比较羟考酮与舒芬太尼对下肢骨折手术患者的术后镇痛效应

注册号:

Registration number:

ChiCTR2400091258 

最近更新日期:

Date of Last Refreshed on:

2024-10-24 10:34:21 

注册时间:

Date of Registration:

2024-10-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

比较羟考酮与舒芬太尼对下肢骨折手术患者的术后镇痛效应

Public title:

Compare the postoperative analgesic effect of oxycodone and sufentanil in patients with lower extremity fractures

注册题目简写:

English Acronym:

研究课题的正式科学名称:

比较羟考酮与舒芬太尼对下肢骨折手术患者的术后镇痛效应

Scientific title:

Compare the postoperative analgesic effect of oxycodone and sufentanil in patients with lower extremity fractures

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:

李水英 

研究负责人:

吕治全 

Applicant:

lishuiying 

Study leader:

lvzhiquan 

申请注册联系人电话:

Applicant telephone:

+86 151 2322 9435

研究负责人电话:

Study leader's
telephone:

+86 159 2308 2966

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:

616024527@qq.com

研究负责人电子邮件:

Study leader's E-mail:

lzq6656@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:

重庆市沙坪坝上桥新街青秀阅山1-15-1

研究负责人通讯地址:

重庆市永川区萱花路 439 号

Applicant address:

Qingxiu Yueshan 1-15-1, Shangqiao New Street, Shapingba, Chongqing

Study leader's address:

No.439, Xuanhua Road, Yongchuan Chongqing

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:

重庆市公共卫生医疗救治中心

Applicant's institution:

Chongqing Public Health and Medical Treatment Center

研究负责人所在单位:

重庆医科大学附属永川医院

Affiliation of the Leader:

The Affiliated Yongchuan Hospital of Chongqing 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:

YCLCKX2023007

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:

重庆医科大学附属永川医院临床研究科学性审查委员会

Name of the ethic committee:

Clinical Research Scientific Science Review Committee of Yongchuan Hospital affiliated to Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2023-03-28 00:00:00

伦理委员会联系人:

王群波

Contact Name of the ethic committee:

wangqunbo

伦理委员会联系地址:

重庆市永川区萱花路 439 号

Contact Address of the ethic committee:

No.439, Xuanhua Road, Yongchuan Chongqing

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 8538 1616

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:

重庆医科大学附属永川医院

Primary sponsor:

The Affiliated Yongchuan Hospital of Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市永川区萱花路 439 号

Primary sponsor's address:

No.439, Xuanhua Road, Yongchuan Chongqing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆市

市(区县):

Country:

China

Province:

chongqing

City:

单位(医院):

重庆医科大学附属永川医院

具体地址:

重庆市永川区萱花路 439 号

Institution
hospital:

The Affiliated Yongchuan Hospital of Chongqing Medical University

Address:

No.439, Xuanhua Road, Yongchuan Chongqing

国家:

中国

省(直辖市):

重庆市

市(区县):

Country:

china

Province:

chongqing

City:

单位(医院):

重庆市公共卫生医疗救治中心

具体地址:

重庆市沙坪坝区歌乐山保育路109号

Institution
hospital:

Chongqing Public Health Medical Center

Address:

No. 109, Glorious Hill Conservation Road, Shapingba District, Chongqing, China

经费或物资来源:

白求恩公益基金会

Source(s) of funding:

The Bethune Charity Foundation

研究疾病:

下肢骨折  

Target disease:

Fracture of lower limb

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:

本研究通过双盲随机对照试验,观察与舒芬太尼相比,患者围术期应用羟考酮对下肢骨折手术后早期静息状态下疼痛的影响  

Objectives of Study:

In this study, a double-blind randomized controlled trial was conducted to observe the effect of perioperative application of oxycodone in patients on pain at rest in the early postoperative period after lower extremity fracture surgery compared with sufentanil

