不同剂量艾司氯胺酮复合舒芬太尼对腹腔镜结直肠癌根治术后患者自控静脉镇痛效果的影响:一项随机、双盲、平行对照研究

注册号:

Registration number:

ChiCTR2600126992 

最近更新日期:

Date of Last Refreshed on:

2026-06-22 16:11:12 

注册时间:

Date of Registration:

2026-06-22 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

不同剂量艾司氯胺酮复合舒芬太尼对腹腔镜结直肠癌根治术后患者自控静脉镇痛效果的影响:一项随机、双盲、平行对照研究

Public title:

Effect of different doses of esketamine combined with sufentanil on patient‑controlled intravenous analgesia after laparoscopic radical resection of colorectal cancer: a randomized, double‑blind, parallel‑controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

不同剂量艾司氯胺酮复合舒芬太尼用于腹腔镜下结直肠癌根治术术后患者自控静脉镇痛的效果研究

Scientific title:

Effect of different doses of esketamine combined with sufentanil on postoperative patient-controlled intravenous analgesia in patients undergoing laparoscopic radical resection of colorectal cancer

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:

胡宪文 

研究负责人:

胡宪文 

Applicant:

Xianwen Hu 

Study leader:

Xianwen Hu 

申请注册联系人电话:

Applicant telephone:

+86 551 6386 9625

研究负责人电话:

Study leader's
telephone:

+86 551 6386 9625

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:

efy110302@fy.ahmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

efy110302@fy.ahmu.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:

安徽省合肥市芙蓉路678号

研究负责人通讯地址:

安徽省合肥市芙蓉路678号

Applicant address:

678 Furong Road, Hefei, Anhui, China

Study leader's address:

678 Furong Road, Hefei, Anhui, China

申请注册联系人邮政编码:

Applicant postcode:

230601

研究负责人邮政编码:

Study leader's postcode:

230601

申请人所在单位:

安徽医科大学第二附属医院

Applicant's institution:

The Second Affiliated Hospital of Anhui Medical University

研究负责人所在单位:

安徽医科大学第二附属医院

Affiliation of the Leader:

The Second Affiliated Hospital of Anhui Medical 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:

SL-YX2026-140,, YX2026-140 (F1)

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:

安徽医科大学第二附属医院医学研究伦理委员会

Name of the ethic committee:

Medical Research Ethics Committee of the Second Affiliated Hospital of Anhui Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-29 00:00:00

伦理委员会联系人:

张静

Contact Name of the ethic committee:

Jing Zhang

伦理委员会联系地址:

安徽省合肥市芙蓉路678号

Contact Address of the ethic committee:

678 Furong Road, Hefei, Anhui, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 551 5380 6061

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:

安徽医科大学第二附属医院

Primary sponsor:

The Second Affiliated Hospital of Anhui Medical University

研究实施负责(组长)单位地址:

安徽省合肥市芙蓉路678号

Primary sponsor's address:

678 Furong Road, Hefei, Anhui, 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):

安徽

市(区县):

合肥

Country:

China

Province:

Anhui

City:

Hefei

单位(医院):

安徽医科大学第二附属医院

具体地址:

安徽省合肥市芙蓉路678号

Institution
hospital:

The Second Affiliated Hospital of Anhui Medical University

Address:

678 Furong Road, Hefei, Anhui, China

经费或物资来源:

安徽省卫生健康委员会科研项目(AHWJ2024BAf30027)

Source(s) of funding:

Anhui Provincial Health and Wellness Research Project (AHWJ2024BAf30027)

研究疾病:

结直肠恶性肿瘤  

Target disease:

Colorectal Malignancy

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:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在观察腹腔镜下结直肠癌根治术术后自控静脉镇痛中使用舒芬太尼复合艾司氯胺酮的有效性和安全性,以评估其对患者术后镇痛的效果,并以此改进围术期管理。 1. 探讨不同剂量艾司氯胺酮联合舒芬太尼术后自控静脉镇痛对腹腔镜下结直肠癌根治术患者术后镇痛效果的影响; 2. 探讨不同剂量艾司氯胺酮联合舒芬太尼术后自控静脉镇痛对腹腔镜下结直肠癌根治术患者术后恢复的影响; 3. 阐明不同剂量艾司氯胺酮联合用于腹腔镜下结直肠癌根治术患者术后自控静脉镇痛的效果,为临床应用艾司氯胺酮于腹腔镜手术患者术后镇痛提供指导和参考。  

