不同剂量右美托咪定鼻喷雾剂对骨科手术的老年患者应激反应和术后谵妄的影响

注册号:

Registration number:

ChiCTR2500095748 

最近更新日期:

Date of Last Refreshed on:

2025-01-13 10:52:47 

注册时间:

Date of Registration:

2025-01-13 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

不同剂量右美托咪定鼻喷雾剂对骨科手术的老年患者应激反应和术后谵妄的影响

Public title:

Effect of different doses of dexmedetomidine nasal spray on stress response and postoperative delirium in elderly patients undergoing orthopedic surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

不同剂量右美托咪定鼻喷雾剂对骨科手术的老年患者应激反应和术后谵妄的影响

Scientific title:

Effect of different doses of dexmedetomidine nasal spray on stress response and postoperative delirium in elderly patients undergoing orthopedic 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:

林锦雨 

研究负责人:

林锦雨 

Applicant:

Lin Jinyu 

Study leader:

Lin Jinyu 

申请注册联系人电话:

Applicant telephone:

+86 186 8965 5057

研究负责人电话:

Study leader's
telephone:

+86 186 8965 5057

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:

846902967@qq.com

研究负责人电子邮件:

Study leader's E-mail:

846902967@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:

中国海南省海口市美兰区和平北路47号

研究负责人通讯地址:

中国海南省海口市美兰区和平北路47号

Applicant address:

No. 47, Heping North Road, Meilan District, Haikou City, Hainan Province,P.R.China

Study leader's address:

No. 47, Heping North Road, Meilan District, Haikou City, Hainan Province,P.R.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:

广东省中医院海南医院

Applicant's institution:

Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

研究负责人所在单位:

广东省中医院海南医院

Affiliation of the Leader:

Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

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:

HNSZYY-2024-LL-069

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:

广东省中医院海南医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2024-07-10 00:00:00

伦理委员会联系人:

姚茂忠

Contact Name of the ethic committee:

Yao Maozhong

伦理委员会联系地址:

中国海南省海口市美兰区和平北路47号

Contact Address of the ethic committee:

No. 47, Heping North Road, Meilan District, Haikou City, Hainan Province,P.R.China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 898 6621 0281

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:

广东省中医院海南医院

Primary sponsor:

Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

研究实施负责(组长)单位地址:

中国海南省海口市美兰区和平北路47号

Primary sponsor's address:

No. 47, Heping North Road, Meilan District, Haikou City, Hainan Province,P.R.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):

海南省

市(区县):

Country:

China

Province:

Hainan

City:

单位(医院):

广东省中医院海南医院

具体地址:

中国海南省海口市美兰区和平北路47号

Institution
hospital:

Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

Address:

No. 47, Heping North Road, Meilan District, Haikou City, Hainan Province,P.R.China

经费或物资来源:

湖北陈孝平科技发展基金会

Source(s) of funding:

Hubei Chen Xiaoping Science and Technology Development Foundation

研究疾病:

下肢骨折  

Target disease:

Lower limb fractures

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:

连续入组 

Study design:

Sequential 

研究目的:

此研究旨在为老年患者术后谵妄的防治提供新策略。  

Objectives of Study:

The purpose of this study is to provide a new strategy for the prevention and treatment of postoperative delirium in elderly patients.

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:

窦性心动过缓(<50次/分)、房室传导阻滞、病态窦房结综合征;对麻醉药品过敏;既往使用过免疫抑制剂和近期放化疗;目前使用非甾体抗炎药或类固醇、血管紧张素转换酶抑制剂或支气管扩张剂;肝肾功能不全;癫痫及相关的精神和认知功能障碍、长期应激刺激或心理障碍;酗酒史、镇痛药依赖史和长期使用镇静剂;严重哮喘、严重肺气肿、严重支气管炎、严重慢性阻塞性肺病、心功能不全。

Exclusion criteria:

Sinus bradycardia (<50 beats/min), atrioventricular block, sick sinus syndrome; allergy to narcotic drugs; Prior use of immunosuppressants and recent chemoradiotherapy; Current use of non-steroidal anti-inflammatory drugs or steroids, angiotensin-converting enzyme inhibitors, or bronchodilators; hepatic and renal insufficiency; epilepsy and related mental and cognitive dysfunction, long-term stress stimuli or psychological disorders; history of alcoholism, analgesic dependence, and long-term use of sedatives; Severe asthma, severe emphysema, severe bronchitis, severe chronic obstructive pulmonary disease, cardiac insufficiency.

研究实施时间:

Study execute time:

From 2025-01-15 00:00:00 To 2025-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-01-15 00:00:00 To 2025-06-30 00:00:00

干预措施:

Interventions:

组别:

A组

样本量:

30

Group:

A Group

Sample size:

干预措施:

所有老年患者提前30min进入预麻室,由鼻腔喷入安慰剂生理盐水,两侧鼻孔各喷入1喷,停留约30s,总共给药2喷,给药在2min内完成。

干预措施代码:

Intervention:

All elderly patients entered the pre-anesthesia room 30 minutes in advance, sprayed placebo normal saline from the nasal cavity, sprayed 1 spray into each nostril, stayed for about 30s, a total of 2 sprays were administered, and the administration was completed within 2 minutes.

