右美托咪定联合艾司氯胺酮对老年髋部骨折术前睡眠障碍患者术后谵妄的影响

注册号:

Registration number:

ChiCTR2600118313 

最近更新日期:

Date of Last Refreshed on:

2026-02-04 10:04:16 

注册时间:

Date of Registration:

2026-02-04 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

右美托咪定联合艾司氯胺酮对老年髋部骨折术前睡眠障碍患者术后谵妄的影响

Public title:

Dexmedetomidine Combined with Esketamine for the Prevention of Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery with Preoperative Sleep Disturbance: A Randomized Double-Blind Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

右美托咪定联合艾司氯胺酮对老年髋部骨折术前睡眠障碍患者术后谵妄的影响

Scientific title:

Dexmedetomidine Combined with Esketamine for the Prevention of Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery with Preoperative Sleep Disturbance: A Randomized Double-Blind 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:

刘清仁 

研究负责人:

刘清仁 

Applicant:

Qingren Liu 

Study leader:

Qingren Liu 

申请注册联系人电话:

Applicant telephone:

+86 136 0151 0412

研究负责人电话:

Study leader's
telephone:

+86 136 0151 0412

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:

liuqr5250@163.com

研究负责人电子邮件:

Study leader's E-mail:

liuqr5250@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:

无锡市锡山区安镇街道大成路1128号

研究负责人通讯地址:

无锡市锡山区安镇街道大成路1128号

Applicant address:

1128 Dacheng Road, Xishan District, Wuxi, Jiangsu, China

Study leader's address:

1128 Dacheng Road, Xishan District, Wuxi, Jiangsu, China

申请注册联系人邮政编码:

Applicant postcode:

214105

研究负责人邮政编码:

Study leader's postcode:

214105

申请人所在单位:

无锡市锡山人民医院

Applicant's institution:

Xishan People’s Hospital of Wuxi City

研究负责人所在单位:

无锡市锡山人民医院

Affiliation of the Leader:

Xishan People’s Hospital of Wuxi City

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:

2025-K085-01

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:

无锡市锡山人民医院临床研究伦理委员会

Name of the ethic committee:

IEC for Clinical Research of Xishan people's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-01-13 00:00:00

伦理委员会联系人:

拜红霞

Contact Name of the ethic committee:

Hongxia Bai

伦理委员会联系地址:

无锡市锡山区安镇街道大成路1128号

Contact Address of the ethic committee:

1128 Dacheng Road, Xishan District, Wuxi, Jiangsu, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 133 9514 2372

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:

无锡市锡山人民医院

Primary sponsor:

Xishan People’s Hospital of Wuxi City

研究实施负责(组长)单位地址:

无锡市锡山区安镇街道大成路1128号

Primary sponsor's address:

1128 Dacheng Road, Xishan District, Wuxi, Jiangsu, 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

市(区县):

无锡

Country:

China

Province:

Jiangsu

City:

Wuxi

单位(医院):

无锡市锡山人民医院

具体地址:

无锡市锡山区安镇街道大成路1128号

Institution
hospital:

Xishan People’s Hospital of Wuxi City

Address:

1128 Dacheng Road, Xishan District, Wuxi, Jiangsu, China

经费或物资来源:

江苏省医学会医学科研项目

Source(s) of funding:

Scientific Research Program of Jiangsu Medical Association

研究疾病:

髋部骨折手术  

Target disease:

Hip Fracture 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:

明确右美托咪定联合艾司氯胺酮对老年髋部骨折手术术前睡眠障碍患者POD的预防作用及其潜在机制。  

Objectives of Study:

To determine the preventive effect of dexmedetomidine combined with esketamine on postoperative delirium in elderly hip fracture surgery patients with preoperative sleep disturbance, and to explore the underlying mechanisms.

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:

术前谵妄病史,术前简易精神状态检查表(MMSE)判定认知功能障碍(文盲≤17分,小学文化程度≤20分,中学及以上文化程度≤24分),严重心律失常、心动过缓(HR < 50 次/分)或房室传导阻滞,严重肝、肾功能障碍,精神疾病史,语言或感官障碍,对研究药物有过敏史或禁忌症。

Exclusion criteria:

A history of preoperative delirium; preexisting cognitive impairment as determined by the Mini-Mental State Examination (MMSE) (illiterate ≤17, primary school ≤20, secondary school or above ≤24); severe arrhythmia, bradycardia (heart rate <50 beats/min), or atrioventricular block; severe hepatic or renal dysfunction; a history of psychiatric disorders; language or sensory impairment precluding assessment; and known allergy or contraindications to the study medications.