Objectives of Study:

This study aims to observe the efficacy and safety of sufentanil combined with esketamine for postoperative patient-controlled intravenous analgesia (PCIA) after laparoscopic radical resection of colorectal cancer, in order to evaluate its analgesic effect and thereby improve perioperative management. To investigate the effect of different doses of esketamine combined with sufentanil for PCIA on postoperative analgesia in patients undergoing laparoscopic radical resection of colorectal cancer. To investigate the effect of different doses of esketamine combined with sufentanil for PCIA on postoperative recovery in patients undergoing laparoscopic radical resection of colorectal cancer. To elucidate the analgesic effects of different doses of esketamine combined with sufentanil for PCIA in patients undergoing laparoscopic radical resection of colorectal cancer, and to provide guidance and reference for the clinical application of esketamine in postoperative analgesia for patients undergoing laparoscopic 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. 慢性疼痛病史; 2. 长期滥用镇痛药物或精神类药物的患者; 3. 患有精神疾病或有精神病病史者; 4. 有其他严重系统性疾病(严重的心脏、肾脏或者肝肺疾病)的患者; 5. 有艾司氯胺酮使用禁忌证(严重高血压、颅内高压、肺动脉高压、青光眼等)的患者; 6. 妊娠及哺乳期妇女; 7. 体重<40 kg的患者; 8. 可能导致知情同意无效的心理或其他情绪问题的患者,依从性不佳、难以配合治疗和随访的患者。

Exclusion criteria:

1. History of chronic pain; 2. Patients with long-term abuse of analgesic or psychotropic drugs; 3. Patients with mental illness or a history of psychiatric disorders; 4. Patients with other severe systemic diseases (severe cardiac, renal, hepatic, or pulmonary diseases); 5. Patients with contraindications to esketamine (such as severe hypertension, intracranial hypertension, pulmonary hypertension, glaucoma, etc.); 6. Pregnant or lactating women; 7. Patients with body weight < 40 kg; 8. Patients with psychological or other emotional problems that may invalidate informed consent, poor compliance, or difficulty cooperating with treatment and follow-up.

研究实施时间:

Study execute time:

From 2026-07-01 00:00:00 To 2027-09-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-07-01 00:00:00 To 2027-09-01 00:00:00

干预措施:

Interventions:

组别:

舒芬太尼组

样本量:

36

Group:

Sufentanil group

Sample size:

干预措施:

PCIA配液方案:舒芬太尼2 ug/kg+格拉司琼2 mg+生理盐水共100 ml溶液

干预措施代码:

Intervention:

PCIA solution formulation: sufentanil 2 μg/kg + granisetron 2 mg, diluted with normal saline to a total volume of 100 mL.

Intervention code:

组别:

0.5 mg/kg/48h艾司氯胺酮复合舒芬太尼组

样本量:

36

Group:

Esketamine 0.5 mg/kg/48 h combined with sufentanil group

Sample size:

干预措施:

PCIA配液方案:舒芬太尼2 ug/kg+艾司氯胺酮0.5 mg/kg+格拉司琼2 mg+生理盐水共100 ml溶液

干预措施代码:

Intervention:

PCIA solution formulation: sufentanil 2 μg/kg + esketamine 0.5 mg/kg + granisetron 2 mg, diluted with normal saline to a total volume of 100 mL

Intervention code:

组别:

1 mg/kg/48h艾司氯胺酮复合舒芬太尼组

样本量:

36

Group:

Esketamine 1 mg/kg/48 h combined with sufentanil group

Sample size:

干预措施:

PCIA配液方案:舒芬太尼2 ug/kg+艾司氯胺酮1 mg/kg+格拉司琼2 mg+生理盐水共100 ml溶液

干预措施代码:

Intervention:

PCIA solution formulation: sufentanil 2 μg/kg + esketamine 1 mg/kg + granisetron 2 mg, diluted with normal saline to a total volume of 100 mL

Intervention code:

组别:

2 mg/kg/48h艾司氯胺酮复合舒芬太尼组

样本量:

36

Group:

Esketamine 2 mg/kg/48 h combined with sufentanil group

Sample size:

干预措施:

PCIA配液方案:舒芬太尼2 ug/kg+艾司氯胺酮2 mg/kg+格拉司琼2 mg+生理盐水共100 ml溶液

干预措施代码:

Intervention:

PCIA solution formulation: sufentanil 2 μg/kg + esketamine 2 mg/kg + granisetron 2 mg, diluted with normal saline to a total volume of 100 mL

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

安徽 

市(区县):

合肥 

Country:

China

Province:

Anhui

City:

Hefei

单位(医院):

安徽医科大学第二附属医院 

单位级别:

三甲 

Institution
hospital:

The Second Affiliated Hospital of Anhui Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

静息疼痛评分与运动疼痛评分

指标类型:

主要指标

Outcome:

NRS at rest and NRS on movement

Type:

Primary indicator

测量时间点:

术后3小时、6小时、12小时、24小时及48小时

测量方法:

采用数字评定量表(NRS,0~10分)评估患者疼痛程度。测量前向患者详细解释:0分代表无痛,1~3分代表轻度疼痛,4~6分代表中度疼痛,7~9分代表重度疼痛,10分代表难以忍受的最剧烈疼痛。静息NRS评分在患者平卧、安静状态下进行测量;运动NRS评分在患者主动进行咳嗽或床上翻身活动时进行测量。

Measure time point of outcome:

3, 6, 12, 24, and 48 hours postoperatively

Measure method:

Pain intensity was assessed using the Numerical Rating Scale (NRS, 0–10). Before measurement, patients were given a detailed explanation: 0 represents no pain, 1–3 represents mild pain, 4–6 represents moderate pain, 7–9 represents severe pain, and 10 represents the worst imaginable pain. The resting NRS score was measured with the patient lying supine and at rest; the movement-evoked NRS score was measured while the patient actively performed coughing or turning in bed.

指标中文名:

贝克抑郁量表(BDI-II)

指标类型:

次要指标

Outcome:

Beck Depression Inventory-II (BDI-II)

Type:

Secondary indicator

测量时间点:

术后第1天、术后第2天、术后第3天

测量方法:

BDI-II量表共21个条目,每个条目0~3分,总分0~63分,以>16分提示存在抑郁状态。由经培训的研究人员在术后第1、2、3天上午9:00~11:00以面对面访谈或患者自填方式测量,测量前统一说明“请根据过去24小时内的真实感受选择最符合的选项”,同一患者尽量由同一名研究人员执行,结果双人核对录入。

Measure time point of outcome:

Postoperative days 1, 2, and 3

Measure method:

The BDI-II has 21 items (each 0–3, total 0–63); scores >16 suggest a depressive state. Trained researchers assessed patients on postoperative days 1–3 between 9:00–11:00 a.m. by interview or self-report, using the standard instruction: "Please choose the option that best describes how you have felt over the past 24 hours." The same researcher assessed the same patient when possible; data were double-entered and verified.

指标中文名:

雅典失眠量表(AIS)评分

指标类型:

次要指标

Outcome:

Athens Insomnia Scale (AIS) score

Type:

Secondary indicator

测量时间点:

术后第1天及第2天

测量方法:

术后第1天及第2天,由研究人员采用雅典失眠量表(AIS)评估患者睡眠状况。AIS包含8个条目,每个条目0~3分,总分0~24分,分值越高提示失眠越严重。患者根据自身情况独立填写,研究人员核对回收。

Measure time point of outcome:

Postoperative days 1 and 2

Measure method:

On postoperative days 1 and 2, the patients' sleep status was assessed by researchers using the Athens Insomnia Scale (AIS). The AIS consists of 8 items, each scored from 0 to 3, yielding a total score ranging from 0 to 24, with higher scores indicating more severe insomnia. Patients completed the scale independently based on their own experience, and the researchers verified and collected the questionnaires.

