切口局部浸润超前镇痛在开腹患者ERAS理念中的临床应用

注册号:

Registration number:

ChiCTR1800020045 

最近更新日期:

Date of Last Refreshed on:

2018-12-12 20:58:35 

注册时间:

Date of Registration:

2018-12-12 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

切口局部浸润超前镇痛在开腹患者ERAS理念中的临床应用

Public title:

Clinical application of preemptive analgesia with local infiltration of incision in patients undergoing open surgery under ERAS concept

注册题目简写:

English Acronym:

研究课题的正式科学名称:

切口局部浸润超前镇痛在开腹患者ERAS理念中的临床应用

Scientific title:

Clinical application of preemptive analgesia with local infiltration of incision in patients undergoing open surgery under ERAS concept

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:

任益锋 

研究负责人:

郑孝振 

Applicant:

REN Yi-feng 

Study leader:

ZHENG Xiao-zhen 

申请注册联系人电话:

Applicant telephone:

+86 18039679378

研究负责人电话:

Study leader's
telephone:

+86 13938632449

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:

hdyfyryf@163.com

研究负责人电子邮件:

Study leader's E-mail:

573870613@qq.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:

河南省开封市龙亭区西门大街357号

研究负责人通讯地址:

河南省开封市龙亭区西门大街357号

Applicant address:

357 Ximen Street, Longting District, Kaifeng, He'nan, China

Study leader's address:

357 Ximen Street, Longting District, Kaifeng, He'nan, 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:

河南大学第一附属医院

Applicant's institution:

The First Affiliated Hospital of Henan University

研究负责人所在单位:

河南大学第一附属医院

Affiliation of the Leader:

The First Affiliated Hospital of Henan 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:

2018LW026

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:

河南大学第一附属医院伦理委员会

Name of the ethic committee:

Ethic Committee of the First Affiliated Hospital of Henan University

伦理委员会批准日期:

Date of approved by ethic committee:

2018-12-10 00:00:00

伦理委员会联系人:

陈景涛

Contact Name of the ethic committee:

CHEN Jing-tao

伦理委员会联系地址:

河南省开封市龙亭区西门大街357号

Contact Address of the ethic committee:

357 Ximen Street, Longting District, Kaifeng, He'nan, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

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:

河南大学第一附属医院麻醉科

Primary sponsor:

Department of Anesthesiology, First Affiliated Hospital of Henan University

研究实施负责(组长)单位地址:

河南省开封市龙亭区西门大街357号

Primary sponsor's address:

357 Ximen Street, Longting District, Kaifeng, He'nan, 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):

河南省

市(区县):

开封市

Country:

China

Province:

He'nan

City:

Kaifeng

单位(医院):

河南大学第一附属医院麻醉科

具体地址:

河南省开封市龙亭区西门大街357号

Institution
hospital:

Department of Anesthesiology, First Affiliated Hospital of Henan University

Address:

357 Ximen Street, Longting District, Kaifeng, He'nan, China

经费或物资来源:

河南省高等学校重点科研项目基金

Source(s) of funding:

Major research projects fund of Henan higher education institutions

研究疾病:

开腹手术  

Target disease:

laparotomy

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:

治疗新技术临床试验 

Study phase:

New Treatment Measure Clinical Study

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

由于开腹手术手术创伤大、持续时间长,患者术后常遭受剧烈的疼痛,而术后疼痛可导致机体出现全身炎性反应,进而引发肺部感染、肺不张及术后恶心呕吐等一系列并发症,甚至导致伤口出现感染、撕裂等严重情况。“超前镇痛”这一理念是指在术前施以有效的手段能够抑制或切断创伤刺激导致的神经系统的痛觉致敏阶段,使患者能够安全平稳的渡过围麻醉期,促进术后恢复。加速康复外科(enhanced recovery after surgery, ERAS)理念的核心就是采取有效的镇痛方法,降低患者应激和炎性反应水平,从而缩短住院时间和减少并发症的发生。近年来,切口局部浸润作为新型的镇痛方式逐渐运用于临床,已成为多模式镇痛的重要组成部分。和全身麻醉相比,切口局部浸润能够有效抑制痛觉信号的传导,从而产生超前镇痛效果。本研究拟通过观察和分析术中血流动力学、炎性因子水平、术后疼痛状况、睡眠质量、住院时间等指标以及不良反应发生情况,多方面评价切口局部浸润超前镇痛在开腹患者ERAS理念中的临床效果,为ERAS理念在开腹患者中的运用提供参考。  

Objectives of Study:

