基于脑电小波指数的人工智能给药系统临床应用

注册号:

Registration number:

ChiCTR2100049859 

最近更新日期:

Date of Last Refreshed on:

2022-04-16 07:48:52 

注册时间:

Date of Registration:

2021-08-10 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于脑电小波指数的人工智能给药系统临床应用

Public title:

Automated Titration Guided by Wavelet Index: A Randomized Multicenter Study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于脑电小波指数的人工智能给药系统临床应用

Scientific title:

Automated Titration Guided by Wavelet Index: A Randomized Multicenter Study

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:

何士凤 

研究负责人:

孙振涛 

Applicant:

He Shifeng 

Study leader:

Sun Zhentao 

申请注册联系人电话:

Applicant telephone:

+86 15736737328

研究负责人电话:

Study leader's
telephone:

+86 15736737328

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:

hsfsj8123@163.com

研究负责人电子邮件:

Study leader's E-mail:

hsfsj8123@163.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:

河南省郑州市二七区建设东路1号

研究负责人通讯地址:

河南省郑州市二七区建设东路1号

Applicant address:

1 Jianshe Road East, Erqi District, Zhengzhou, He'nan, China

Study leader's address:

1 Jianshe Road East, Erqi District, Zhengzhou, He'nan, China

申请注册联系人邮政编码:

Applicant postcode:

450018

研究负责人邮政编码:

Study leader's postcode:

450018

申请人所在单位:

郑州大学第一附属医院

Applicant's institution:

The First Affiliated Hospital of Zhengzhou University

研究负责人所在单位:

郑州大学第一附属医院

Affiliation of the Leader:

The First Affiliated Hospital of Zhengzhou University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2021-KY-1106-002

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:

郑州大学第一附属医院科研和临床试验伦理委员会

Name of the ethic committee:

Scientific Research and Clinical Trial Ethics Committee of the First Affiliated Hospital of Zhengzhou University

伦理委员会批准日期:

Date of approved by ethic committee:

2022-02-04 00:00:00

伦理委员会联系人:

田丽

Contact Name of the ethic committee:

Tian Li

伦理委员会联系地址:

河南省郑州市二七区建设东路1号

Contact Address of the ethic committee:

1 Jianshe Road East, Erqi District, Zhengzhou, He'nan, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

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:

郑州大学第一附属医院

Primary sponsor:

The First Affiliated Hospital of Zhengzhou University

研究实施负责(组长)单位地址:

河南省郑州市二七区建设东路1号

Primary sponsor's address:

1 Jianshe Road East, Erqi District, Zhengzhou, He'nan, 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):

河南

市(区县):

郑州

Country:

China

Province:

He'nan

City:

Zhengzhou

单位(医院):

郑州大学第一附属医院

具体地址:

二七区建设东路1号

Institution
hospital:

The First Affiliated Hospital of Zhengzhou University

Address:

1 Jianshe Road East, Erqi District

经费或物资来源:

自费

Source(s) of funding:

self-funded

研究疾病:

腹腔镜结直肠癌  

Target disease:

colorectal cancer

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

主要目的:拟探讨以WLi和PTi为反馈信号的人工智能给药系统在结直肠外科手术麻醉诱导和维持的临床应用效果。  

Objectives of Study:

Main purpose: to investigate the clinical application effect of artificial intelligence drug delivery system with WLi and PTi as feedback signals in the induction and maintenance of anesthesia in colorectal surgery.

药物成份或治疗方案详述:

所有患者常规禁食禁饮,无术前用药。入手术室后建立外周静脉通道,常规吸氧,连接心电监护及麻醉全深度监护仪(HXD-I)。局麻下行桡动脉穿刺置管测压,取诱导前平均动脉压为基础血压,超声引导下行右侧颈内静脉穿刺置管。充分预充氧后,舒芬太尼0.5~0.6mg/kg静脉缓慢推注,推注完3min后,IT组开始运行易飞科技人工智能给药系统丙泊酚通路,CT组开启恒速泵丙泊酚通路。待患者意识消失后,静脉推注顺式阿曲库铵0.15mg/kg,当WLi值下降至60以下并稳定30s以上时,可视喉镜引导下气管插管,进入麻醉维持阶段,开启瑞芬太尼输注通路。IT组中人工智能给药系统根据反馈的WLi、PTi值自动调整瑞芬太尼和丙泊酚输注速率,维持WLi、PTi值为40~60;CT组则由麻醉医师根据WLi、PTi值手动调整瑞芬太尼和丙泊酚输注速率,维持相同目标。在MAP<65mmHg或SBP<90mmHg时,IT组触发单次事件自动推注去甲肾上腺素同时于手持终端示警(如图2所示);CT组由麻醉医师手动静注去甲肾上腺素,每次8mg。两组均行容量控制通气,设置潮气量6~8ml/kg、吸呼比1∶2、氧流量2L/min,适当调节呼吸频率,维持PETCO2在35~45mmHg,间断追加顺阿曲库铵。所有患者术中WLi/PTi>60或<40,持续超过3分钟以上仍不能至目标值时,添加手动干预,加深或者减浅麻醉深度,维持WLi/PTi值为40~60。 由同一组技术熟练的手术医生实施手术,纳入患者均采用相同的腹腔镜切口,术中CO2气腹压维持在12mmHg。缝皮快结束时停止瑞芬太尼、丙泊酚输注,同时静脉推注地佐辛5mg、帕洛诺司琼0.25mg。手术结束后转入PACU,等待患者苏醒,拔除气管导管,待患者Aldert护理评分达到10分后送回病房。 

