对乙酰氨基酚注射液在儿童日间扁桃体腺样体切除术中应用的研究

注册号:

Registration number:

ChiCTR2400079538 

最近更新日期:

Date of Last Refreshed on:

2025-01-21 17:57:40 

注册时间:

Date of Registration:

2024-01-05 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

对乙酰氨基酚注射液在儿童日间扁桃体腺样体切除术中应用的研究

Public title:

Application of acetaminophen injection in daytime tonsillectomy and adenoidectomy in children

注册题目简写:

English Acronym:

研究课题的正式科学名称:

对乙酰氨基酚注射液在儿童日间扁桃体腺样体切除术中应用的研究

Scientific title:

Application of acetaminophen injection in daytime tonsillectomy and adenoidectomy in children

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:

陈芳 

研究负责人:

陈芳 

Applicant:

Chen Fang 

Study leader:

Chen Fang 

申请注册联系人电话:

Applicant telephone:

+86 189 3869 0929

研究负责人电话:

Study leader's
telephone:

+86 189 3869 0929

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:

18938690929@163.com

研究负责人电子邮件:

Study leader's E-mail:

18938690929@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:

中国广东省深圳市福田区益田路7019号深圳市儿童医院

研究负责人通讯地址:

深圳市福田区莲花街道益田路7019号

Applicant address:

Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen City

Study leader's address:

7019 Yitian Road, Lianhua Street, Futian District, Shenzhen

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:

中国广东省深圳市儿童医院

Applicant's institution:

Shenzhen Children's Hospital, Guangdong Province, China

研究负责人所在单位:

深圳市儿童医院

Affiliation of the Leader:

Shenzhen Children’s Hospital

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:

深儿医伦审(科研)批件202314202号

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:

深圳市儿童医院生物医学研究伦理委员会

Name of the ethic committee:

Shenzhen Children's Hospital Ethical Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2023-11-16 00:00:00

伦理委员会联系人:

李晨曦

Contact Name of the ethic committee:

Li Chenxi

伦理委员会联系地址:

深圳市福田区莲花街道益田路7019号

Contact Address of the ethic committee:

7019 Yitian Road, Lianhua Street, Futian District, Shenzhen

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 755 8300 8379

伦理委员会联系人邮箱:

Contact email of the ethic committee:

Lizalichenxi@163.com

研究实施负责(组长)单位:

深圳市儿童医院

Primary sponsor:

Shenzhen Children’s Hospital

研究实施负责(组长)单位地址:

深圳市福田区莲花街道益田路7019号

Primary sponsor's address:

7019 Yitian Road, Lianhua Street, Futian District, Shenzhen

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):

深圳市儿童医院

具体地址:

深圳市福田区莲花街道益田路7019号

Institution
hospital:

Shenzhen Children’s Hospital

Address:

7019 Yitian Road, Lianhua Street, Futian District, Shenzhen

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Red Cross Foundation

研究疾病:

扁桃体肥大:喉咙疼痛,呼吸困难,吞咽困难,打呼噜,食欲不佳,发烧、咳嗽、嗓子干等;腺样体肥大:鼻塞,流涕,可发生分泌性中耳炎,甚至化脓性中耳炎,出现耳闷、耳痛、听力下降等症状,分泌物下流并刺激呼吸道黏膜,可引起咽部不适、阵咳、支气管炎症状,腺样体面容,阻塞性睡眠呼吸暂停。  

Target disease:

Tonsillar hypertrophy: sore throat, dyspnea, dysphagia, snoring, poor appetite, fever, cough, dry throat, etc. Adenoid hypertrophy: nasal congestion, runny nose, can occur secretory otitis media, even suppurative otitis media, ear fullness, otalgia, hearing loss and other symptoms, secretion and irritation of respiratory mucosa, can cause pharyngeal discomfort, cough, bronchitis symptoms, adenoid

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:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

