超声引导下胸肋间筋膜平面阻滞治疗正中开胸心脏手术后慢性疼痛的随机对照试验

注册号:

Registration number:

ChiCTR2500104378 

最近更新日期:

Date of Last Refreshed on:

2025-08-11 15:28:16 

注册时间:

Date of Registration:

2025-06-16 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

超声引导下胸肋间筋膜平面阻滞治疗正中开胸心脏手术后慢性疼痛的随机对照试验

Public title:

Ultrasound-guided Pecto-Intercostal Fascial Plane Block for Chronic Postoperative Pain After Cardiac Surgery via Median Sternotomy: A Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

超声引导下胸肋间筋膜平面阻滞对正中开胸心脏手术后慢性疼痛发生率的影响

Scientific title:

Effect of Ultrasound-guided Pecto-Intercostal Fascial Plane Block on Chronic Postoperative Pain Incidence After Median Sternotomy for Cardiac 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:

姚娟 

研究负责人:

姚娟 

Applicant:

Juan Yao 

Study leader:

Juan Yao 

申请注册联系人电话:

Applicant telephone:

+86 159 5056 3770

研究负责人电话:

Study leader's
telephone:

+86 159 5056 3770

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:

yaojuanmazui@163.com

研究负责人电子邮件:

Study leader's E-mail:

yaojuanmazui@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:

南京市鼓楼区丁家桥87号

研究负责人通讯地址:

南京市鼓楼区丁家桥87号

Applicant address:

87 Dingjiaqiao, Gulou District, Nanjing, China

Study leader's address:

87 Dingjiaqiao, Gulou District, Nanjing, 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:

东南大学附属中大医院麻醉手术与疼痛管理科

Applicant's institution:

Department of Anesthesiology, Surgery and Pain Management, Zhong da Hospital, Southeast University

研究负责人所在单位:

东南大学附属中大医院麻醉手术与疼痛管理科

Affiliation of the Leader:

Department of Anesthesiology, Surgery and Pain Management, Zhong da Hospital, Southeast 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:

2025ZDSYLL053-P01

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:

东南大学附属中大医院临床研究伦理委员会

Name of the ethic committee:

Clinical Research Ethics Committee of Zhongda Hospital Affiliated to Southeast University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-03-19 00:00:00

伦理委员会联系人:

王慧萍

Contact Name of the ethic committee:

Huiping Wang

伦理委员会联系地址:

南京市鼓楼区丁家桥87号

Contact Address of the ethic committee:

87 Dingjiaqiao, Gulou District, Nanjing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 25 8327 2015

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:

东南大学附属中大医院

Primary sponsor:

Zhongda Hospital, Southeast University

研究实施负责(组长)单位地址:

南京市鼓楼区丁家桥87号

Primary sponsor's address:

87 Dingjiaqiao, Gulou District, Nanjing, 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):

江苏省

市(区县):

Country:

China

Province:

Jiangsu

City:

单位(医院):

东南大学附属中大医院

具体地址:

南京市鼓楼区丁家桥87号

Institution
hospital:

Zhongda Hospital Affiliated to Southeast University

Address:

87 Dingjiaqiao, Gulou District, Nanjing, China

经费或物资来源:

东南大学附属中大医院江苏省高水平医院建设经费资助

Source(s) of funding:

Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-Level Hospital Construction Funds

研究疾病:

正中开胸心脏术后急慢性疼痛  

Target disease:

Acute and chronic pain after median thoracotomy for cardiac surgery

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:

PIFP阻滞(神经阻滞技术)在正中开胸心脏手术围术期疼痛治疗中有一定的应用前景,但它对开胸心脏术后慢性疼痛(Chronic Post-surgical Pain,CPSP)的影响,仍不明确。为了探讨这一问题,我们设计了一项单中心、前瞻性、随机、对照、双盲研究,旨在假设术前行PIFP阻滞可减轻胸骨正中切开心脏手术患者CPSP的发生率。  

Objectives of Study:

Pecto-intercostal fascial block shows promise for perioperative pain management in cardiac surgery via median sternotomy, but its impact on chronic postsurgical pain (CPSP) remains unclear. To investigate this, we designed a single-center, prospective, randomized, controlled, double-blind trial. We hypothesized that preoperative PIFP block would reduce CPSP incidence in patients undergoing median sternotomy for cardiac 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.经评估存在神经阻滞穿刺相对或绝对禁忌症的患者:如对使用局麻药物过敏、穿刺点感染、血肿等; 2.术前已存在急慢性疼痛; 3.术前阿片类药物滥用史; 4.严重全身疾病(肾、肝、肺或内分泌)的患者; 5.术前合并精神系统问题或沟通困难、拒绝参加的患者; 6.二次手术或术后死亡的患者。

Exclusion criteria:

1. Patients with relative or absolute contraindications to nerve block puncture: e.g., allergy to local anesthetics, infection or hematoma at the puncture site; 2. Pre-existing acute or chronic pain; 3. History of preoperative opioid use; 4. Severe systemic diseases (renal, hepatic, pulmonary, or endocrine); 5. Preoperative psychiatric disorders, communication barriers, or refusal to participate; 6. Patients requiring reoperation or postoperative death.

