围术期持续输注低剂量艾司氯胺酮对腰椎手术患者术后抑郁情绪的影响:前瞻性随机对照试验

注册号:

Registration number:

ChiCTR2500105637 

最近更新日期:

Date of Last Refreshed on:

2025-07-08 11:49:08 

注册时间:

Date of Registration:

2025-07-08 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

围术期持续输注低剂量艾司氯胺酮对腰椎手术患者术后抑郁情绪的影响:前瞻性随机对照试验

Public title:

Effect of Perioperative Continuous Infusion of Low-Dose Esketamine on Postoperative Depressive Symptoms in Patients Undergoing Lumbar Surgery: A Prospective Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

围术期持续输注低剂量艾司氯胺酮对腰椎手术患者术后抑郁情绪的影响:前瞻性随机对照试验

Scientific title:

Effect of Perioperative Continuous Infusion of Low-Dose Esketamine on Postoperative Depressive Symptoms in Patients Undergoing Lumbar Surgery: A Prospective Randomized Controlled Trial

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:

李娜 

研究负责人:

李娜 

Applicant:

Li Na 

Study leader:

Li Na 

申请注册联系人电话:

Applicant telephone:

+86 186 8700 0606

研究负责人电话:

Study leader's
telephone:

+86 186 8700 0606

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:

lina@kmmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

lina@kmmu.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:

云南省昆明市西山区大观路212号

研究负责人通讯地址:

云南省昆明市西山区大观路212号

Applicant address:

212 Daguan Road, Xishan District, Kunming, Yunnan

Study leader's address:

212 Daguan Road, Xishan District, Kunming, Yunnan

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:

联勤保障部队第九二〇医院

Applicant's institution:

920th Hospital of Joint Logistics Support Force

研究负责人所在单位:

联勤保障部队第九二〇医院

Affiliation of the Leader:

920th Hospital of Joint Logistics Support Force

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:

伦审2024-167(科)-02

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:

中国人民解放军联勤保障部队第九二〇医院伦理委员会

Name of the ethic committee:

Ethics Committee of 920th Hospital of Joint Logistics Support Force

伦理委员会批准日期:

Date of approved by ethic committee:

2025-01-10 00:00:00

伦理委员会联系人:

吴颖

Contact Name of the ethic committee:

Wu Ying

伦理委员会联系地址:

云南省昆明市西山区大观路212号

Contact Address of the ethic committee:

212 Daguan Road, Xishan District, Kunming, Yunnan

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 871 6477 4287

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:

联勤保障部队第九二〇医院

Primary sponsor:

920th Hospital of the Joint Logistics Support Force

研究实施负责(组长)单位地址:

云南省昆明市西山区大观路212号

Primary sponsor's address:

212 Daguan Road, Xishan District, Kunming, Yunnan

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

云南省

市(区县):

Country:

China

Province:

Yunnan

City:

单位(医院):

联勤保障部队第九二〇医院

具体地址:

云南省昆明市西山区大观路212号

Institution
hospital:

920th Hospital of the Joint Logistics Support Force

Address:

212 Daguan Road, Xishan District, Kunming, Yunnan

经费或物资来源:

云南省中青年学术和技术带头人后备人才项目

Source(s) of funding:

Yunnan Provincial Reserve Talents Program for Academic and Technical Leaders of Middle-aged and Young Scientists

研究疾病:

术后抑郁  

Target disease:

Postoperative depressive

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:

探究围术期持续输注低剂量艾司氯胺酮对腰椎手术患者术后抑郁情绪的影响  

Objectives of Study:

Investigating the Effects of Perioperative Continuous Infusion of Low-Dose Esketamine on Postoperative Depressive Symptoms in Patients Undergoing Lumbar Surgery

药物成份或治疗方案详述:

患者在常规麻醉诱导后,实验组在术中持续泵注艾司氯胺酮 0.2mg/kg/h,术后使用含有艾司氯胺酮的镇痛泵(1mg/kg) 48h。对照组在术中和镇痛泵中均不使用艾司氯胺酮 

Description for medicine or protocol of treatment in detail:

