全膝置换术收肌管阻滞镇痛氢吗啡酮的剂量优化及预测模型研究

注册号:

Registration number:

ChiCTR2500113467 

最近更新日期:

Date of Last Refreshed on:

2025-11-28 14:54:45 

注册时间:

Date of Registration:

2025-11-28 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

全膝置换术收肌管阻滞镇痛氢吗啡酮的剂量优化及预测模型研究

Public title:

Dose Optimization and Prediction Modeling of Hydromorphone in Adductor Canal Block for Total Knee Replacement Analgesia

注册题目简写:

English Acronym:

研究课题的正式科学名称:

全膝置换术收肌管阻滞镇痛氢吗啡酮的剂量优化及预测模型研究

Scientific title:

Study on Dose Optimization and Prediction Model of Hydroxycobalamin for Tibialis Anterior Nerve Block in Total Knee Arthroplasty

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:

喻栌以 

研究负责人:

李跃兵 

Applicant:

Yu Luyi 

Study leader:

Li Yuebing 

申请注册联系人电话:

Applicant telephone:

+86 198 5810 2450

研究负责人电话:

Study leader's
telephone:

+86 159 8812 1853

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:

Y19858739619@163.com

研究负责人电子邮件:

Study leader's E-mail:

lyb1853@zcmu.edu.cn

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:

浙江省杭州市拱墅区上塘路158号

研究负责人通讯地址:

浙江省杭州市拱墅区潮王路318号

Applicant address:

158 Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province

Study leader's address:

No. 318 Chao Wang Road, Gongshu District, Hangzhou City, Zhejiang Province

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:

浙江省人民医院

Applicant's institution:

Zhejiang Provincial People's Hospital

研究负责人所在单位:

浙江中医药大学附属第二医院

Affiliation of the Leader:

The Second affiliated Hospital of Zhejiang Chinese Medicine 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:

浙中医大二院伦审2025研第005号-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:

浙江中医药大学附属第二医院医学研究伦理委员会

Name of the ethic committee:

Ethics Committee of the Second Affiliated Hospital, Zhejiang Chinese Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-01-23 00:00:00

伦理委员会联系人:

黄延彪

Contact Name of the ethic committee:

Huang Yanbiao

伦理委员会联系地址:

杭州市拱墅区潮王路318号

Contact Address of the ethic committee:

No. 318 Chaowang Road, Gongshu District, Hangzhou City

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 571 8808 9970

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:

浙江中医药大学附属第二医院

Primary sponsor:

The Second affiliated Hospital of Zhejiang Chinese Medicine University

研究实施负责(组长)单位地址:

浙江省杭州市拱墅区潮王路318号

Primary sponsor's address:

No. 318 Chao Wang Road, Gongshu District, Hangzhou City, Zhejiang Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江省

市(区县):

杭州市

Country:

China

Province:

Zhejiang Province

City:

Hangzhou City

单位(医院):

浙江中医药大学附属第二医院

具体地址:

浙江省杭州市拱墅区潮王路318号

Institution
hospital:

The Second affiliated Hospital of Zhejiang Chinese Medicine University

Address:

No. 318 Chao Wang Road, Gongshu District, Hangzhou City, Zhejiang Province

经费或物资来源:

浙江省医学会临床医学专项资金项目

Source(s) of funding:

Zhejiang Provincial Medical Association Special Fund Project for Clinical Medicine

研究疾病:

膝关节痛  

Target disease:

Knee pain

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:

(1)阐明 HM 联合 RP 用于 TKA 患者术后 ACB 的镇痛效果并提供新的临床依据。 (2)拟从预测模型的角度探讨 HM 在 TKA 患者中行 ACB 镇痛的最优剂量并阐述新的理论依据。  

Objectives of Study:

(1) To elucidate the analgesic efficacy of hydromorphone (HM) combined with ropivacaine (RP) for adductor canal block (ACB) in total knee arthroplasty (TKA) patients and provide new clinical evidence. (2) This study aims to explore the optimal dosage of HM for ACB analgesia in TKA patients from the perspective of predictive modeling and establish novel theoretical foundations.

