艾司氯胺酮对老年患者瑞马唑仑诱导镇静ED95及其血流动力学稳定性的影响:一项前瞻性、随机、双盲、序贯剂量探索研究

注册号:

Registration number:

ChiCTR2600124569 

最近更新日期:

Date of Last Refreshed on:

2026-05-14 00:28:16 

注册时间:

Date of Registration:

2026-05-14 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

艾司氯胺酮对老年患者瑞马唑仑诱导镇静ED95及其血流动力学稳定性的影响:一项前瞻性、随机、双盲、序贯剂量探索研究

Public title:

Effect of Esketamine Pretreatment on the ED95 of Remimazolam for Sedation Induction and Hemodynamic Stability in Elderly Patients: A Prospective, Randomized, Double-Blind, Sequential Dose-Finding Study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

艾司氯胺酮对老年患者瑞马唑仑诱导镇静ED95及其血流动力学稳定性的影响:一项前瞻性、随机、双盲、序贯剂量探索研究

Scientific title:

Effect of Esketamine Pretreatment on the ED95 of Remimazolam for Sedation Induction and Hemodynamic Stability in Elderly Patients: A Prospective, Randomized, Double-Blind, Sequential Dose-Finding Study

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:

赵海树 

研究负责人:

惠康丽 

Applicant:

Zhao Haishu 

Study leader:

Hui Kangli 

申请注册联系人电话:

Applicant telephone:

+86 158 4059 0585

研究负责人电话:

Study leader's
telephone:

+86 159 5189 9306

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:

Haishuzhao1998@163.com

研究负责人电子邮件:

Study leader's E-mail:

m15951899306@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:

中国江苏省南京市秦淮区杨公井34号

研究负责人通讯地址:

中国江苏省南京市秦淮区杨公井34号

Applicant address:

34 Yanggongjing, Qinhuai District, Nanjing, Jiangsu, China

Study leader's address:

34 Yanggongjing, Qinhuai District, Nanjing, Jiangsu, 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:

中国人民解放军东部战区总医院

Applicant's institution:

General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

研究负责人所在单位:

中国人民解放军东部战区总医院

Affiliation of the Leader:

General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

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:

2026DZKY-073-01

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:

中国人民解放军东部战区总医临床试验伦理委员会

Name of the ethic committee:

Clinical Trial Ethics Committee, General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

伦理委员会批准日期:

Date of approved by ethic committee:

2026-04-28 00:00:00

伦理委员会联系人:

刘玉秀

Contact Name of the ethic committee:

Liu Yuxiu

伦理委员会联系地址:

中国江苏省南京市秦淮区杨公井34号

Contact Address of the ethic committee:

34 Yanggongjing, Qinhuai District, Nanjing, Jiangsu, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 25 8086 3234

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:

中国人民解放军东部战区总医院

Primary sponsor:

General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

研究实施负责(组长)单位地址:

中国江苏省南京市秦淮区杨公井34号

Primary sponsor's address:

34 Yanggongjing, Qinhuai District, Nanjing, 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):

南京

Country:

China

Province:

Jiangsu

City:

Nanjing

单位(医院):

中国人民解放军东部战区总医院

具体地址:

中国江苏省南京市秦淮区杨公井34号

Institution
hospital:

General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

Address:

34 Yanggongjing, Qinhuai District, Nanjing, Jiangsu, China

经费或物资来源:

自筹

Source(s) of funding:

Self-funded

研究疾病:

老年患者全身麻醉诱导镇静  

Target disease:

Induction of Sedation for General Anesthesia in Elderly Patients

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:

偏倚化抛硬币设计 

Study design:

Biased Coin Design 

研究目的:

确定与固定亚麻醉剂量的艾氯胺酮共同给药时成功实现镇静诱导所需的瑞马唑仑的 ED95,量化艾司氯胺酮对瑞马的“节省效应”;评估两套诱导方案的血流动力学波动、诱导期及术后恢复期的不良反应、恢复情况。  

Objectives of Study:

To determine the ED95 of remimazolam required to achieve successful sedation induction when co-administered with a fixed subanesthetic dose of esketamine, and to quantify the sparing effect of esketamine on remimazolam; to evaluate the hemodynamic fluctuations, adverse effects during the induction period and the postoperative recovery period, as well as recovery status associated with the two induction regimens.