Following routine anesthesia induction, patients in the experimental group received a continuous intraoperative infusion of esketamine at 0.2 mg/kg/h, followed by a 48-hour postoperative analgesia pump(1mg/kg) containing esketamine. Patients in the control group did not receive esketamine during surgery or in the analgesia pump 

纳入标准:

Inclusion criteria

排除标准:

1.术前阿片类药物滥用及酗酒史 2.妊娠妇女 3.对艾司氯胺酮或麻醉药物过敏患者 4.接受腰背部二次手术 5.不会使用自控镇痛泵或拒绝使用的患者 6.因语言、智力、精神状态障碍无法交流合作 7.身体残疾 8.术前严重的肝肾功能损伤(血清肌酐>2.0mg/dl) 9.不稳定型心绞痛者 10.脑出血史、颅内高压、青光眼者 11.高血压未经治疗或控制不佳者(收缩压≥180mmHg或舒张压≥100mmHg)

Exclusion criteria:

1.History of preoperative opioid abuse or alcoholism 2.pregnancy 3.allergy to esketamine or anesthetic agents 4.patients with prior lumbar reoperation 5.use or non-use of intravenous patient-controlled analgesia (PCA) pumps 6.inability to communicate or cooperate due to language, intellectual, or psychiatric disorders 7.physical disabilities 8.preoperative severe hepatic or renal dysfunction (serum creatinine >2.0 mg/dL) 9.unstable angina 10.history of cerebral hemorrhage, intracranial hypertension, or glaucoma 11.untreated or poorly controlled hypertension (systolic blood pressure >= 180 mmHg or diastolic blood pressure >= 100 mmHg).

研究实施时间:

Study execute time:

From 2024-12-01 00:00:00 To 2026-05-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-07-10 00:00:00 To 2026-05-31 00:00:00

干预措施:

Interventions:

组别:

艾司氯胺酮组

样本量:

60

Group:

esketamine group

Sample size:

干预措施:

术中持续泵注艾司氯胺酮 0.2mg/kg/h,术后使用含有艾司氯胺酮的镇痛泵(1mg/kg)48h

干预措施代码:

Intervention:

continuous intraoperative infusion of esketamine at 0.2 mg/kg/h, followed by a 48-hour postoperative analgesia pump(1mg/kg) containing esketamine.

Intervention code:

组别:

对照组

样本量:

60

Group:

control group

Sample size:

干预措施:

对照组在术中和镇痛泵中均不使用艾司氯胺酮

干预措施代码:

Intervention:

in the control group did not receive esketamine during surgery or in the analgesia pump

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

云南 

市(区县):

 

Country:

China

Province:

Yunnan

City:

单位(医院):

中国人民解放军联勤保障部队第九二〇医院 

单位级别:

三级甲等  

Institution
hospital:

920th Hospital of the Joint Logistics Support Force

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后90天的汉密尔顿抑郁量表(HAMD)评分

指标类型:

主要指标

Outcome:

90-day postoperative Hamilton Depression Rating Scale (HAMD) score

Type:

Primary indicator

测量时间点:

术后90天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

90 days after surgery

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术前的简明疼痛评分量表(BPI)

指标类型:

次要指标

Outcome:

preoperative BPI scores.

Type:

Secondary indicator

测量时间点:

术前

测量方法:

简明疼痛量表(BPI)

Measure time point of outcome:

preoperative

Measure method:

Brief Pain Inventory

指标中文名:

术前汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

preoperative Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术前

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

preoperative

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术前的Oswestry功能障碍指数(Oswestry disability Index, ODI)评分

指标类型:

次要指标

Outcome:

preoperative ODI scores

Type:

Secondary indicator

测量时间点:

术前

测量方法:

功能障碍指数评分

Measure time point of outcome:

preoperative

Measure method:

Oswestry disability Index

指标中文名:

术前血清脑源性神经营养因子(BNDF)

指标类型:

次要指标

Outcome:

Serum BDNF concentrations at baseline (preoperative)

Type:

Secondary indicator

测量时间点:

术前

测量方法:

采集患者血液

Measure time point of outcome:

Preoperative

Measure method:

Collect patient's blood

指标中文名:

恶心

指标类型:

副作用指标

Outcome:

Nausea

Type:

Adverse events

测量时间点:

术后48h

测量方法:

问诊

Measure time point of outcome:

48 hours after surgery

Measure method:

Ask the patient

指标中文名:

呕吐

指标类型:

副作用指标

Outcome:

vomiting

Type:

Adverse events

测量时间点:

术后48h

测量方法:

问诊

Measure time point of outcome:

48 hours after surgery

Measure method:

Ask the patient

指标中文名:

谵妄

指标类型:

副作用指标

Outcome:

delirium

Type:

Adverse events

测量时间点:

术后48h

测量方法:

问诊

Measure time point of outcome:

48 hours after surgery

Measure method:

Ask the patient

指标中文名:

头晕

指标类型:

副作用指标

Outcome:

dizziness

Type:

Adverse events

测量时间点:

术后48h

测量方法:

问诊

Measure time point of outcome:

48 hours after surgery

Measure method:

Ask the patient

指标中文名:

术前5-羟色胺(5-HT)水平

指标类型:

次要指标

Outcome:

5-HT concentrations at baseline (preoperative)

Type:

Secondary indicator

测量时间点:

术前

测量方法:

采集患者血液

Measure time point of outcome:

Preoperative

Measure method:

Collect patient's blood

指标中文名:

头痛

指标类型:

副作用指标

Outcome:

headaches

Type:

Adverse events

测量时间点:

术后48h

测量方法:

问诊

Measure time point of outcome:

48 hours after surgery

Measure method:

Ask the patient

指标中文名:

术后30天的简明疼痛评分量表(BPI)

指标类型:

次要指标

Outcome:

postoperative 30 days BPI scores.

Type:

Secondary indicator

测量时间点:

术后30天

测量方法:

简明疼痛量表(BPI)

Measure time point of outcome:

postoperative 30 days

Measure method:

Brief Pain Inventory

指标中文名:

术后45天的简明疼痛评分量表(BPI)

指标类型:

次要指标

Outcome:

postoperative 45 days BPI scores.

Type:

Secondary indicator

测量时间点:

术后45天

测量方法:

简明疼痛量表(BPI)

Measure time point of outcome:

postoperative 45 days

Measure method:

Brief Pain Inventory

指标中文名:

术后60天的简明疼痛评分量表(BPI)

指标类型:

次要指标

Outcome:

postoperative 60 days BPI scores.

Type:

Secondary indicator

测量时间点:

术后60天

测量方法:

简明疼痛量表(BPI)

Measure time point of outcome:

postoperative 60 days

Measure method:

Brief Pain Inventory

指标中文名:

术后90天的简明疼痛评分量表(BPI)

指标类型:

次要指标

Outcome:

postoperative 90 days BPI scores.

Type:

Secondary indicator

测量时间点:

术后90天

测量方法:

简明疼痛量表(BPI)

Measure time point of outcome:

postoperative 90 days

Measure method:

Brief Pain Inventory

指标中文名:

术后3天汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

postoperative 3 days Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术后3天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

postoperative 3 days

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术后14天汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

postoperative 14 days Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术后14天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

postoperative 14 days

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术后30天汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

postoperative 30 days Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术后30天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

postoperative 30 days

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术后45天汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

postoperative 45 days Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术后45天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

postoperative 45 days

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术后60天汉密顿抑郁量表的评分

指标类型:

次要指标

Outcome:

postoperative 60 days Hamilton Depression Rating Scale (HAMD) score

Type:

Secondary indicator

测量时间点:

术后60天

测量方法:

汉密尔顿抑郁量表(HAMD)

Measure time point of outcome:

postoperative 60 days

Measure method:

Hamilton Depression Rating Scale (HAMD)

指标中文名:

术后30天的Oswestry功能障碍指数(Oswestry disability Index, ODI)评分

指标类型:

次要指标

Outcome:

postoperative 30 days ODI scores

Type:

Secondary indicator

测量时间点:

术后30天

测量方法:

功能障碍指数评分

Measure time point of outcome:

postoperative 30 days

Measure method:

Oswestry disability Index

指标中文名:

术后45天的Oswestry功能障碍指数(Oswestry disability Index, ODI)评分

指标类型:

次要指标

Outcome:

postoperative 45 days ODI scores

Type:

Secondary indicator

测量时间点:

术后45天

测量方法:

功能障碍指数评分

Measure time point of outcome:

postoperative 45 days

Measure method:

Oswestry disability Index

指标中文名:

术后60天的Oswestry功能障碍指数(Oswestry disability Index, ODI)评分

指标类型:

次要指标

Outcome:

postoperative 60 days ODI scores

Type:

Secondary indicator

测量时间点:

术后60天

测量方法:

功能障碍指数评分

Measure time point of outcome:

postoperative 60 days

Measure method:

Oswestry disability Index

指标中文名:

术后90天的Oswestry功能障碍指数(Oswestry disability Index, ODI)评分

指标类型:

次要指标

Outcome:

postoperative 90 days ODI scores

Type:

Secondary indicator

测量时间点:

术后90天

测量方法:

功能障碍指数评分

Measure time point of outcome:

postoperative 90 days

Measure method:

Oswestry disability Index

指标中文名:

术后3天血清脑源性神经营养因子(BNDF)

指标类型:

次要指标

Outcome:

Serum BDNF concentrations at POD 3

Type:

Secondary indicator

测量时间点:

术后3天

测量方法:

采集患者血液

Measure time point of outcome:

3 days postoperative

Measure method:

Collect patient's blood

指标中文名:

术后3天5-羟色胺(5-HT)水平

指标类型:

次要指标

Outcome:

5-HT concentrations at POD 3

Type:

Secondary indicator

测量时间点:

术后3天

测量方法:

采集患者血液

Measure time point of outcome:

3 days postoperative

Measure method:

Collect patient's blood

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 18 years
最大 Max age 65 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):

使用电脑采用随机数字表法

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

Using a computer to generate a random number table method

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:

为最大程度减少研究偏倚,我们采用以下分组和设盲策略: 非盲团队:由负责术前访视和术中管理的麻醉医生、护士及手术医师组成。该团队不参与术后评估,以避免评估偏倚。 盲法团队:包括患者、家属、外科医生、负责术后评估的麻醉医师、PACU(麻醉后监护室)医护人员及数据收集人员,确保其均不了解分组信息,以减少主观因素干扰。 双盲实施方法: 由未参与研究的独立医生生成密封且不透明的随机化信封;由与研究无关的护士在术前 2 小时拆封信封,并按分组要求准备药物;所有药物均使用统一规格的注射器抽取,确保外观无差异;负责术后随访的麻醉医师不参与患者术前任何管理工作,避免信息泄露;所有患者术前均不获知自身分组情况,以确保盲法有效性。该设计通过严格的随机化和盲法控制,旨在最大程度减少操作偏倚、评估偏倚和报告偏倚,从而提高研究结果的可靠性。

Blinding:

To minimize research bias to the greatest extent, the following grouping and blinding strategies are adopted: Non-blinded Team: Composed of anesthesiologists, nurses, and surgeons responsible for preoperative visits and intraoperative management. This team does not participate in postoperative evaluations to avoid assessment bias. Blinded Team: Includes patients, family members, surgeons, anesthesiologists conducting postoperative evaluations, PACU (Post-Anesthesia Care Unit) healthcare providers, and data collectors, ensuring they remain unaware of the grouping information to reduce interference from subjective factors. Implementation of Double-Blinding: Sealed and opaque randomization envelopes are generated by independent physicians not involved in the study;Nurses unrelated to the study open the envelopes 2 hours before surgery and prepare medications according to the grouping requirements;All medications are drawn using syringes of uniform specifications to ensure no visual differences;Anesthesiologists performing postoperative follow-ups do not participate in any preoperative management of patients to avoid information leakage;All patients remain unaware of their own grouping before surgery to ensure the effectiveness of the blinding method. This design aims to minimize operational bias, assessment bias, and reporting bias through strict randomization and blinding control, thereby enhancing the reliability of research outcomes.

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):

国家生物信息中心 China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/)

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

China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/)

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:

EDC

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

EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-07-08 11:49:03