儿童扁桃体切除术术后疼痛感明显,围术期疼痛管理是亟待解决的重要问题之一,多模式镇痛有助于优化围术期疼痛管理策略。本研究分三阶段进行,通过不同的镇痛管理方案,将对乙酰氨基酚甘露醇注射液应用在儿童日间扁桃体腺样体切除术围术期,比较各种方案在患儿麻醉苏醒期以及术后的疼痛评分、谵妄评分及不良反应的差异,评估每种镇痛方案的有效性及安全性。并探求学龄前儿童扁桃体切除术围术期更优化的镇痛方式,以促进患儿快速康复,增强舒适化医疗的体验。 (1)第一阶段:在行日间扁桃体切除术的学龄前患儿中分别采用常规芬太尼镇痛、对乙酰氨基酚联合芬太尼的方案进行围术期疼痛管理,探求对乙酰氨基酚在该类手术围术期的有效性及安全性。 (2)第二阶段:若验证对乙酰氨基酚安全有效,则分别采用术前或术毕使用对乙酰氨基酚的方案进行围术期疼痛管理,探求对乙酰氨基酚是否具有超前镇痛效用,以优化围术期疼痛管理方案。 (3)第三阶段:若已验证对乙酰氨基酚在超前镇痛中的作用,则分别采用常规对乙酰氨基酚联合芬太尼镇痛、对乙酰氨基酚联合芬太尼并行罗哌卡因局部阻滞的方案进行围术期疼痛管理,探求对乙酰氨基酚联合局部阻滞的多模式镇痛方案在该类手术围术期的有效性及安全性。  

Objectives of Study:

This study is conducted in three phases. Through various analgesic management approaches, we aim to apply acetaminophen propofol injection in the perioperative period of pediatric day-case tonsillectomy and adenoidectomy surgeries. We will compare the different strategies in terms of pain scores, sedation scores, and adverse reactions during the anesthetic emergence and postoperative period in pediatric patients. The primary objective is to evaluate the effectiveness and safety of each analgesic regimen. Additionally, we seek to optimize perioperative analgesia for preschool children undergoing tonsillectomy and adenoidectomy procedures, with the ultimate goal of promoting rapid recovery and enhancing the patient experience in the context of comfort-oriented medical care. The study unfolds in three phases: (1) Phase one: In preschool children undergoing day-case tonsillectomy, we will employ conventional fentanyl analgesia and a combination of acetaminophen and fentanyl in the perioperative pain management. This phase is intended to investigate the efficacy and safety of acetaminophen in this surgical context. (2) Phase two: If the safety and efficacy of acetaminophen are confirmed, we will explore the preemptive analgesic effect of acetaminophen administered either before or after the surgery in preschool children undergoing day-case tonsillectomy and adenoidectomy surgeries, aiming to optimize perioperative pain management. (3) Phase three: If the role of acetaminophen in preemptive analgesia has been validated, conventional acetaminophen combined with fentanyl analgesia and acetaminophen combined with fentanyl and ropivacaine local block schemes will be used for perioperative pain management to explore the effectiveness and safety of the multimodal analgesia scheme of acetaminophen combined with local block in this type of surgery.

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.患有先天性心脏病、支气管肺发育不良者; 2.术前合并肝肾疾病、胃肠疾病及出血性疾病家族史者; 3.对对乙酰氨基酚、罗哌卡因或试验中任何一种药物过敏者; 4.术前24小时使用过其他止痛药物者; 5.因癫痫等疾病,长期使用镇静镇痛药物者; 6.患有先天性G6PD缺乏症、线粒体病者。

Exclusion criteria:

1. Patients with congenital heart disease or bronchopulmonary dysplasia. 2. Preoperative comorbidities including liver, kidney, gastrointestinal disorders, or a family history of bleeding disorders. 3. Known allergies to acetaminophen, ropivacaine, or any investigational drug. 4. Use of other analgesic medications within 24 hours prior to surgery. 5. Chronic use of sedative or analgesic drugs due to conditions such as epilepsy. 6. Patients with congenital G6PD deficiency or mitochondrial diseases.

研究实施时间:

Study execute time:

From 2023-06-01 00:00:00 To 2024-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-01-05 00:00:00 To 2024-12-31 00:00:00

干预措施:

Interventions:

组别:

第一阶段A组

样本量:

40

Group:

Phase 1 group A

Sample size:

干预措施:

麻醉诱导期静脉注射对乙酰氨基酚15mg/kg

干预措施代码:

Intervention:

Group A patients received intravenous administration of 15mg/kg of acetaminophen during the anesthesia induction phase

Intervention code:

组别:

第二阶段A组

样本量:

40

Group:

Phase 2 group A

Sample size:

干预措施:

在常规阿片类药物镇痛的基础上,第二阶段A组患儿在麻醉诱导期注射对乙酰氨基酚15mg/kg,在术毕注射等容量生理盐水。

干预措施代码:

Intervention:

Group A patients received an intravenous injection of 15mg/kg of acetaminophen during the anesthesia induction.

