围手术期利多卡因静脉输注降低胰腺癌术后复发和转移风险:一项多中心、随机、双盲、安慰剂对照试验

注册号:

Registration number:

ChiCTR2600127030 

最近更新日期:

Date of Last Refreshed on:

2026-06-23 11:19:49 

注册时间:

Date of Registration:

2026-06-23 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

围手术期利多卡因静脉输注降低胰腺癌术后复发和转移风险:一项多中心、随机、双盲、安慰剂对照试验

Public title:

Perioperative Intravenous Lidocaine Infusion Reduces the Risk of Postoperative Recurrence and Metastasis of Pancreatic Cancer: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

围手术期利多卡因静脉输注降低胰腺癌术后复发和转移风险:一项多中心、随机、双盲、安慰剂对照试验

Scientific title:

Perioperative Intravenous Lidocaine Infusion Reduces the Risk of Postoperative Recurrence and Metastasis of Pancreatic Cancer: A Multicenter, Randomized, Double-Blind, Placebo-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:

张丽芸 

研究负责人:

张丽芸 

Applicant:

Zhang Liyun 

Study leader:

Zhang Liyun 

申请注册联系人电话:

Applicant telephone:

+86 21 64370045

研究负责人电话:

Study leader's
telephone:

+86 21 64370045

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:

zlzhangliyun@126.com

研究负责人电子邮件:

Study leader's E-mail:

zlzhangliyun@126.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:

中国上海市黄浦区瑞金二路197号

研究负责人通讯地址:

中国上海市黄浦区瑞金二路197号

Applicant address:

197 Ruijin 2nd Road, Huangpu District, Shanghai, China

Study leader's address:

197 Ruijin 2nd Road, Huangpu District, Shanghai, 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:

上海交通大学医学院附属瑞金医院

Applicant's institution:

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

研究负责人所在单位:

上海交通大学医学院附属瑞金医院

Affiliation of the Leader:

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

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:

(2026)临伦审第(345)号

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:

上海交通大学医学院附属瑞金医院涉及人体的临床与科研项目伦理委员会

Name of the ethic committee:

Ruijin Hospital Ethics Committee, Shanghai JiaoTong University School of Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-21 00:00:00

伦理委员会联系人:

赵彦琳

Contact Name of the ethic committee:

Zhao Yanlin

伦理委员会联系地址:

中国上海市黄浦区瑞金二路197号

Contact Address of the ethic committee:

197 Ruijin 2nd Road, Huangpu District, Shanghai, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 80585870

伦理委员会联系人邮箱:

Contact email of the ethic committee:

zyl02d86@rjh.com.cn

研究实施负责(组长)单位:

上海交通大学医学院附属瑞金医院

Primary sponsor:

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

研究实施负责(组长)单位地址:

中国上海市黄浦区瑞金二路197号

Primary sponsor's address:

197 Ruijin 2nd Road, Huangpu District, Shanghai, 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):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属瑞金医院

具体地址:

中国上海市黄浦区瑞金二路197号

Institution
hospital:

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Address:

197 Ruijin 2nd Road, Huangpu District, Shanghai, China

经费或物资来源:

自筹

Source(s) of funding:

Self-funded

研究疾病:

胰腺癌  

Target disease:

Pancreatic cancer

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:

主要目的:评估围手术期(术中及术后72小时)利多卡因静脉输注对接受根治性切除术的胰腺癌患者术后无病生存期(DFS)的影响。 次要目的:评估围手术期利多卡因静脉输注对胰腺癌患者术后总生存期(OS)、术后恢复质量及安全性的影响。  

Objectives of Study:

Main objective: To evaluate the impact of intravenous lidocaine infusion during the perioperative period (intraoperative and 72 hours postoperatively) on disease-free survival (DFS) in patients with pancreatic cancer undergoing radical resection. Secondary objective: To evaluate the impact of perioperative intravenous lidocaine infusion on overall survival (OS), postoperative recovery quality, and safety in patients with pancreatic cancer.

