布比卡因脂质体腹横肌平面阻滞联合静脉PCA在剖宫产术后镇痛的应用研究

注册号:

Registration number:

ChiCTR2300077433 

最近更新日期:

Date of Last Refreshed on:

2024-05-27 15:30:53 

注册时间:

Date of Registration:

2023-11-08 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

布比卡因脂质体腹横肌平面阻滞联合静脉PCA在剖宫产术后镇痛的应用研究

Public title:

Application of Bupivacaine Liposome Abdominal Transverse Muscle Planar Block Combined with Intravenous PCA for Postoperative Analgesia after Cesarean Section

注册题目简写:

English Acronym:

研究课题的正式科学名称:

布比卡因脂质体腹横肌平面阻滞联合静脉PCA在剖宫产术后镇痛的应用研究

Scientific title:

Application of Bupivacaine Liposome Abdominal Transverse Muscle Planar Block Combined with Intravenous PCA for Postoperative Analgesia after Cesarean Section

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:

黄瑞平 

研究负责人:

张光英 

Applicant:

Huang Ruiping 

Study leader:

Zhuang Guangying 

申请注册联系人电话:

Applicant telephone:

+86 180 7813 6209

研究负责人电话:

Study leader's
telephone:

+86 150 7717 6909

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:

445016549@qq.con

研究负责人电子邮件:

Study leader's E-mail:

86799488@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:

广西南宁市青秀区双拥路6号

研究负责人通讯地址:

广西南宁市青秀区双拥路6号

Applicant address:

6 Shuangyong Road, Qingxiu District, Nanning, Guangxi

Study leader's address:

6 Shuangyong Road, Qingxiu District, Nanning, Guangxi

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:

2023-K246-01

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:

2023-09-21 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:

广西南宁市青秀区双拥路6号

Contact Address of the ethic committee:

6 Shuangyong Road, Qingxiu District, Nanning, Guangxi

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 771 535 6557

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:

广西南宁市青秀区双拥路6号

Primary sponsor's address:

6 Shuangyong Road, Qingxiu District, Nanning, Guangxi

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

市(区县):

Country:

China

Province:

Guangxi

City:

单位(医院):

广西医科大学第一附属医院

具体地址:

广西南宁市青秀区双拥路6号

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University

Address:

6 Shuangyong Road, Qingxiu District, Nanning, Guangxi

经费或物资来源:

北京弘医医学发展资金会临床研究资金

Source(s) of funding:

Beijing Hongyi Medical Development Foundation

研究疾病:

剖宫产术后疼痛  

Target disease:

Pain after cesarean section

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:

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:

通过观察剖宫产术后采用长效局麻药布比卡因脂质体行双侧腹横肌平面阻滞联合布托啡诺静脉镇痛泵的镇痛模式与连续硬膜外镇痛相比,观察镇痛效果探讨该镇痛模式是否减少静脉镇痛药物用量,提高术后镇痛效果;观察术后肠鸣音恢复时间、排气时间,检测术前及术后第3天血清胃动素水平、二胺氧化酶及D-乳酸浓度水平探讨该模式是否可加快胃肠道功能的恢复,缩短住院时间以达到促进产妇快速康复的目的。  

Objectives of Study:

By observing the analgesic effect of using long-acting local anesthetic bupivacaine liposomes for bilateral transverse abdominal muscle plane block combined with butorphanol intravenous analgesia pump after cesarean section compared to continuous epidural analgesia, we investigate whether this analgesic mode reduces the dosage of intravenous analgesics and improves postoperative analgesic effect; Observe the recovery time and exhaust time of postoperative bowel sounds, detect the levels of serum motilin, diamine oxidase, and D-lactate before and on the third day after surgery, and explore whether this mode can accelerate the recovery of gastrointestinal function, shorten hospitalization time, and promote rapid recovery of postpartum women.