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. 已知对苯二氮卓类药物、艾氯胺酮过敏或有禁忌症; 2. 未控制的高血压(定义为静息收缩压 > 180 mmHg 或舒张压 > 110 mmHg); 3. 严重的精神疾病、严重肝肾功能障碍; 4. 阿片类药物、酒精、苯二氮䓬类药物以及非处方助眠药的使用; 5. 已诊断患有痴呆症或严重认知障碍; 6. 拒绝参与试验。

Exclusion criteria:

1. Known allergy or contraindication to benzodiazepines or esketamine; 2. Uncontrolled hypertension (defined as resting systolic blood pressure > 180 mmHg or diastolic blood pressure > 110 mmHg); 3. Severe psychiatric illness, severe liver or renal dysfunction; 4. Use of opioids, alcohol, benzodiazepines, or over-the-counter sleep aids; 5. Diagnosed dementia or severe cognitive impairment; 6. Refusal to participate in the study.

研究实施时间:

Study execute time:

From 2026-06-01 00:00:00 To 2027-06-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-06-01 00:00:00

干预措施:

Interventions:

组别:

R组

样本量:

40

Group:

R group

Sample size:

干预措施:

瑞马唑仑诱导镇静(序贯剂量探索)

干预措施代码:

Intervention:

Remazolam induction sedation (sequential dose exploration)

Intervention code:

组别:

R+E组

样本量:

40

Group:

R+E group

Sample size:

干预措施:

艾司氯胺酮预处理 + 瑞马唑仑诱导镇静(序贯剂量探索)

干预措施代码:

Intervention:

Esketamine pre-treatment + Remazolam induction sedation (sequential dose exploration)

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):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

中国人民解放军东部战区总医院 

单位级别:

三甲 

Institution
hospital:

General Hospital of the Eastern Theatre of the Chinese People's Liberation Army

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

瑞马唑仑诱导成功镇静的 ED95

指标类型:

主要指标

Outcome:

ED95 of remimazolam for successful induction sedation

Type:

Primary indicator

测量时间点:

瑞马唑仑给药后 3 min 内

测量方法:

成功镇静定义为瑞马唑仑给药后 3 min 内 MOAA/S 评分<=1;

Measure time point of outcome:

Within 3 min after remimazolam administration

Measure method:

Successful induction sedation is defined as a Modified Observer’s Assessment of Alertness/Sedation score <=1 within 3 min after remimazolam administration;

指标中文名:

初始诱导观察窗内低血压发生率

指标类型:

次要指标

Outcome:

Incidence of hypotension during the initial induction observation window

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

初始诱导观察窗内最低 MAP

指标类型:

次要指标

Outcome:

Minimum MAP during the initial induction observation window

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

初始诱导观察窗内 MAP 最大下降幅度

指标类型:

次要指标

Outcome:

Maximum decrease in MAP during the initial induction observation window

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

完整诱导-插管观察窗内低血压发生率

指标类型:

次要指标

Outcome:

Incidence of hypotension during the complete induction-to-intubation observation window

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

去氧肾上腺素使用率

指标类型:

次要指标

Outcome:

Rate of phenylephrine use

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血流动力学指标

指标类型:

次要指标

Outcome:

Hemodynamic parameters

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:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 60 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):

使用计算机生成随机数字表法,并按1:1的比例分为预先处理组和瑞马唑仑组

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

Patients were randomized in a 1:1 ratio to either the pretreatment group or the remimazolam group using a computer‑generated random number table.

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:

本研究采用双盲设计。受试者、实施麻醉的麻醉医生、结局评估者、术后随访人员及统计分析人员均对分组信息保持盲法。由于本研究采用有偏硬币序贯剂量设计,负责剂量递推及研究药物配置的独立研究助理不设盲,但其不参与麻醉实施、结局评估、术后随访或统计分析。研究药物均装入外观一致的注射器中,仅标注受试者编号,以维持盲法。

Blinding:

This study will use a double-blind design. Participants, attending anesthesiologists, outcome assessors, postoperative follow-up personnel, and statisticians will be blinded to group allocation. Because a biased-coin up-and-down dose-finding design is used, an independent unblinded research assistant will be responsible for dose adjustment and study drug preparation but will not participate in anesthesia management, outcome assessment, follow-up, or statistical analysis. Study drugs will be prepared in identical syringes labeled only with participant identification numbers.

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):

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:

数据采集使用CRF表记录,通过入组筛选患者,记录表记录患者一般情况及围术期数据,数据整理后使用Excel电子表格(微软)记录

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

Data collection was recorded using a CRF sheet, patients were screened by enrolment, general patient and perioperative data were recorded on the record sheet, and data were collated and recorded using an Excel spreadsheet (Microsoft)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-05-14 00:28:16