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.体重<40kg;
2.合并其他活动性恶性肿瘤;
3.术前评估为无法根治切除的姑息手术或探查性手术;
4.自身免疫性疾病;
5.严重肝功能不全(天冬氨酸转氨酶或丙氨酸转氨酶或胆红素>正常值上限2.5倍);
6.严重肾功能不全(血肌酐≥186μmol/L或肌酐清除率<30mL/min);
7.严重的心律失常或心力衰竭,包括Ⅱ度或Ⅲ度房室传导阻滞、病窦综合征,以及左心室射血分数<50%的患者;
8.已知对酰胺类局麻药过敏;
9.存在严重中枢神经系统疾病者,包括癫痫病史、未控制的精神疾病等;
10.妊娠或哺乳期妇女;
11.有药物滥用史或长期(>3个月)规律使用阿片类药物史的患者;

Exclusion criteria:

1.weight under 40kg;
2.Combined with other active malignant tumors;
3.Preoperative assessment indicated palliative surgery or exploratory surgery without the possibility of radical resection;
4.Autoimmune disease;
5.Severe hepatic insufficiency (aspartate aminotransferase or alanine aminotransferase or bilirubin > 2.5 times the upper limit of normal);
6.Severe renal insufficiency (serum creatinine ≥186μmol/L or creatinine clearance rate <30mL/min);
7.Patients with severe arrhythmias or heart failure, including second-degree or third-degree atrioventricular block, sick sinus syndrome, and left ventricular ejection fraction <50%;
8.Known to be allergic to amide local anesthetics;
9.Individuals with severe central nervous system diseases, including history of epilepsy, uncontrolled mental illness, etc;
10.Pregnant or lactating women;
11.Patients with a history of drug abuse or long-term (>3 months) regular use of opioids;

研究实施时间:

Study execute time:

From 2026-07-01 00:00:00 To 2029-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-07-01 00:00:00 To 2028-12-31 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

587

Group:

Trial group

Sample size:

干预措施:

利多卡因静脉输注:麻醉诱导时按理想体重(IBW)静脉注射1.5 mg/kg,10分钟内注射完毕,随后术中持续按1.5 mg/kg/h输注至手术结束。术后72小时内使用患者自控静脉镇痛(PCIA)泵,内含利多卡因30mg/kg。

干预措施代码:

Intervention:

Lidocaine intravenous infusion: Intravenous injection of 1.5 mg/kg based on ideal body weight (IBW) during anesthesia induction, completed within 10 minutes, followed by continuous infusion at 1.5 mg/kg/h intraoperatively until the end of surgery. Patient-controlled intravenous analgesia (PCIA) pump containing lidocaine 30 mg/kg used for 72 hours postoperatively.

Intervention code:

组别:

对照组

样本量:

587

Group:

Placebo group

Sample size:

干预措施:

安慰剂(0.9%生理盐水):麻醉诱导时静脉注射生理盐水1.5 ml/kg(模拟利多卡因推注体积和速率),随后术中持续输注等速率的生理盐水至手术结束。术后72小时内使用患者自控静脉镇痛(PCIA)泵,不含利多卡因。

干预措施代码:

Intervention:

Placebo (0.9% saline): Intravenous injection of saline 1.5 ml/kg during anesthesia induction (mimicking volume and rate of lidocaine bolus), followed by continuous infusion of saline at the same rate intraoperatively until the end of surgery. Patient-controlled intravenous analgesia (PCIA) pump without lidocaine used for 72 hours postoperatively.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属瑞金医院 

单位级别:

三级甲等 

Institution
hospital:

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅三医院 

单位级别:

三级甲等 

Institution
hospital:

The Third Xiangya Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江苏省肿瘤医院 

单位级别:

三级甲等 

Institution
hospital:

Jiangsu Provincial Cancer Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河南 

市(区县):

 

Country:

China

Province:

Henan

City:

单位(医院):

河北医科大学第四医院 

单位级别:

三级甲等 

Institution
hospital:

The Fourth Hospital of Hebei Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广西壮族自治区 

市(区县):

 

Country:

China

Province:

Guangxi Zhuang Autonomous Region

City:

单位(医院):

广西医科大学附属肿瘤医院 

单位级别:

三级甲等 

Institution
hospital:

Guangxi Medical University Affiliated Cancer Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

无病生存期

指标类型:

主要指标

Outcome:

Disease-Free Survival(DFS)

Type:

Primary indicator

测量时间点:

从手术日期至首次出现任何原因导致的肿瘤复发、转移或任何原因死亡的时间间隔,以先发生者为准。

测量方法:

依据实体瘤疗效评价标准,通过影像学检查、结合肿瘤标志物进行独立评估。DFS事件定义为影像学确诊的肿瘤局部复发、远处转移或任何原因导致的死亡。必要时通过组织病理学确诊。

Measure time point of outcome:

The time interval between the first postoperative tumor recurrence, metastasis, or death

Measure method:

Based on the criteria for evaluating the efficacy of solid tumors, independent assessment is conducted through imaging examination combined with tumor markers. The DFS event is defined as local recurrence, distant metastasis, or death from any cause confirmed by imaging. Histopathological confirmation is performed when necessary.