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1)拒绝参与试验的患者;2)对试验药物过敏或既往有严重不 良反应的患者;3)术前长期服用镇静或镇痛药物的患者;4)既往精神分裂症、癫痫、 帕金森病、重症肌无力或严重痴呆史的患者;5)因听力、视力或语言障碍而无法交 流的患者;6)合并严重肝功能障碍的患者(Child-Pugh 分级 C 级);7)合并严重肾 功能障碍的患者(需要肾脏替代治疗);8)伴有创伤性休克的患者。

Exclusion criteria:

1) patients who refuse to participate in the trial; 2) patients allergic to the trial drug or with previous serious adverse reactions; 3) patients with long preoperative sedative or analgesic drugs; 4) patients with previous schizophrenia, epilepsy, Parkinson's disease, myasthenia gravis, or severe dementia; 5) patients unable to communicate due to hearing, visual or language impairment; 6) patients with severe liver dysfunction (Child-Pugh grade C); 7) patients with severe renal dysfunction (requiring renal replacement therapy); 8) patients with traumatic shock.

研究实施时间:

Study execute time:

From 2024-11-01 00:00:00 To 2025-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-11-01 00:00:00 To 2025-06-30 00:00:00

干预措施:

Interventions:

组别:

实验组

样本量:

58

Group:

experimental group

Sample size:

干预措施:

1.全身麻醉方案:麻醉诱导方案如下:羟考酮 0.15mg/kg,依托咪酯 0.3mg/kg,罗库溴铵0.8mg/kg,充分给氧去氮后经口可视喉镜下插入气管导管,行控制通气,潮气量 10ml/kg,频率 12-14 次/min。麻醉维持:术中予以七氟烷 1-1.3MAC 持续吸入,维库溴铵 0.05mg/kg.h 持续泵注,维持患者BIS值 40-60。若患者心率或血压升高超过基础值 30%,静脉注射羟考酮 0.04mg/kg。若患者血压心率降低超过基础值 30%,给予麻黄碱 10-15mg处理。 2.椎管内麻醉方案:患者取侧卧位,选择L3~L4间隙进行腰硬联合穿刺,穿刺成功后在蛛网膜下腔注入0.5%的布比卡因 1.5-2.0ml,退出腰穿针,经硬膜外穿刺针置入导管,深度3-4cm,使麻醉平面达T8-T10。术中血压和心率均按照维持±20%基线数值进行调节。 术后镇痛:羟考酮 0.6mg/kg+酮咯酸丁三醇 90mg,以生理盐水稀释至 100ml,背景输注速度 2ml/h,单次追加剂量 0.5ml,锁定时间 15min。

干预措施代码:

Intervention:

1. General anesthesia program: anesthesia induction program is as follows: oxycodone 0.15mg/kg, etomidate 0.3mg/kg, rocuronium bromide 0.8mg/kg, adequate oxygen denitrification after oral visualization laryngoscopic insertion of the tracheal tube, controlled ventilation, tidal volume of 10ml/kg, the frequency of 12-14 times/min. anesthesia maintenance: intraoperative sevoflurane 1-1.3MAC continuous inhalation, vecuronium bromide 0.05mg/kg.h continuous pumping to maintain the patient's BIS value 40-60. Anesthesia maintenance: sevoflurane 1-1.3MAC is continuously inhaled, vecuronium bromide 0.05mg/kg.h is continuously pumped to maintain the patient's BIS value of 40-60; if the patient's heart rate or blood pressure increases more than 30% of the basal value, oxycodone 0.04mg/kg is injected intravenously, and if the patient's blood pressure and heart rate decreases more than 30% of the basal value, ephedrine 10-15 mg is given to deal with the situation. 2. Intravertebral anesthesia program: the patient takes the lateral position, selects the L3~L4 gap for lumbar and hard joint puncture, after successful puncture, injects 1.5-2.0ml of 0.5% bupivacaine into the subarachnoid space, withdraws the lumbar puncture needle, and inserts the catheter through the epidural puncture needle to a depth of 3-4cm, so as to make the plane of anesthesia up to T8-T10. during the operation, the blood pressure and the heart rate were adjusted in accordance with the maintenance of the baseline value of ±20%. Postoperative analgesia: oxycodone Postoperative analgesia: oxycodone 0.6mg/kg + ketorolac butanetriol 90mg, diluted to 100ml with saline, background infusion rate 2ml/h, single additional dose 0.5ml, lock time 15min.