药物成份或治疗方案详述:

3组产妇均在连续硬膜外麻醉下完成剖宫产术,手术结束后,根据术后镇痛方案分组为:A组使用腹横肌平面阻滞+静脉自控镇痛( PCIA) ,用药配制:枸橼酸舒芬太尼注射液100 ug + 酒石酸布托菲诺注射液6 mg + 昂丹司琼16 mg + 0.9% 氯化钠注射稀释至 150 ml,PCIA 泵的参数设置:预充5ml,背景剂量 3 ml /h,PCA剂量 3 ml,锁定时间 20 min,持续使用48小时。同时,手术切口无菌覆盖后行超声引导下双侧腹横肌平面阻滞,每侧给予0.067%布比卡因脂质体+4mg地塞米松注射液20 mL缓慢注射。 B组使用静脉自控镇痛( PCIA) ,用药配制:枸橼酸舒芬太尼注射液100 ug + 酒石酸布托菲诺注射液6 mg + 昂丹司琼16 mg + 0.9% 氯化钠注射稀释至 150 ml,PCIA 泵的参数设置:预充5ml,背景剂量 3 ml /h,PCA剂量 3 ml,锁定时间 20 min,持续使用48小时。 C组连接硬膜外镇痛泵(PCEA),用药配制:枸橼酸芬太尼注射液0.4 mg+0.75 % 盐酸罗哌卡因225 mg + 0.9% 氯化钠注射液稀释至150 ml , 参数设置:预充5ml,背景剂量 3 ml/h,PCA剂量3 ml,锁定时间 20 min,持续使用48小时。 镇痛泵药液继续配置够48小时使用量,如静息VAS评分≥4分且产妇要求镇痛补救,给予布洛芬片0.2g/次,4-6小时/次,记录布洛芬镇痛补救例数。 

Description for medicine or protocol of treatment in detail:

All three groups of postpartum women underwent cesarean section under continuous epidural anesthesia. After the surgery, they were divided into two groups according to the postoperative pain relief plan: Group A received plane block of the transverse abdominal muscle and patient-controlled intravenous analgesia (PCIA). The medication was prepared as follows: 100 ug of sufentanil citrate injection, 6 mg of butorphanol tartrate injection, 16 mg of ondansetron, and 0.9% sodium chloride injection diluted to 150 ml. The parameters of the PCIA pump were pre charged with 5ml, background dose of 3 ml/h, and PCA dose of 3 ml, Lock for 20 minutes and continue to use for 48 hours. Meanwhile, after sterile coverage of the surgical incision, ultrasound guided bilateral transverse abdominal muscle plane block was performed, and each side was slowly injected with 0.067% bupivacaine liposome+4 mg dexamethasone injection in 20 mL. Group B was treated with intravenous patient-controlled analgesia (PCIA), with medication formulation of 100 ug of sufentanil citrate injection+6 mg of butorphanol tartrate injection+16 mg of ondansetron+0.9% sodium chloride injection diluted to 150 ml. The PCIA pump parameters were set to pre charge 5ml, background dose 3 ml/h, PCA dosage 3 ml, locking time 20 minutes, and continuous use for 48 hours. Group C was connected to an epidural analgesia pump (PCEA), with medication formulation: fentanyl citrate injection 0.4 mg+0.75% ropivacaine hydrochloride 225 mg+0.9% sodium chloride injection diluted to 150 ml. Parameter settings: pre charge 5ml, background dose 3 ml/h, PCA dose 3 ml, locking time 20 minutes, continuous use for 48 hours. Continue to prepare the analgesic pump solution for 48 hours of use. If the resting VAS score is ≥ 4 and the mother requests analgesic relief, give ibuprofen tablets 0.2g/time, 4-6 hours/time, and record the number of cases of ibuprofen analgesic relief. 