指标中文名:

术后30天内主要并发症发生率

指标类型:

次要指标

Outcome:

The incidence rate of major complications within 30 days after surgery

Type:

Secondary indicator

测量时间点:

自本次手术结束(以离开手术室时间为准)起,至术后第 30 天(含出院后的随访期)期间发生的任何并发症事件。

测量方法:

通过查阅住院病历及术后30天随访记录收集数据。计算发生至少一次主要并发症的患者比例。

Measure time point of outcome:

Any complications that occur from the end of this surgery until the 30th day after surgery.

Measure method:

Data were collected by reviewing inpatient medical records and 30-day postoperative follow-up records. The proportion of patients who experienced at least one major complication was calculated.

指标中文名:

阿片类药物总消耗量

指标类型:

次要指标

Outcome:

Total consumption of opioids

Type:

Secondary indicator

测量时间点:

术中、术后 0-24h、24-48h、48-72h,以及整个住院期间的累计消耗量

测量方法:

通过查阅麻醉记录单、术后镇痛泵电子记录及病房医嘱系统,提取所有阿片类药物种类及剂量。统一采用国际标准的”静脉吗啡等效剂量“换算系数,将所有不同种类、不同给药途径的阿片类药物折算为等效静脉吗啡剂量(毫克)进行加总和统计。

Measure time point of outcome:

Cumulative consumption during the operation, and at 0-24h, 24-48h, 48-72h after the operation

Measure method:

By reviewing anesthesia records, electronic records of postoperative analgesia pumps, and ward doctor's order systems, all types and doses of opioids were extracted. Using the internationally standardized "intravenous morphine equivalent dose" conversion factor, all opioids of different types and administration routes were converted to equivalent intravenous morphine doses (mg) for summation and statistics.

指标中文名:

术后住院时间

指标类型:

次要指标

Outcome:

Postoperative hospitalization duration

Type:

Secondary indicator

测量时间点:

自本次手术结束(以麻醉记录单为准)起,至患者办理出院离院的时间。

测量方法:

通过提取医院信息系统中的实际离院时间记录,计算实际术后住院时间。

Measure time point of outcome:

From the completion of this surgery to the time when the patient is discharged from the hospital.

Measure method:

By extracting the actual discharge time records from the hospital information system, the actual postoperative hospitalization time is calculated.

指标中文名:

术后疼痛评分,术后睡眠评分

指标类型:

次要指标

Outcome:

Postoperative pain score, postoperative sleep score

Type:

Secondary indicator

测量时间点:

术前基线,及术后24 小时、48 小时和 72 小时

测量方法:

采用 0-10 分数字评定量表(NRS)评估疼痛,采用睡眠质量视觉模拟评分评估睡眠

Measure time point of outcome:

Preoperative baseline, and postoperative 24 hours, 48 hours, and 72 hours

Measure method:

Pain was assessed using a 0-10 numerical rating scale (NRS), and sleep was assessed using a visual analog scale for sleep quality.

指标中文名:

复发/转移率

指标类型:

次要指标

Outcome:

Recurrence/metastasis rate

Type:

Secondary indicator

测量时间点:

随访频次与无病生存期(DFS)一致。主要测量和报告特定里程碑时间点(如随机化后第 1 年、第 2 年、第 3 年)的累积复发/转移率。

测量方法:

通过标准影像学进行评估,必要时结合病理学确诊。记录发生局部区域复发或远处转移的受试者例数。统计时,将考虑“无复发死亡”的竞争风险,采用累积发生率函数计算特定时间点的复发/转移率。

Measure time point of outcome:

The cumulative recurrence/metastasis rate at specific milestone time points

Measure method:

Evaluation is conducted through standard imaging, and pathology is used for confirmation when necessary. The number of subjects experiencing local regional recurrence or distant metastasis is recorded. In statistical analysis, the competing risk of "recurrence-free death" will be taken into account, and the cumulative incidence function will be used to calculate the recurrence/metastasis rate at specific time points.

指标中文名:

术后认知功能障碍发生率

指标类型:

次要指标

Outcome:

Incidence of postoperative cognitive dysfunction

Type:

Secondary indicator

测量时间点:

术前 1 天(基线评估),术后第 7 天(或出院前),以及术后第 30 天。

测量方法:

采用蒙特利尔认知评估量表电话版 MoCA Telephone (T-MoCA)评估

Measure time point of outcome:

One day before op, the seventh day after surgery (or before discharge), the thirtieth day after op

Measure method:

Assessment using Montreal Cognitive Assessment Telephone (T-MoCA)

指标中文名:

围手术期炎症/免疫生物标志物(如CRP, IL-6, NLR, PLR)

指标类型:

次要指标

Outcome:

Dynamic changes of perioperative inflammatory/immune biomarkers

Type:

Secondary indicator

测量时间点:

术前 1 天,术后第 1 天、第 3 天及第 5 或第 7 天(或出院日,以先发生者为准)

测量方法:

通过静脉采血获取样本。比较两组各时间点绝对值及动态变化曲线。

Measure time point of outcome:

1 day before surgery, and on the 1st, 3rd, 5th, or 7th day after surgery (or the day of discharge)

Measure method:

Obtain samples through venous blood sampling. Compare the absolute values and dynamic change curves of the two groups at various time points.