指标中文名:

镇痛泵总按压次数、有效按压次数及补救性镇痛需求

指标类型:

次要指标

Outcome:

Total PCA pump demands, number of successful deliveries, and requirement for rescue analgesia

Type:

Secondary indicator

测量时间点:

术后24小时和术后48小时

测量方法:

于术后24小时和术后48小时两个时间点,由研究人员分别记录自术后开始至该时间点累计的镇痛泵总按压次数、有效按压次数,并评估是否需要补救性镇痛(即患者静息NRS≥4分或活动NRS≥6分且连续按压PCA泵两次无效后,是否接受了氟比洛芬酯50mg静脉注射)。

Measure time point of outcome:

24 and 48 hours postoperatively

Measure method:

At 24 and 48 hours postoperatively, the researchers recorded the cumulative total number of analgesic pump presses and the number of effective presses from the end of surgery to each time point, and assessed the need for rescue analgesia (defined as whether the patient received intravenous flurbiprofen axetil 50 mg after a resting NRS score ≥4 or a movement-evoked NRS score ≥6, along with two consecutive ineffective PCA pump presses).

指标中文名:

简易精神状态检查(MMSE)评分

指标类型:

次要指标

Outcome:

Mini-Mental State Examination (MMSE) score

Type:

Secondary indicator

测量时间点:

术后第1天、术后第2天、术后第3天

测量方法:

由培训合格的研究人员在安静环境下对患者一对一评估。MMSE共30项,涵盖定向力、记忆力、注意计算力、语言及视空间能力,正确计1分,错误计0分,总分0~30分,分数越高认知功能越好。于术后第1、2、3天同一时间段(如上午9~11时)评估,每次约5~10分钟。

Measure time point of outcome:

Postoperative days 1, 2, and 3

Measure method:

The MMSE was administered one-on-one by trained researchers in a quiet setting. It includes 30 items covering orientation, memory, attention/calculation, language, and visuospatial ability (1 point per correct answer; total score 0–30, higher scores indicate better cognitive function). Assessments were conducted on postoperative days 1, 2, and 3 during the same time window (e.g., 9:00–11:00 a.m.) and lasted approximately 5–10 minutes each.

指标中文名:

RASS镇静评分

指标类型:

次要指标

Outcome:

Richmond Agitation-Sedation Scale (RASS) score

Type:

Secondary indicator

测量时间点:

术后12小时、术后1天、术后2天及术后3天

测量方法:

采用里士满激越镇静量表(RASS)评估。先观察患者是否警觉平静(0分);若无反应,依次呼唤、摇肩刺激,根据反应评分(+4有攻击性至-5无法唤醒)。由培训人员于术后12小时、第1、2、3天统一评估。

Measure time point of outcome:

Postoperative 12 hours and on postoperative days 1, 2, and 3

Measure method:

Assessment was performed using the Richmond Agitation-Sedation Scale (RASS). Patients were first observed to determine if they were alert and calm (score 0). If there was no response, verbal stimulation followed by shoulder shaking were applied sequentially, and the score was assigned based on the response (ranging from +4 combative to ?5 unarousable). Assessments were uniformly conducted by trained personnel at 12 hours postoperatively and on postoperative days 1, 2, and 3.