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.长期使用阿片类药物者(连续 4 周以上,如吗啡、芬太尼等); 2.既往有罗哌卡因过敏史; 3.长期嗜酒、酒精成瘾者; 4.肝肾功能不全患者; 5.心肺功能较差者; 6.患侧下肢既往有过血管手术者; 7.长期坐轮椅无法行走者; 8.穿刺部位有感染者; 9.主观不配合、无法交流者; 10.合并免疫系统病变者。

Exclusion criteria:

1. Chronic opioid users (continuous use for ≥4 weeks, e.g., morphine, fentanyl, etc.); 2. History of ropivacaine allergy; 3. Chronic alcohol abuse or alcohol dependence; 4. Patients with hepatic or renal insufficiency; 5. Individuals with poor cardiopulmonary function; 6. Previous vascular surgery on the affected lower limb; 7. Non-ambulatory patients (wheelchair-bound long-term); 8. Infection at the puncture site; 9. Uncooperative or non-communicative patients; 10. Patients with immune system disorders.

研究实施时间:

Study execute time:

From 2024-07-01 00:00:00 To 2026-07-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-11-06 00:00:00 To 2026-04-30 00:00:00

干预措施:

Interventions:

组别:

干预组1

样本量:

20

Group:

intervention gruop1

Sample size:

干预措施:

2μg/kg的氢吗啡酮2ml复合0.25%罗哌卡因18ml用以收肌管阻滞

干预措施代码:

Intervention:

The adductor canal block was performed using a mixture of 2 μg/kg hydromorphone (2 mL) and 0.25% ropivacaine (18 mL)

Intervention code:

组别:

对照组

样本量:

20

Group:

control gruop

Sample size:

干预措施:

0.25%的罗哌卡因20ml进行收肌管阻滞

干预措施代码:

Intervention:

0.25% ropivacaine 20ml for adductor canal block

Intervention code:

组别:

干预组2

样本量:

20

Group:

intervention gruop2

Sample size:

干预措施:

4μg/kg的氢吗啡酮2ml复合0.25%罗哌卡因18ml用以收肌管阻滞

干预措施代码:

Intervention:

The adductor canal block was performed using a mixture of 4 μg/kg hydromorphone (2 mL) and 0.25% ropivacaine (18 mL)

Intervention code:

组别:

干预组3

样本量:

20

Group:

intervention gruop3

Sample size:

干预措施:

6μg/kg的氢吗啡酮2ml复合0.25%罗哌卡因18ml用以收肌管阻滞

干预措施代码:

Intervention:

The adductor canal block was performed using a mixture of 6 μg/kg hydromorphone (2 mL) and 0.25% ropivacaine (18 mL)

Intervention code:

组别:

干预组4

样本量:

20

Group:

intervention gruop4

Sample size:

干预措施:

8μg/kg的氢吗啡酮2ml复合0.25%罗哌卡因18ml用以收肌管阻滞

干预措施代码:

Intervention:

The adductor canal block was performed using a mixture of 8 μg/kg hydromorphone (2 mL) and 0.25% ropivacaine (18 mL)

Intervention code:

组别:

干预组5

样本量:

20

Group:

intervention gruop5

Sample size:

干预措施:

10μg/kg的氢吗啡酮2ml复合0.25%罗哌卡因18ml用以收肌管阻滞

干预措施代码:

Intervention:

The adductor canal block was performed using a mixture of 10 μg/kg hydromorphone (2 mL) and 0.25% ropivacaine (18 mL)

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

浙江省 

市(区县):

杭州市 

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江省中医院大学附属第二医院 

单位级别:

三甲 

Institution
hospital:

The Second affiliated Hospital of Zhejiang Chinese Medicine University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

全膝关节置换后VAS评分

指标类型:

主要指标

Outcome:

VAS score after total knee replacement

Type:

Primary indicator

测量时间点:

测量方法:

工具准备: 使用一条 10厘米(100毫米)的水平直线。 左端标注 “无痛”(0分),右端标注 “最剧烈的疼痛”(10分)。 操作步骤: 向患者说明:“请根据您当前的疼痛程度,在这条线上标记最符合的位置。” 患者自行在线上画竖线(如“│”)表示疼痛强度。 测量标记点距离左端的厘米数(精确到1毫米),即为VAS评分。

Measure time point of outcome:

Measure method:

Preparation: A 10 cm (100 mm) horizontal line is used. Left end: "No pain" (0), Right end: "Worst pain imaginable" (10). Procedure: Instruct the patient: "Please mark on this line to indicate your current pain level." The patient draws a vertical line (e.g., "│") on the scale. Measure the distance (in cm/mm) from the left end to the mark

指标中文名:

全膝置换术后股四头肌肌力评分

指标类型:

主要指标

Outcome:

Quadriceps muscle strength score after total knee replacement

Type:

Primary indicator

测量时间点:

测量方法:

患者坐位,检查者一手托住患者小腿,另一手置于大腿前方感受肌肉收缩,要求患者伸直膝关节对抗阻力。

Measure time point of outcome:

Measure method:

Patient sits with knee flexed. Examiner supports the lower leg while palpating the quadriceps, then asks patient to extend knee against resistance.

指标中文名:

全膝置换术后PCIA按压次数

指标类型:

主要指标

Outcome:

Number of PCIA compressions after total knee replacement

Type:

Primary indicator

测量时间点:

测量方法:

通过镇痛系统查询患者术后按压次数

Measure time point of outcome:

Measure method:

check the patient's postoperative PCA demand counts through the analgesia system

指标中文名:

全膝置换术后Ramasy镇静评分

指标类型:

主要指标

Outcome:

Ramasy sedation score after total knee replacement

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

全膝置换术后BCS舒适评分

指标类型:

主要指标

Outcome:

BCS comfort score after total knee replacement

Type:

Primary indicator

测量时间点:

术后24小时内每8小时评估一次

测量方法:

Measure time point of outcome:

Perform assessments at 8-hour intervals during the initial 24-hour postoperative period.

Measure method:

指标中文名:

有无使用追加补救镇痛药物

指标类型:

主要指标

Outcome:

Use of supplemental remedial analgesics

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后不良反应的发生率

指标类型:

次要指标

Outcome:

Incidence of postoperative adverse reactions

Type:

Secondary indicator

测量时间点:

测量方法:

术后严密监测患者身体情况,随访时观察及询问患者本人及家属身体情况,向管床护士及医生询问

Measure time point of outcome:

Measure method:

Observe and inquire about the patient's condition **from both the patient and family members. Consult the assigned bedside nurse and attending physician for updates.

指标中文名:

术后24h内血液白介素-6的浓度

指标类型:

主要指标

Outcome:

Postoperative 24-hour serum IL-6 levels

Type:

Primary indicator

测量时间点:

测量方法:

ELISA

Measure time point of outcome:

Measure method:

ELISA

指标中文名:

术后24h内血液白介素-10的浓度

指标类型:

主要指标

Outcome:

Postoperative 24-hour serum IL-10 levels

Type:

Primary indicator

测量时间点:

测量方法:

ELISA

Measure time point of outcome:

Measure method:

ELISA

指标中文名:

术后24h内血液人前列腺素E2的浓度

指标类型:

主要指标

Outcome:

Postoperative 24-hour serum PGE2 levels

Type:

Primary indicator

测量时间点:

测量方法:

elisa试剂盒

Measure time point of outcome:

Measure method:

ELISA

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血浆

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 50 years
最大 Max age 80 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):

由非本研究小组的人员使用计算机生成随机数字分组,进行简单随机化

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

Simple randomization was carried out by computer generated random number groups by people who were not part of the research team

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:

受试者和研究者盲

Blinding:

double-blind (participants and investigators)

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):

2030.12.31后,联系课题负责人 lyb1853@zcmu.edu.cn

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

After December 31, 2030, please contact the principal investigator at lyb1853@zcmu.edu.cn.

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:

电子记录表和纸质记录表,采用医院病历及麻醉记录单填写系统收集数据,根据研究进展和数据收集情况,必要时将评估是否引入电子数据采集与管理系统(Electronic Data Capture, EDC)。

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

Electronic Case Report Form (eCRF) and Paper Case Report Form (pCRF),data collection will initially utilize the hospital's existing EMR and anesthesia documentation systems. Based on ongoing study progression and data acquisition requirements, the research team will evaluate the potential implementation of an Electronic Data Capture (EDC) system to enhance data management capabilities.

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:

 2025-11-28 14:54:28