂量调整为 1mg/kg/h,之后给予顺式阿曲库铵 0.2mg/kg,60s 后开始气管插管。插管后及术中继续以环泊酚 0.4-3mg/kg/h 速度维持,瑞芬太尼以 0.01-0.5ug/kg/min 泵注,直至手术结束。术中以滴定的方案进行麻醉维持,其给药逻辑为:将 BIS 目标设置为50,在术中以此为目标进行调整

干预措施代码:

Intervention:

Anesthesia induction was performed by continuous infusion of propofol at a rate of 3 mg/kg/h, combined with remifentanil at 1.2 μg/kg, until the patient lost consciousness, as indicated by an OAA/S score of 1. The maintenance dose of propofol was then adjusted to 1 mg/kg/h, followed by administration of cisatracurium at 0.2 mg/kg. Endotracheal intubation was initiated 60 seconds later. After intubation and throughout the surgery, anesthesia was maintained with propofol infused at a rate of 0.4–3 mg/kg/h and remifentanil at a rate of 0.01–0.5 μg/kg/min, continued until the end of the procedure. Intraoperative anesthesia maintenance was titrated according to the following protocol: the BIS target was set at 50, and drug dosages were adjusted during surgery to maintain this target.

Intervention code:

组别:

对照组

样本量:

250

Group:

Controled group

Sample size:

干预措施:

采用环泊酚+瑞芬进行常规诱导和维持。铵0.2mg/kg,完成气管插管后以环泊酚+瑞芬太尼维持,环泊酚给药速度主要固定为 1.5mg/kg*h,必要时可在 0.4-3mg/kg*h 范围内调节,瑞芬太尼剂量范围为 0.05-2ug/kg*min。药物剂量的调控由麻医生根据患者的血压、心率进行调节。围术期给予 BIS 监测,但屏幕背对麻醉医生

干预措施代码:

Intervention:

Routine induction and maintenance were performed using remimazolam and remifentanil. Remimazolam was administered at an initial dose of 0.2 mg/kg for induction. Following endotracheal intubation, maintenance was continued with a combination of remimazolam and remifentanil. The infusion rate of remimazolam was primarily fixed at 1.5 mg/kg/h, but could be adjusted within a range of 0.4–3 mg/kg/h as needed. The dose of remifentanil was titrated between 0.05–2 μg/kg/min. Drug dosages were adjusted by the attending anesthesiologist based on the patient’s blood pressure and heart rate. During the perioperative period, BIS monitoring was performed; however, the monitor screen was positioned facing away from the anesthesiologist.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东 

市(区县):

广州 

Country:

China 

Province:

Guangdong 

City:

Guangzhou 

单位(医院):

中山大学附属第六医院 

单位级别:

三甲 

Institution
hospital:

The Sixth Affiliated Hospital of Sun Yat-sen University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

低血压发病率

指标类型:

主要指标

Outcome:

Rate of hypotension

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

时间平均曲线下面积(<65mmHg)

指标类型:

次要指标

Outcome:

The time-weighted area under the curve (TWA) for MAP <65 mmHg during the anesthesia period

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

去甲肾上腺素累积剂量及需要缩血管药的患者百分比

指标类型:

次要指标

Outcome:

Cumulative dose of norepinephrine and the proportion of patients requiring vasoactive support;

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

时间平均曲线下面积(<0.8基线血压)

指标类型:

次要指标

Outcome:

The time-weighted area under the curve (TWA) for MAP <0.8 baseline during the anesthesia period

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

第一次出现低血压的时间

指标类型:

次要指标

Outcome:

Time to first hypotensive episode

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

CI趋势

指标类型:

次要指标

Outcome:

Cardiac index(CI) trend

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

低血压高发时期

指标类型:

次要指标

Outcome:

The time periods with a higher incidence of hypotension between the two groups

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中单位时间的环泊酚和瑞芬剂量

指标类型:

次要指标

Outcome:

Intraoperative ciprofol and remifentanil dose per unit time

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中血压变异率是否不同

指标类型:

次要指标

Outcome:

Whether blood pressure variability (CV) and the average rate of blood pressure variation (ARV) are different.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

严重低血压的发生率

指标类型:

次要指标

Outcome:

The incidence of severe intraoperative hypotension

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

停药到苏醒时间

指标类型:

次要指标

Outcome:

The time from general anesthesia drug discontinuation to awakening.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后谵妄

指标类型:

次要指标

Outcome:

The rate of postoperative delirium

Type:

Secondary indicator

测量时间点:

术后4-6小时,第1、2、3天

测量方法:

Measure time point of outcome:

Postoperatively 4-6 hours, Day 1, Day 2, Day 3

Measure method:

指标中文名:

术后并发症

指标类型:

次要指标

Outcome:

Postoperative complications

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后死亡率和30天内二次手术率

指标类型:

次要指标

Outcome:

The mortality rate and readmission rate within 30 days after the operation.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中血压最低值

指标类型:

次要指标

Outcome:

The lowest MAP during surgery

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 65 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

统计学人员采用 R 语言"blockrand"包,按试验组与对照组 1:1 的比例进行随机分配,以 ASA 分级对患者进行分层。

Randomization Procedure (please state who generates the random number sequence and by what method):

Statistical personnel used the R language "blockrand" package to perform random allocation in a 1:1 ratio between the trial and control groups, stratified by ASA classification.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

本研究中不同的给药策略对受试者设盲。患者的主麻医生在在手术当日取得随机信封后根据对应的分组采用不同的给药方式对患者进行麻醉诱导和维持。因此主麻医生对患者的分组知情;患者对自身分组不知情;术后随访者和术后数据处理者对患者分组不知情。

Blinding:

In this study, different administration strategies were used to blind the subjects. On the day of the surgery, the patient's anesthesiologist, after obtaining a random envelope, used different administration methods to induce and maintain anesthesia for the patient according to the corresponding group. Therefore, the anesthesiologist is informed of the grouping of patients. The patient was unaware of their own grouping. Postoperative follow-up and postoperative data processors were unaware of the patient grouping.

是否共享原始数据:

IPD sharing

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

不共享原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Do not share

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-12-31 15:01:59