指标中文名:

术后入 ICU 比率

指标类型:

次要指标

Outcome:

Postoperative ICU admission rate

Type:

Secondary indicator

测量时间点:

手术日至本次术后出院之日或术后 30 天(以先发生者为准)

测量方法:

通过查阅医院电子病历系统提取患者床位流转记录。计算术后实际转入 ICU 的受试者比例。同时记录转入 ICU 的主要原因及停留时间。

Measure time point of outcome:

From the date of surgery to the date of discharge after this surgery or 30 days after surgery

Measure method:

Extract patient bed turnover records by accessing the hospital's electronic medical record system. Calculate the proportion of subjects who were actually transferred to the ICU after surgery. Simultaneously, record the primary reason for transfer to the ICU and the duration of stay.

指标中文名:

首次排气时间

指标类型:

次要指标

Outcome:

First exhaust time

Type:

Secondary indicator

测量时间点:

自本次手术结束(以麻醉记录单为准)起,至患者术后首次发生自主肛门排气的时间间隔(精确至小时)。

测量方法:

通过患者主诉结合医护人员标准化问询进行记录,计算从手术结束至首次排气的小时数。

Measure time point of outcome:

The time interval from this surgery to the patient's first spontaneous anal exhaust

Measure method:

Record the patient's chief complaint combined with standardized inquiries from medical staff, and calculate the number of hours from the end of surgery to the first exhaust.

指标中文名:

总生存期

指标类型:

次要指标

Outcome:

Overall Survival(OS)

Type:

Secondary indicator

测量时间点:

从手术日期至任何原因死亡的时间间隔

测量方法:

通过门诊复诊记录、住院病历审查、受试者或其家属的电话访谈,或查阅官方死亡登记系统获取。记录确切的死亡日期及死亡原因

Measure time point of outcome:

The time interval from the date of surgery to death from any cause

Measure method:

The information is obtained through outpatient follow-up records, review of inpatient medical records, telephone interviews with subjects or their families, or by consulting the official death registration system. The exact date of death and cause of death are recorded

指标中文名:

术后谵妄发生率

指标类型:

次要指标

Outcome:

Incidence of postoperative delirium

Type:

Secondary indicator

测量时间点:

自术后起至术后第 7 天或患者出院(以先发生者为准),每日进行两次固定时间点的量表评估。

测量方法:

采用国际通用的意识模糊评估法(CAM)。对于普通病房患者,由经过培训的评估员使用 3D-CAM 量表进行评估;对于转入 ICU 或气管插管的患者,先使用 RASS 镇静程度评估表,再使用 CAM-ICU 量表评估。观察期内任一次 CAM/CAM-ICU 结果为阳性,即定义为发生术后谵妄。

Measure time point of outcome:

From the day after surgery until the 7th day after surgery or the patient's discharge, twice per day

Measure method:

The internationally recognized Confusion Assessment Method (CAM) is employed. For patients in general wards, trained assessors utilize the 3D-CAM scale for evaluation. For patients transferred to the ICU or those with tracheal intubation, the RASS sedation assessment scale is initially used, followed by the CAM-ICU scale. Any positive CAM/CAM-ICU result during the observation period is defined as the occurrence of postoperative delirium.

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

使用后保存  

说明

Fate of sample:

Preservation 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 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):

由独立于临床研究团队的第三方生物统计学家,采用 SAS 统计软件,以“研究中心”为分层因素,通过计算机生成分层、可变区组随机数列,按 1:1 比例分配至试验组和对照组。生成的随机数列直接导入交互式网络响应系统进行中央随机化管理。

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

A third-party biostatistician, independent of the clinical research team, utilized SAS statistical software to generate a stratified, variable block random sequence based on the "research center" as the stratification factor. The sequence was then allocated to the experimental group and the control group in a 1:1 ratio. The generated random sequence was directly imported into the Interactive Web Response System for centralized randomization management.

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:

双盲

Blinding:

Double blind

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):

2030-01;国家生物信息中心(https://www.cncb.ac.cn/)

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

2030-01; China National Center for Bioinformation (https://www.cncb.ac.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:

病历记录表,电子采集和管理系统

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

Case Record Form, Electronic Data Capture

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-06-23 11:17:55