Intervention code:

组别:

第一阶段B组

样本量:

40

Group:

Phase 1 group B

Sample size:

干预措施:

麻醉诱导期注射等量生理盐水

干预措施代码:

Intervention:

Group B patients received an equivalent volume of normal saline during the anesthesia induction phase.

Intervention code:

组别:

第二阶段B组

样本量:

40

Group:

phase 2 group B

Sample size:

干预措施:

第二阶段B组患儿在麻醉诱导期注射等容量生理盐水,在术毕注射对乙酰氨基酚15mg/kg。

干预措施代码:

Intervention:

Group B patients received an intravenous injection of 15mg/kg of acetaminophen at the end of surgery.

Intervention code:

组别:

第三阶段A组

样本量:

40

Group:

Phase 2 group A

Sample size:

干预措施:

扁桃体切除前使用0.2%罗哌卡因3-5ml于双侧扁桃体床周围组织行局部浸润阻滞

干预措施代码:

Intervention:

3-5ml of 0.2% ropivacaine was used for local infiltration block around the bilateral tonsillar beds before tonsillectomy.

Intervention code:

组别:

第三阶段B组

样本量:

40

Group:

phase 2 group B

Sample size:

干预措施:

儿童日间扁桃体切除术术中常规镇痛

干预措施代码:

Intervention:

Routine analgesia during daytime tonsillectomy in children

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):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

深圳市儿童医院 

单位级别:

三级甲等 

Institution
hospital:

Shenzhen Children’s Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

拔管后1h(T1)时FLACC疼痛评分

指标类型:

主要指标

Outcome:

The FLACC pain score at T1

Type:

Primary indicator

测量时间点:

拔管后1h(T1)时

测量方法:

使用FLACC疼痛评分量表

Measure time point of outcome:

1 hour post-extubation (T1).

Measure method:

Using the FLACC pain rating scale

指标中文名:

手术时间

指标类型:

次要指标

Outcome:

The time of operation

Type:

Secondary indicator

测量时间点:

手术中

测量方法:

分钟计时

Measure time point of outcome:

During the surgery

Measure method:

Time in minutes

指标中文名:

拔管后10min(T0)、拔管后4h(T2)FLACC疼痛评分。通过电话随访记录患儿术后8h与24h时FLACC疼痛评分。

指标类型:

次要指标

Outcome:

The FLACC pain score at T0、T2,The FLACC pain scores at 8h and 24h after surgery.

Type:

Secondary indicator

测量时间点:

拔管后10min(T0)、拔管后4h(T2);术后8h与24h时

测量方法:

使用FLACC疼痛评分量表

Measure time point of outcome:

10 minutes and 4 hours post-extubation (T0、T2);8h and 24h after surgery.

Measure method:

Using the FLACC pain rating scale

指标中文名:

PACU停留时间

指标类型:

次要指标

Outcome:

The time of staying at PACU

Type:

Secondary indicator

测量时间点:

PACU中

测量方法:

分钟计时

Measure time point of outcome:

Staying at PACU

Measure method:

Time in minutes

指标中文名:

围术期心率与平均动脉压

指标类型:

次要指标

Outcome:

Perioperative heart rate and mean arterial pressure

Type:

Secondary indicator

测量时间点:

围术期各时间点

测量方法:

麻醉监护仪测量与显示

Measure time point of outcome:

Perioperative each point in time

Measure method:

Anesthesia monitoring measurement and display

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 3 years
最大 Max age 6 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):

使用StataSE软件设置80个观测数

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

Set 80 observations using StataSE software

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:

双盲,对受试者和研究者均设盲。

Blinding:

Double blind, both subjects and researchers are blinded.

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):

2024年12月前,研究论文完成后,将原始数据上传至公共数据库

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

December 2024, after the completion of the research papers, the original data uploaded to the public database

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:

制定病例记录表(Case Record Form,CRF),建立电子采集和管理系统(Electronic Data Capture, EDC)

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

Establish Case Record Form (CRF) and Electronic Data Capture (EDC) system.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2024-01-05 11:54:13