Intervention code:

组别:

B组

样本量:

30

Group:

B Grop

Sample size:

干预措施:

所有老年患者提前30min进入预麻室,由鼻腔喷入右美托咪定,两侧鼻孔各喷入1喷,停留约30s,总共给药2喷,共计50ug,给药在2min内完成。

干预措施代码:

Intervention:

All elderly patients entered the pre-anesthesia room 30 minutes in advance, sprayed dexmedetomidine from the nasal cavity, sprayed 1 spray into each nostril on both sides, stayed for about 30s, and a total of 2 sprays were administered, a total of 50ug, and the administration was completed within 2 minutes.

Intervention code:

组别:

C组

样本量:

30

Group:

C Group

Sample size:

干预措施:

所有老年患者提前30min进入预麻室,由鼻腔喷入右美托咪定,两侧鼻孔各喷入1喷,停留约30s后再于一侧鼻孔喷入1喷,总共给药3喷,共计75ug,给药在2min内完成。

干预措施代码:

Intervention:

All elderly patients entered the pre-anesthesia room 30 minutes in advance, sprayed dexmedetomidine from the nasal cavity, sprayed 1 spray into each nostril on each side, stayed for about 30 seconds, and then sprayed 1 spray into one nostril, a total of 3 sprays were administered, a total of 75ug, and the administration was completed within 2 minutes.

Intervention code:

组别:

D组

样本量:

30

Group:

D Grop

Sample size:

干预措施:

所有老年患者提前30min进入预麻室,由鼻腔喷入右美托咪定,两侧鼻孔各喷入1喷,停留约30s,后再于两侧鼻孔各喷入1喷,总共给药4喷,共计100ug,给药在2min内完成。

干预措施代码:

Intervention:

All elderly patients entered the pre-anesthesia room 30 minutes in advance, sprayed dexmedetomidine from the nasal cavity, sprayed 1 spray into each nostril on both sides, stayed for about 30s, and then sprayed 1 spray into each nostril on both sides, a total of 4 sprays were administered, a total of 100ug, and the administration was completed within 2 minutes.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

海南省 

市(区县):

 

Country:

China

Province:

Hainan

City:

单位(医院):

广东省中医院海南医院 

单位级别:

三甲 

Institution
hospital:

Hainan Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

谵妄情况

指标类型:

主要指标

Outcome:

Delirium conditions

Type:

Primary indicator

测量时间点:

术前及术后(第2天和第7天),每天两次(08:00和20:00)

测量方法:

3分钟谵妄诊断量表(3D-CAM表)

Measure time point of outcome:

Preoperative and postoperative (days 2 and 7), twice a day (08:00 and 20:00)

Measure method:

3-Minute Delirium Diagnostic Scale (3D-CAM Scale)

指标中文名:

降钙素原(PCT)

指标类型:

次要指标

Outcome:

Procalcitonin (PCT)

Type:

Secondary indicator

测量时间点:

给药前及术后 24 小时

测量方法:

Measure time point of outcome:

Predose and 24 hours postoperatively

Measure method:

指标中文名:

白细胞介素-6

指标类型:

次要指标

Outcome:

Interleukin-6

Type:

Secondary indicator

测量时间点:

给药前及术后 24 小时

测量方法:

Measure time point of outcome:

Predose and 24 hours postoperatively

Measure method:

指标中文名:

血清淀粉样蛋白A(SAA)

指标类型:

次要指标

Outcome:

Serum amyloid A (SAA)

Type:

Secondary indicator

测量时间点:

给药前及术后 24 小时

测量方法:

Measure time point of outcome:

Predose and 24 hours postoperatively

Measure method:

指标中文名:

术中舒芬太尼的用量

指标类型:

次要指标

Outcome:

Intraoperative dose of sufentanil

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中低氧血症的发生(SPO2<90%)

指标类型:

次要指标

Outcome:

Occurrence of intraoperative hypoxemia (SPO2<90%)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后拔管时间

指标类型:

次要指标

Outcome:

Time to postoperative extubation

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 24 小时恶心呕吐发生率

指标类型:

次要指标

Outcome:

Incidence of nausea and vomiting at 24 hours postoperatively

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

应激反应

指标类型:

次要指标

Outcome:

Stress response

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:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 65 years
最大 Max age 75 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):

使用密闭封信封随机分组。当一个患者进入研究时,由指定的主管打开信封,并将患者随机(1:1:1:1)分配到4组之一。患者被随机分配了一个号码。所有研究文书工作和数据库中仅使用ID号。

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

Randomization using airtight envelopes. When a patient enters the study, the envelope is opened by the assigned supervisor and the patient is randomly assigned (1:1:1:1) to one of the 4 groups. Patients were randomly assigned a number. Only ID numbers are used in all research paperwork and databases.

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:

双盲,在整个研究期间,研究人员、医疗团队成员和患者都被不清楚分组信息。

Blinding:

Double-blind, the investigators, medical team members, and patients were unclear about the grouping information throughout the study.

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):

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

None

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:

 2025-01-13 10:52:33