Intervention code:

组别:

对照组

样本量:

58

Group:

control group

Sample size:

干预措施:

对照组麻醉诱导中以舒芬太尼 0.4μg/kg 代替羟考酮,麻醉维持中以镇痛药追加剂量以舒芬太尼 0.04μg/kg 代替羟考酮,术后镇痛中以舒芬太尼 2μg/kg 代替羟考酮,其余方案与实验组相同。

干预措施代码:

Intervention:

In the control group, sufentanil 0.4 μ g / kg was replaced by oxycodone, in the anesthesia maintenance with analgesics, sufentanil 0.04 μ g / kg was replaced by oxycodone, and sufentanil 2 μ g / kg was used for oxycodone, and the remaining regimen was the same as in the experimental group.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆市 

市(区县):

 

Country:

China

Province:

chongqing

City:

单位(医院):

重庆医科大学附属永川医院 

单位级别:

三甲 

Institution
hospital:

The Affiliated Yongchuan Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

下肢骨折手术患者术后镇痛应用舒芬太尼或羟考酮对术后第 3h、12h、24h、48h 静息状态下 NRS 评分情况

指标类型:

主要指标

Outcome:

Postoperative analgesic application of sufentanil or oxycodone in patients undergoing lower extremity fracture surgery on NRS scores at rest at the 3rd, 12th, 24th, and 48th postoperative hours

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 48h 内静息状态下中重度疼痛(NRS≥4)发生率的影响

指标类型:

主要指标

Outcome:

effects on the incidence of moderate to severe pain (NRS 4) in resting state within 48h

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

患者麻醉完全恢复后 48h 内下肢活动中重度疼痛(NRS≥4) 的发生率

指标类型:

主要指标

Outcome:

Incidence of moderate-to-severe pain (NRS≥4) in lower extremity activities within 48h after patients fully recovered from anesthesia

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

测量术前、术中、术后 48h 内静息状态下血清皮质醇激素水 平和儿茶酚胺类肾上腺素水平的变化情况。5)患者术后额外按压镇痛泵的次 数和实施神经阻滞的数量

指标类型:

主要指标

Outcome:

Changes in serum cortisol hormone levels and catecholamine epinephrine levels were measured before, during, and within 48h after surgery.5) The number of additional postoperative pressure presses on the analgesic pump and the number of nerve blocks performed

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后恶心、呕吐等并发症的发生率

指标类型:

主要指标

Outcome:

Incidence of postoperative complications such as nausea and vomiting

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

患者从手术结束至首次开始功能锻炼的时间

指标类型:

次要指标

Outcome:

Time from the end of surgery to the first start of functional exercise

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

下肢深静脉血栓发生率

指标类型:

次要指标

Outcome:

The incidence of deep vein thrombosis in the lower limbs

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后住院时间

指标类型:

次要指标

Outcome:

Postoperative hospital stay

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:

血清皮质醇激素水平和儿茶酚胺类肾上腺素水平

组织:

Sample Name:

Serum cortisol hormone levels and catecholamine epinephrine levels

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 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):

由负责统计学人员采用 SAS 软件,生成随机数字(区组长度 4,组间比 1:1)并放入连续编号的不透明信封。研究者按患者入组顺序,依次从前至后拿取信封,根据信封内数字所对应试验组或对照组,将患者随机分组。

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

The statistics cian used SAS software to generate random numbers (block length 4, group ratio 1:1) and put them in continuously numbered opaque envelopes. The investigator took the envelope in the order of enrolling the patients, and randomized the patients according to the corresponding test group or the control group according to the number in the envelope.

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

是Yes

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):

邮箱616024527@qq.com

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

Mailbox, 616024527@qq.com

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:

病例采集表和SPAs等

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

Case collection form and the SPAs et al

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:

 2024-10-24 10:34:15