指标中文名:

15项恢复质量评分量表(QoR-15)评分

指标类型:

次要指标

Outcome:

Quality of Recovery-15 (QoR-15) score

Type:

Secondary indicator

测量时间点:

术后1天、术后2天、术后3天

测量方法:

QoR-15量表共包含15个条目。每个条目采用0~10分数字评分法(0分表示“从未”或“非常差”,10分表示“总是”或“非常好”),总分范围为0~150分,分数越高代表术后恢复质量越好。评估时由研究人员逐条读出条目内容,患者根据过去24小时内的实际感受给出相应分值,研究人员记录。

Measure time point of outcome:

Postoperative day 1, day 2, and day 3

Measure method:

The QoR-15 scale consists of 15 items. Each item is scored on a 0–10 numerical rating scale (0 indicates "never" or "very poor" and 10 indicates "always" or "very good"). The total score ranges from 0 to 150, with higher scores representing better quality of recovery. During the assessment, the researcher read each item aloud, and the patient provided a score based on their actual experience over the preceding 24 hours. The researcher recorded the scores.

指标中文名:

术后不良反应发生率(包括恶心呕吐、谵妄、低血压、呼吸抑制、皮肤瘙痒等)

指标类型:

主要指标

Outcome:

Incidence of postoperative adverse events (including nausea and vomiting, delirium, hypotension, respiratory depression, pruritus, etc.)

Type:

Primary indicator

测量时间点:

术后3小时、6小时、12小时、24小时和48小时

测量方法:

术后恶心呕吐、谵妄、低血压、呼吸抑制(SpO2<90%)、皮肤瘙痒等不良反应,于术后48小时内持续监测并记录。具体评估时间点为术后3小时、6小时、12小时、24小时和48小时,与NRS疼痛评分时间点保持一致。

Measure time point of outcome:

3, 6, 12, 24, and 48 hours after surgery

Measure method:

Postoperative adverse events, including nausea and vomiting, delirium, hypotension, respiratory depression (SpO? < 90%), and pruritus, were continuously monitored and recorded within 48 hours postoperatively. The specific assessment time points were 3, 6, 12, 24, and 48 hours after surgery, consistent with the time points for NRS pain score assessment.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

N/A

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

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):

由研究人员采用随机数字表法进行随机分组

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

Randomization was performed by the researchers using a 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:

研究中,受试者方和研究者方对治疗分组信息均处于盲态,数据揭盲将由第三方在数据锁定后执行。

Blinding:

Both the participants and the investigators are blinded to the group assignment. Unblinding will be performed by a third party after database lock.

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):

研究完成后,经匿名化处理的原始数据将存储于安徽医科大学第二附属医院麻醉与围术期医学科的数据管理平台。在主要研究者批准且符合伦理委员会要求的前提下,可向其他研究者提供去标识化的数据,用于验证研究结果或二次分析。数据共享需签署数据使用协议,并确保不泄露受试者隐私。论文发表后,数据保留期限不少于5年。

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

After completion of the study, the anonymized raw data will be stored on the data management platform of the Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University. With the approval of the principal investigator and in compliance with the requirements of the ethics committee, de-identified data may be made available to other researchers for verification of study results or secondary analysis. Data sharing requires a signed data use agreement and must ensure that the privacy of the research participants is not compromised. After publication, the data will be retained for no less than five years.

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:

数据采集由经过统一培训的研究人员完成,使用纸质版病例报告表(CRF)记录受试者术前、术中及术后的所有临床数据,包括人口学信息、手术情况、NRS评分、量表评估(QoR-15、RASS、BDI-II、MMSE、AIS)、镇痛泵使用参数及不良反应等。CRF表双人核对后,由专人录入EpiData或Excel数据库,并进行逻辑校验。所有电子数据加密存储,纸质资料存放于上锁文件柜,仅主要研究者及授权人员可访问。研究结束后,数据保存至少5年。

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

Data collection will be performed by uniformly trained researchers using paper-based case report forms (CRFs) to record all clinical data before, during, and after surgery, including demographic information, surgical details, NRS scores, scale assessments (QoR-15, RASS, BDI-II, MMSE, AIS), analgesic pump usage parameters, and adverse events. The CRFs will be double-checked and then entered into an EpiData or Excel database by dedicated personnel, with logical validation performed. All electronic data will be stored in encrypted form, and paper records will be kept in locked filing cabinets, accessible only by the principal investigator and authorized personnel. After the study, data will be retained for at least five years.

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:

 2026-06-22 16:10:57