Owing to the large trauma and long duration of laparotomy, patients often suffer severe pain after operation. Postoperative pain can lead to systemic inflammatory reaction, which can lead to a series of complications such as pulmonary infection, atelectasis, nausea and vomiting after operation, and even lead to serious wound infection, tear and other serious conditions. The concept of "preemptive analgesia" refers to the use of effective means before surgery to inhibit or cut off the pain sensitization stage of the nervous system caused by traumatic stimulation, so that patients can safely and smoothly cross the peri-anesthesia period and promote post-operative recovery. The core of the concept of enhanced recovery after surgery (ERAS) is to adopt effective analgesic methods to reduce the level of stress and inflammatory reaction of patients, thus shortening the hospitalization time and reducing the occurrence of complications. In recent years, local infiltration of incision, as a new analgesic method, has gradually been used in clinical practice, and has become an important part of multimodal analgesia. Compared with general anesthesia, local infiltration of incision can effectively inhibit the transmission of pain signals, thus producing preemptive analgesic effect. The purpose of this study is to evaluate the clinical effect of preemptive analgesia with local infiltration of incision in patients undergoing laparotomy by observing and analyzing intraoperative hemodynamics, levels of inflammatory factors, post-operative pain, sleep quality, hospitalization time and adverse reactions, so as to apply the concept of ERAS in patients undergoing laparotomy. Provide reference.

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:

有开腹手术病史,切口部位感染,凝血功能障碍,局麻药物过敏,长期阿片类药物或止吐药服用史,怀孕女性,中枢神经病变患者,肝肾功能障碍患者,有精神障碍的患者,超重患者(BMI>30 kg/m2),低血压者,以及患者拒绝参加。

Exclusion criteria:

History of open surgery, wound site infection, coagulation dysfunction, local anesthesia drug allergy, long-term opioid or antiemetic drug use, pregnant women, patients with central neuropathy, patients with liver and kidney dysfunction, patients with mental disorders, overweight patients (BMI > 30 kg / m2), hypotension, etc. And patients refused to participate.

研究实施时间:

Study execute time:

From 2018-12-17 00:00:00 To 2019-04-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2018-12-17 00:00:00 To 2019-03-31 00:00:00

干预措施:

Interventions:

组别:

实验组

样本量:

32

Group:

Group L

Sample size:

干预措施:

0.375%罗哌卡因10ml

干预措施代码:

Intervention:

0.375% ropivacaine 10ml

Intervention code:

组别:

对照组

样本量:

32

Group:

Group C

Sample size:

干预措施:

0.9%生理盐水10ml

干预措施代码:

Intervention:

0.9% normal saline 10ml

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

河南省 

市(区县):

开封市 

Country:

China

Province:

He'nan

City:

Kaifeng

单位(医院):

河南大学第一附属医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Henan University

Level of the institution:

Tertiary A Hospital

测量指标:

Outcomes:

指标中文名:

炎性因子浓度

指标类型:

主要指标

Outcome:

Inflammatory factor concentration

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

NRS评分

指标类型:

主要指标

Outcome:

NRS score

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血流动力学变化

指标类型:

主要指标

Outcome:

Hemodynamic changes

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

睡眠质量

指标类型:

次要指标

Outcome:

sleep 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:

住院时间

指标类型:

次要指标

Outcome:

hospital 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:

不良反应

指标类型:

副作用指标

Outcome:

Side effects

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后慢性疼痛情况

指标类型:

次要指标

Outcome:

Postoperative chronic pain

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:

NO

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 35 years
最大 Max age 60 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):

由不参与该项研究的医师按照局部切口浸润镇痛药物的不同,采用计算机随机数字表法将参与者随机分为两组。

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

Doctors who did not participate in the study were randomly divided into two groups according to the difference of local incision infiltration analgesics.

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:

参加研究的研究人员及纳入研究的患者均对分组不知情。

Blinding:

The researchers and patients who participated in the study were unaware of the group.

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):

根据项目进展,试验完成后6个月内通过ResMan临床试验公共管理平台公开原始数据

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

According to the project progress, raw data were released through the ResMan Clinical Trial Public Management Platform within six months after completion of the trial

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:

研究者根据受试者的原始观察记录,将观察数据及时、准确、完整、清晰地录入RCT报告中,录入采用相应的数据库双人双机录入,后对录入数据进行两遍对比,电子数据文件分类保存并备份于磁盘上,妥善保存,防止损坏。

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

According to the original observation records of the subjects, the observational data are promptly, accurately, completely and clearly entered into the RCT report. The data are entered into the corresponding database with two people and two computers.

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:

 2018-12-12 20:58:35