Description for medicine or protocol of treatment in detail:

All patients routinely fasted and fasted without preoperative medication. After entering the operating room, peripheral venous access was established, oxygen inhalation was routine, and ECG monitoring and anesthesia full depth monitor (HXD-I) were connected. Under local anesthesia, radial artery puncture and catheterization were performed to measure the pressure. The mean arterial pressure before induction was taken as the basic blood pressure, and the right internal jugular vein was punctured and catheterized under ultrasound guidance. After sufficient pre-oxygenation, sufentanil 0.5-0.6 mg/kg was slowly injected intravenously. After 3 minutes of bolus injection, the IT group started to run the propofol pathway of Yifei Technology artificial intelligence drug delivery system, and the CT group started the constant-speed pump. Propofol pathway. After the patient's consciousness disappeared, cis-atracurium 0.15 mg/kg was injected intravenously. When the WLi value dropped below 60 and stabilized for more than 30 s, the tracheal intubation was guided by a video laryngoscope, and the anesthesia maintenance stage was entered. Fentanyl infusion pathway. In the IT group, the artificial intelligence drug delivery system automatically adjusted the infusion rates of remifentanil and propofol according to the feedback WLi and PTi values, maintaining the WLi and PTi values ??between 40 and 60; Remifentanil and propofol infusion rates were manually adjusted to maintain the same target. When MAP<65mmHg or SBP<90mmHg, the IT group triggered a single event of automatic bolus injection of norepinephrine at the same time as an alarm on the handheld terminal (as shown in Figure 2); in the CT group, norepinephrine was manually injected by the anesthesiologist. 8mg each time. Both groups underwent volume-controlled ventilation, with tidal volume of 6-8 ml/kg, inspiratory ratio of 1:2, and oxygen flow of 2 L/min, appropriate adjustment of respiratory rate, maintenance of PETCO2 at 35-45 mmHg, and intermittent addition of cisatracurium. In all patients intraoperative WLi/PTi>60 or <40, if the target value was still not reached for more than 3 minutes, manual intervention was added to deepen or reduce the depth of anesthesia to maintain the WLi/PTi value of 40-60. The operation was performed by the same group of skilled surgeons, and the included patients all used the same laparoscopic incision, and the intraoperative CO2 pneumoperitoneal pressure was maintained at 12 mmHg. At the end of the suture, the infusion of remifentanil and propofol was stopped, and dezocine 5 mg and palonosetron 0.25 mg were intravenously injected at the same time. After the operation, the patient was transferred to PACU, waited for the patient to wake up, removed the tracheal tube, and returned to the ward when the patient's Aldert nursing score reached 10 points. 

纳入标准:

Inclusion criteria

排除标准:

1.术前患有中枢神经系统和心理疾病;
2.术前患有严重的心律失常;
3.术前患有甲亢、糖尿病等内分泌疾病;
4.术前有神经肌肉系统疾病。

Exclusion criteria:

1. Suffering from central nervous system and psychological diseases before surgery;
2. Severe arrhythmia before surgery;
3. Suffering from endocrine diseases such as hyperthyroidism and diabetes before surgery;
4. Preoperative neuromuscular disease.

研究实施时间:

Study execute time:

From 2022-02-10 00:00:00 To 2022-07-10 00:00:00  

征募观察对象时间:

Recruiting time:

From 2022-02-10 00:00:00 To 2022-07-10 00:00:00

干预措施:

Interventions:

组别:

两组

样本量:

70

Group:

Two groups

Sample size:

干预措施:

麻醉手术

干预措施代码:

Intervention:

anesthesia surgery

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

河南 

市(区县):

 

Country:

China

Province:

He'nan

City:

单位(医院):

郑州大学第一附属医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Zhengzhou University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

BMI

指标类型:

附加指标

Outcome:

Body Mass Index

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

去甲肾上腺素的用量

指标类型:

主要指标

Outcome:

the does of norepinephrine

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

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:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 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):

计算机-随机数字表法

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

Computer-random number table

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:

单盲:只对研究对象和数据收集者设盲

Blinding:

是否共享原始数据:

IPD sharing

否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):

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

no

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:

数据采集:手麻记录单,病例记录表(Case Record Form, CRF)

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

Data collection: Manual anesthesia Record sheet, Case Record Form (CRF)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2021-08-10 11:43:32