研究实施时间:

Study execute time:

From 2025-01-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-08-08 00:00:00 To 2026-12-31 00:00:00

干预措施:

Interventions:

组别:

胸肋间筋膜平面阻滞组(FIFP组)

样本量:

152

Group:

Pecto-Intercostal Fascial Plane Block(FIFP group)

Sample size:

干预措施:

在试验组,一个线性超声探头放置在患者第4和第5肋间隙间的矢状旁弓平面,距中线2-3cm,成像深度调整为2-3cm,在胸大肌与肋间内肌之间的筋膜平面内注入注射局麻药(图B)。于双侧筋膜间平面内各注射0.375%罗哌卡因20mL。

干预措施代码:

Intervention:

In the intervention group, a linear ultrasound transducer was positioned in the parasagittal plane between the fourth and fifth intercostal spaces, 2-3 cm lateral to the midline. Imaging depth was adjusted to 2-3 cm. Local anesthetic was injected into the fascial plane between the pectoralis major and internal intercostal muscles (Figure B). A total of 20 mL of 0.375% ropivacaine was administered bilaterally into each fascial plane.

Intervention code:

组别:

对照组

样本量:

152

Group:

Control group

Sample size:

干预措施:

在对照组,一个线性超声探头放置在患者第4和第5肋间隙间的矢状旁弓平面,距中线2-3cm,成像深度调整为2-3cm,在胸大肌与肋间内肌之间的筋膜平面内注入注射局麻药(图B)。于双侧筋膜间平面内各注射0.9%生理盐水20mL。

干预措施代码:

Intervention:

In the control group, a linear ultrasound transducer was positioned identically in the parasagittal plane between the fourth and fifth intercostal spaces, 2-3 cm lateral to the midline, with imaging depth adjusted to 2-3 cm. Under ultrasound guidance, 20 mL of normal saline (0.9% sodium chloride) was injected bilaterally into each fascial plane between the pectoralis major and internal intercostal muscles as the placebo intervention (Figure B).

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江苏省 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

东南大学附属中大医院 

单位级别:

三甲 

Institution
hospital:

Zhongda Hospital Affiliated to Southeast University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后3个月的慢性疼痛发生率

指标类型:

主要指标

Outcome:

The incidence of chronic pain three months after the surgery

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后急性疼痛

指标类型:

次要指标

Outcome:

Postoperative acute pain

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6个月和12个月的慢性疼痛发生率

指标类型:

次要指标

Outcome:

The incidence of chronic pain at 6 months and 12 months after the surgery

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3、6、12个月的慢性疼痛对生活质量的影响、术后疼痛性质的评估及焦虑抑郁情绪的情况

指标类型:

次要指标

Outcome:

Impact of chronic pain on quality of life, assessment of postoperative pain characteristics, and status of anxiety and depression at 3, 6, and 12 months 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:

患者镇痛满意度

指标类型:

次要指标

Outcome:

Patient satisfaction with analgesia

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

指标类型:

次要指标

Outcome:

Postoperative recovery quality

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5天内阿片类药物消耗总量

指标类型:

次要指标

Outcome:

Total opioid consumption within 5 days after surgery

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

胸肋间筋膜平面阻滞相关的不良事件

指标类型:

次要指标

Outcome:

Adverse events related to thoracic intercostal fascial plane block

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

48h内患者恶心、呕吐、头晕、瘙痒发生率

指标类型:

次要指标

Outcome:

Incidence of nausea, vomiting, dizziness and pruritus within 48h

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

首次给予补救镇痛药的时间

指标类型:

次要指标

Outcome:

Time to first administration of rescue analgesics

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

拔气管导管时间

指标类型:

次要指标

Outcome:

Extubation time

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

ICU住院时间

指标类型:

次要指标

Outcome:

Length of stay in ICU

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总住院时间

指标类型:

次要指标

Outcome:

Total length of stay

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

引流管放置时间

指标类型:

次要指标

Outcome:

Drainage tube placement time

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:

组织:

Sample Name:

none

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 18 years
最大 Max age 100 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):

在纳入研究前,所有符合条件的患者(总样本量n=304)均签署知情同意书。本研究采用区组随机化,事先由一名统计学专家利用计算机生成区组大小为4的随机区组序列,将患者1:1分配至试验组和对照组。

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

Prior to enrollment, all eligible patients (total sample size n=304) provided written informed consent. Using block randomization, a statistician not otherwise involved in the study generated a computer-randomized sequence with a block size of 4, allocating patients 1:1 to the intervention or control group.

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:

受试者、麻醉医生、护理人员、观察指标评估者以及统计分析人员均不清楚具体分组情况。

Blinding:

Participants, anesthesiologists, nursing staff, outcome assessors, and statisticians remained blinded throughout the trial.

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):

临床试验公共管理平台,http://www.medresman.org.cn.

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

ResMan, http://www.medresman.org.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:

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

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:

 2025-06-16 16:53:42