研究实施时间:

Study execute time:

From 2026-02-09 00:00:00 To 2026-07-15 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-02-09 00:00:00 To 2026-07-15 00:00:00

干预措施:

Interventions:

组别:

右美托咪定联合艾司氯胺酮组

样本量:

135

Group:

DE group

Sample size:

干预措施:

艾司氯胺酮在麻醉诱导期静脉给药,右美托咪定通过术后患者自控镇痛泵持续输注。

干预措施代码:

Intervention:

Esketamine was administered intravenously during anesthesia induction, while dexmedetomidine was infused through the postoperative patient-controlled analgesia pump.

Intervention code:

组别:

对照组

样本量:

135

Group:

C group

Sample size:

干预措施:

以等体积生理盐水分别替代艾司氯胺酮和右美托咪定。

干预措施代码:

Intervention:

An equal volume of normal saline was used in place of both esketamine and dexmedetomidine.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江苏 

市(区县):

无锡 

Country:

China

Province:

Jiangsu

City:

Wuxi

单位(医院):

无锡市锡山人民医院 

单位级别:

三乙 

Institution
hospital:

Xishan People’s Hospital of Wuxi City

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

江苏 

市(区县):

常熟 

Country:

China

Province:

Jiangsu

City:

Changshu

单位(医院):

常熟市第二人民医院 

单位级别:

三甲 

Institution
hospital:

ChangShu No.2 People's Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后3 d的POD 发生率

指标类型:

主要指标

Outcome:

Incidence of postoperative delirium within the first 3 postoperative days

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后第1晚和第2晚的睡眠质量

指标类型:

次要指标

Outcome:

postoperative sleep quality on the first and second postoperative nights

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1、3、6、12、24及48 h静息和活动状态下的NRS疼痛评分

指标类型:

次要指标

Outcome:

Numeric Rating Scale pain scores at rest and during movement at 1, 3, 6, 12, 24, and 48 h 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:

术后0–12 h、12–24 h、0–24 h、24–48 h及0–48 h的舒芬太尼累计用量

指标类型:

次要指标

Outcome:

cumulative sufentanil consumption during the intervals 0–12 h, 12–24 h, 0–24 h, 24–48 h, and 0–48 h 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:

术后48 h内不良反应发生率

指标类型:

副作用指标

Outcome:

The incidence of adverse events within 48 h after surgery

Type:

Adverse events

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 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):

随机序列由一名不参与受试者招募、麻醉实施、随访及结局评估的独立麻醉医师,采用计算机随机数字法(SPSS软件)生成。随机分配按研究中心进行分层,在各中心内采用变区组大小的区组随机,以保证各中心组间分配均衡。受试者按1:1比例分配至右美托咪定联合艾司氯胺酮组或对照组。

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

The randomization sequence will be generated by an independent anesthesiologist using a computer-based random number generator (SPSS software). Randomization will be stratified by study center, and block randomization with variable block sizes will be applied to ensure balanced allocation within each center. Participants will be assigned in a 1:1 ratio to either the dexmedetomidine–esketamine group or the control group. The independent anesthesiologist generating the sequence will not be involved in patient recruitment, clinical management, follow-up, or outcome assessment.

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:

研究对象、麻醉医生、手术医生、术后护理人员、结局评估者及数据分析人员均对分组情况未知。两组研究药物均由专职护士配置,注射器和镇痛泵在外观、颜色及体积上完全一致。该护士不参与入组、麻醉实施、术后管理、随访或数据分析。除紧急安全需要外,全程维持盲法。

Blinding:

Participants, anesthesiologists, surgeons, postoperative care staff, outcome assessors, and data analysts were all blinded to group allocation. Study medications for both groups were prepared in identical syringes and patient-controlled analgesia (PCA) pumps, with no differences in appearance, color, or volume. A designated study nurse, who was not involved in patient enrollment, anesthesia management, postoperative care, outcome assessment, or data analysis, prepared the study drugs according to the allocation information. The nurse had no further role in the study after drug preparation. Anesthesiologists responsible for intraoperative management and staff performing postoperative delirium assessments were unaware of the treatment assignments. Blinding was maintained throughout the study period unless emergency unblinding was required for patient safety.

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

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):

论文发表后半年内,国家生物信息中心 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):

Within six months of publication,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:

病例记录表

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

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-02-04 10:04:07