纳入标准:

Inclusion criteria

排除标准:

1.资料不完善; 2.急诊剖宫产; 3.术前合并胃肠疾病,如慢性胃炎、结肠炎、肠结核、肠易激综合征; 4.合并有严重的心、脑、肺、肝、肾疾病; 5.存在椎管内麻醉禁忌症、慢性疼痛疾病史、腹壁皮肤感染破损及研究所用药物过敏史。

Exclusion criteria:

1. Incomplete data; 2. Emergency cesarean section; 3. Preoperative complications of gastrointestinal diseases, such as chronic gastritis, colitis, intestinal tuberculosis, and irritable bowel syndrome; 4. Concomitant with severe heart, brain, lung, liver, and kidney diseases; 5. There are contraindications to spinal anesthesia, a history of chronic pain disorders, abdominal wall skin infection and damage, and a history of drug allergies used in the research institute.

研究实施时间:

Study execute time:

From 2023-11-15 00:00:00 To 2026-09-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-11-15 00:00:00 To 2026-09-30 00:00:00

干预措施:

Interventions:

组别:

A组

样本量:

40

Group:

group A

Sample size:

干预措施:

超声引导下使用布比卡因脂质体实施腹横肌平面阻滞联合静脉PCA

干预措施代码:

Intervention:

Ultrasound guided use of bupivacaine liposomes for horizontal abdominal muscle block combined with intravenous PCA

Intervention code:

组别:

B组

样本量:

40

Group:

group B

Sample size:

干预措施:

采用静脉自控镇痛

干预措施代码:

Intervention:

Using intravenous patient-controlled analgesia

Intervention code:

组别:

C组

样本量:

40

Group:

group C

Sample size:

干预措施:

采用连续硬膜外自控镇痛

干预措施代码:

Intervention:

Continuous epidural controlled analgesia

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广西省 

市(区县):

 

Country:

China

Province:

Guangxi

City:

单位(医院):

广西医科大学第一附属医院 

单位级别:

三甲 

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:

术后72小时镇痛效果评分

指标类型:

主要指标

Outcome:

72 hour postoperative analgesic effect score

Type:

Primary indicator

测量时间点:

术后6小时,12小时,24小时,48小时,72小时

测量方法:

Measure time point of outcome:

Postoperative 6 hours, 12 hours, 24 hours, 48 hours, 72 hours

Measure method:

指标中文名:

术后肠鸣音恢复时间

指标类型:

次要指标

Outcome:

Postoperative recovery time of bowel sounds

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清胃动素水平、二胺氧化酶及D-乳酸浓度水平

指标类型:

主要指标

Outcome:

Serum motilin levels, diamine oxidase, and D-lactate concentration levels

Type:

Primary indicator

测量时间点:

术前1天,术后第3天

测量方法:

Measure time point of outcome:

1 day before surgery, 3 days after surgery

Measure method:

指标中文名:

自控镇痛泵有效按压次数

指标类型:

次要指标

Outcome:

Effective number of compressions with self-control analgesic pump

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

镇痛补救次数

指标类型:

次要指标

Outcome:

Number of analgesic remedies

Type:

Secondary indicator

测量时间点:

手术结束至72小时

测量方法:

Measure time point of outcome:

End of surgery to 72 hours

Measure method:

指标中文名:

不良反应(头晕、恶心、呕吐)发生率

指标类型:

次要指标

Outcome:

Incidence of adverse reactions (dizziness, nausea, vomiting)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后恢复质量评分

指标类型:

次要指标

Outcome:

Postoperative recovery quality score

Type:

Secondary indicator

测量时间点:

术前1天,术后第3天

测量方法:

Measure time point of outcome:

1 day before surgery, 3 days after surgery

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

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:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 19 years
最大 Max age 45 years

性别:

女性

Gender:

Female

随机方法(请说明由何人用什么方法产生随机序列):

使用随机数据表法生成随机分组。

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

Generate random groups using the random data table method.

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):

no

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:

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, 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:

 2023-11-08 16:47:38