不同麻醉方法对心脏外科手术患者术后认知功能的影响

注册号:

Registration number:

ChiCTR2200065314 

最近更新日期:

Date of Last Refreshed on:

2023-04-21 23:58:22 

注册时间:

Date of Registration:

2022-11-02 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

不同麻醉方法对心脏外科手术患者术后认知功能的影响

Public title:

Effects of different anesthesia methods on postoperative cognitive function in patients undergoing cardiac surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

不同麻醉方法对心脏外科手术患者术后认知功能的影响

Scientific title:

Effects of different anesthesia methods on postoperative cognitive function in patients undergoing cardiac surgery

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:

陈燕桦 

研究负责人:

陈燕桦 

Applicant:

Chen Yanhua 

Study leader:

Chen Yanhua 

申请注册联系人电话:

Applicant telephone:

+86 13978858025

研究负责人电话:

Study leader's
telephone:

+86 13978858025

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:

402009694@qq.com

研究负责人电子邮件:

Study leader's E-mail:

402009694@qq.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:

广西壮族自治区南宁市双拥路6号

研究负责人通讯地址:

广西壮族自治区南宁市双拥路6号

Applicant address:

6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China

Study leader's address:

6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

广西医科大学第一附属医院

Applicant's institution:

The First Affiliated Hospital of Guangxi Medical University

研究负责人所在单位:

广西医科大学第一附属医院

Affiliation of the Leader:

The First Affiliated Hospital of Guangxi Medical 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:

NO.2022-KY-(089)

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:

广西医科大学第一附属医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of the First Affiliated Hospital of Guangxi Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2022-09-07 00:00:00

伦理委员会联系人:

刘影

Contact Name of the ethic committee:

Liu Ying

伦理委员会联系地址:

广西壮族自治区南宁市双拥路6号

Contact Address of the ethic committee:

6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 771 5356557

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:

广西医科大学第一附属医院

Primary sponsor:

The First Affiliated Hospital of Guangxi Medical University

研究实施负责(组长)单位地址:

广西壮族自治区南宁市双拥路6号

Primary sponsor's address:

6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 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):

广西壮族自治区

市(区县):

Country:

China

Province:

Guangxi Zhuang Autonomous Region

City:

Nanning

单位(医院):

广西医科大学第一附属医院

具体地址:

广西壮族自治区南宁市双拥路6号

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University

Address:

6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China

经费或物资来源:

自筹

Source(s) of funding:

self-raised

研究疾病:

心脏疾病  

Target disease:

Heart valve disease

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

探讨不同麻醉方法对心脏外科手术患者术后认知功能的影响。  

Objectives of Study:

To investigate the effect of different anesthesia methods on postoperative cognitive function in patients undergoing cardiac surgery.

药物成份或治疗方案详述:

A 组 (丙泊酚组) 患者采用的麻醉诱导为:咪达唑仑 0.04mg/kg+依托咪酯 0.2mg/kg+舒芬太尼 0.8μg/kg+顺阿曲库铵 0.2mg/kg ,麻醉维持:丙泊酚 2- 10mg/(kg /h)+顺式阿曲库铵 0.2mg/(kg / h)+舒芬太尼 0.2 μg/(kg /h) ,根据BIS值调整丙泊酚的速度,非体外循环期间BIS 值保持在 40~50 之间,体外循环期间 BIS 值保持在 30~40 之间。 B 组 (瑞马唑仑组) 患者采用的麻醉诱导为:咪达唑仑 0.04mg/kg+依托咪酯 0.2mg/kg+舒芬太尼 0.8μg/kg+顺阿曲库铵 0.2mg/kg ,麻醉维持:瑞马唑仑 0. 2mg/(kg /h)+丙泊酚 2-8mg/(kg /h)+顺式阿曲库铵 0.2mg/(kg /h)+舒芬 太尼 0.2 μg/(kg /h) ,根据 BIS 值调整丙泊酚的速度,非体外循环期间 BIS值保持在 40~50 之间,体外循环期间 BIS 值保持在 30~40 之间。 C 组 (右美托咪定组) 患者采用的麻醉诱导为:咪达唑仑 0.04mg/kg+ 依托咪酯 0.2mg/kg+舒芬太尼 0.8μg/kg+顺阿曲库铵 0.2mg/kg ,麻醉维持: 右美托咪定 0.3μg/(kg /h)+丙泊酚 2-8mg/(kg /h)+顺式阿曲库铵 0.2mg/(kg /h)+ 舒芬太尼 0.2 μg/(kg /h) ,根据 BIS 值调整丙泊酚的速度,非体外循环期间 BIS 值保持在 40~50 之间,体外循环期间 BIS 值保持在 30~40 之间。 

Description for medicine or protocol of treatment in detail:

Anesthesia induction for patients in group A (propofol group): midazolam 0.04mg/kg+etoposide Imitate 0.2mg/kg+sufentanil 0.8 μg/kg+cisatracurium 0.2mg/kg, anesthesia maintenance: propofol Phenol 2 - 10mg/(kg /h)+cisatracurium 0.2mg/(kg / h)+sufentanil 0.2 μ g/(kg / h) according to the BIS value adjusts the speed of propofol. During off-pump circulation, the BIS value remains between 40 and 50. The BIS value remains between 30 and 40 during the cycle. Anesthesia induction adopted by patients in group B (Remimazolam group): Midazolam 0.04mg/kg+Yitromidate 0.2mg/kg+sufentanil 0.8 μg/kg+cisatracurium 0.2mg/kg, anesthesia maintenance: Remimazolam 0.2mg/(kg /h)+propofol 2-8mg/(kg/ h)+cis atracurium 0.2mg/(kg / h)+sulfentylenol 0.2 μ g/(kg / h), adjust the speed of propofol according to the BIS value, and BIS value during off pump circulation. Keep the BIS value between 40 and 50, and keep the BIS value between 30 and 40 during cardiopulmonary bypass. Anesthesia induction for patients in group C (dexmedetomidine group): midazolam 0.04mg/kg+Etomidate 0.2mg/kg+sufentanil 0.8 μg/kg+cisatracurium 0.2mg/kg, anesthesia maintenance: Dextrmedetomidine 0.3 μ g/(kg / h)+propofol 2-8mg/(kg / h)+cis atracurium 0.2mg/(kg / h)+Sufentanil 0.2 μ g/(kg /h), adjust the speed of propofol according to the BIS value, during non cardiopulmonary bypass. The BIS value remained between 40 and 50, and during cardiopulmonary bypass, the BIS value remained between 30 and 40. 

纳入标准:

Inclusion criteria

排除标准:

1. 对苯二氮卓类药物、阿片类药物、丙泊酚、纳洛酮等药物及其药物组分过敏或禁忌者; 2. 术前左室射血分数小于 40%; 3. 既往有心脏手术史; 4. 严重心肺、肝肾系统的明显异常的患者; 5. 术前存在认知功能异常或精神症状患者; 6. 术前一个月内存在心力衰竭; 7. 药物及酒精成瘾者; 8. 不同意参加本研究的患者。

Exclusion criteria:

1. Allergies or contraindications to benzodiazepines, opioids, propofol, naloxone and other drugs and their drug components; 2. The left ventricular ejection fraction was less than 40% before operation; 3. Previous history of cardiac surgery; 4. Patients with severe abnormal cardio pulmonary, hepatorenal systems; 5. Patients with cognitive dysfunction or mental symptoms before operation; 6. There was heart failure within one month before operation; 7. Drug and alcohol addicts; 8. Patients who do not agree to participate in this study.

研究实施时间:

Study execute time:

From 2022-11-03 00:00:00 To 2025-10-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2022-11-03 00:00:00 To 2025-10-31 00:00:00

干预措施:

Interventions:

组别:

A 组 (丙泊酚组)

样本量:

20

Group:

Group A (propofol group)

Sample size:

干预措施:

诱导后即刻泵注丙泊酚2-10mg/kg/h和等容积生理盐水10mL/h维持适度镇静至手术结束。

干预措施代码:

Intervention:

Immediately after induction, propofol 2-10mg/kg/h and equal volume of normal saline 10mL/h were pumped to maintain moderate sedation until the end of surgery.

Intervention code:

组别:

B 组 (瑞马唑仑组)

样本量:

20

Group:

Group B (Remimazolam group)

Sample size:

干预措施:

诱导后即刻泵注丙泊酚2-8mg/kg/h和瑞马唑仑0.2mg/kg/h维持适度镇静至手术结束。

干预措施代码:

Intervention:

Propofol 2-8mg/kg/h and remimazolam 0.2mg/kg/h were pumped immediately after induction to maintain moderate sedation until the end of surgery.

Intervention code:

组别:

C 组 (右美托咪定组)

样本量:

20

Group:

Group C (dexmedetomidine group)

Sample size:

干预措施:

诱导后即刻泵注丙泊酚2-8mg/kg/h和右美托咪定0.3ug/kg/h维持适度镇静至手术结束。

干预措施代码:

Intervention:

Propofol 2-8mg/kg/h and dexmedetomidine 0.3ug/kg/h were pumped immediately after induction to maintain moderate sedation until the end of surgery.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广西壮族自治区 

市(区县):

 

Country:

China

Province:

Guangxi Zhuang Autonomous Region

City:

单位(医院):

广西医科大学第一附属医院 

单位级别:

三级甲等医院 

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

简易智能精神状态检查量表

指标类型:

主要指标

Outcome:

Mini mental state examination

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

蒙特利尔评分量表

指标类型:

主要指标

Outcome:

Montreal Cognitive Assessment Scale

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

麻醉深度监测

指标类型:

主要指标

Outcome:

Monitoring of anesthesia depth

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

平均动脉压

指标类型:

主要指标

Outcome:

mean arterial pressure

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

心率

指标类型:

主要指标

Outcome:

heart rate

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

视觉模拟评分

指标类型:

次要指标

Outcome:

Visual Analog Assessment Scale

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:

NA

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:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 65 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):

在随机数字表按照顺序连续取60个随机数字,采用随机区组的方法进行随机分组。

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

In the random number table, 60 random numbers are taken consecutively in order, and the random block method is used for random grouping.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

none

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

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):

发表论文

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

article publishing in journal

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:

Case record form

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2022-11-02 08:47:36