Effect of perioperative esketamine on postoperative cognitive function in elderly patients undergoing gastrointestinal cancer surgeryanism Study Based on Intestinal Flora and Bile Acid Metabolism

注册号:

Registration number:

ChiCTR2500097651 

最近更新日期:

Date of Last Refreshed on:

2025-05-16 15:48:25 

注册时间:

Date of Registration:

2025-02-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

围术期应用艾司氯胺酮对老年胃肠道肿瘤手术患者术 后认知功能的影响

Public title:

Effect of perioperative esketamine on postoperative cognitive function in elderly patients undergoing gastrointestinal cancer surgeryanism Study Based on Intestinal Flora and Bile Acid Metabolism

注册题目简写:

English Acronym:

研究课题的正式科学名称:

围术期应用艾司氯胺酮对老年胃肠道肿瘤手术患者术 后认知功能的影响

Scientific title:

Effect of perioperative esketamine on postoperative cognitive function in elderly patients undergoing gastrointestinal cancer surgery

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:

杜培君 

研究负责人:

袁利邦 

Applicant:

Peijun Du 

Study leader:

Libang Yuan 

申请注册联系人电话:

Applicant telephone:

+86 152 8412 3738

研究负责人电话:

Study leader's telephone:

+86 134 5866 5896

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:

1942548587@qq.com

研究负责人电子邮件:

Study leader's E-mail:

lemonbang@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:

四川省成都市金牛区蓉都大道天回路270号

研究负责人通讯地址:

四川省成都市金牛区蓉都大道天回路270号

Applicant address:

No. 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu City, Sichuan Province

Study leader's address:

No. 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu City, Sichuan Province

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:

中国人民解放军西部战区总医院

Applicant's institution:

General Hospital of Western Theater Command of PLA

研究负责人所在单位:

中国人民解放军西部战区总医院

Affiliation of the Leader:

General Hospital of Western Theater Command of PLA

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2024EC7-ky013

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:

中国人民解放军西部战区总医院伦理委员会

Name of the ethic committee:

Ethics Committee of the General Hospital of the Western Theater Command of the Chinese People's Liberation Army

伦理委员会批准日期:

Date of approved by ethic committee:

2024-12-11 00:00:00

伦理委员会联系人:

苗艺凡

Contact Name of the ethic committee:

Yifan Miao

伦理委员会联系地址:

四川省成都市金牛区蓉都大道天回路270号

Contact Address of the ethic committee:

No. 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu City, Sichuan Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 86570332

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:

中国人民解放军西部战区总医院

Primary sponsor:

General Hospital of Western Theater Command of PLA

研究实施负责(组长)单位地址:

四川省成都市金牛区蓉都大道天回路270号

Primary sponsor's address:

No. 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu City, Sichuan Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

四川省

市(区县):

Country:

China

Province:

Sichuan Province

City:

单位(医院):

中国人民解放军西部战区总医院

具体地址:

四川省成都市金牛区蓉都大道天回路270号

Institution
hospital:

General Hospital of Western Theater Command of PLA

Address:

No. 270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu City, Sichuan Province

经费或物资来源:

成都市医学科研课题

Source(s) of funding:

Chengdu Medical Research Project

Target disease:

Postoperative cognitive dysfunction

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:

探讨围术期应用艾司氯胺酮对老年胃肠道肿瘤手术患者术后认知功能的影响并探讨其作用机制是否与肠道菌群-胆汁酸代谢相关。  

Objectives of Study:

To investigate the impact of perioperative application of esmketamine on postoperative cognitive function in elderly patients with gastrointestinal tumor surgery,and to explore whether the mechanism of esketamine impaction is related to intestinal flora - bile acid metabolism.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1.年龄>=65岁; 2.美国麻醉医师协会(American Society of Anesthesiologists, ASA)分级I-III级; 3.有胃肠道肿瘤切除手术指征者; 4.均接受术后镇痛者; 5.所有患者或家属均自愿签署知情同意书。

Inclusion criteria

1. Age >=65 years old; 2. American Society of Anesthesiologists (ASA) grade I-III; 3. Patients with indications for gastrointestinal tumor resection; 4. All patients received postoperative analgesia; 5. All patients or their family members voluntarily signed informed consent.

排除标准:

1.ASA分级>III级; 2.既往脑卒中、脑梗塞、TIA病史者;阻塞性睡眠呼吸暂停综合征者; 3.有传染病或血液系统疾病者; 4.患终末期慢性疾病、严重肺动脉高压、急性心梗者; 5.有手术禁忌、麻醉禁忌者; 6.患老年痴呆、阿尔兹海默症等大脑退行性病变者; 7.精神障碍、心理疾病无法配合者。

Exclusion criteria:

1.ASA grade > III; 2. Previous history of stroke, cerebral infarction or TIA; Obstructive sleep apnea syndrome; 3. Patients with infectious diseases or hematological diseases; 4. Patients with end-stage chronic disease, severe pulmonary hypertension, acute myocardial infarction; 5. Patients with contraindications to surgery and anesthesia; 6. Patients with senile dementia, Alzheimer's disease and other brain degenerative diseases; 7. Those with mental disorder or mental illness who are unable to cooperate.

研究实施时间:

Study execute time:

From 2025-01-01 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-02-27 00:00:00 To 2025-12-31 00:00:00  

干预措施:

Interventions:

组别:

试验组

样本量:

76

Group:

Test group

Sample size:

干预措施:

麻醉维持:术中采用七氟醚 1.5%-3%浓度吸入、瑞芬太尼0.01-0.02μg/(kg·min)持续泵注维持麻醉。在此基础上,实验组采用艾司氯胺酮0.15mg/kg/h 持续泵注至手术结束前 30 分钟。麻醉深度维持BIS(脑电双频谱指数)在 40-60 之间。 术后镇痛:两患者术后镇痛采用病人自控静脉镇痛(PCIA)模式。实验组药物配方:舒芬太尼 2μg/kg、艾司氯胺酮 0.015mg/(kg·h)、盐酸帕洛诺司琼0.5mg;镇痛泵参数设置:首次剂量 2ml,背景剂量 2.5ml/h,病人自控镇痛(PCA)剂量 2ml,锁定时间为 30min。

干预措施代码:

Intervention:

Anesthesia maintenance: During the operation, sevoflurane was inhaled at a concentration of 1.5%-3% and remifentanil was continuously pumped with 0.01-0.02μg/(kg·min) to maintain anesthesia. On this basis, esketamine 0.15mg/kg/h was continuously pumped in the experimental group until 30 minutes before the end of surgery. Anesthesia depth maintenance BIS (EEG bispectral index) between 40-60. Postoperative analgesia: Patient-controlled intravenous analgesia (PCIA) mode was used for postoperative analgesia in both patients. The drug formula of the experimental group was as follows: sufentanil 2μg/kg, esketamine 0.015mg/(kg·h), palonosetron hydrochloride 0.5mg, analgesic pump parameter settings: first dose 2ml, background dose 2.5ml/h, patient-controlled analgesia (PCA) dose 2ml, locking time 30min.

Intervention code:

组别:

对照组

样本量:

76

Group:

Control group

Sample size:

干预措施:

麻醉维持:术中采用七氟醚 1.5%-3%浓度吸入、瑞芬太尼0.01-0.02μg/(kg·min)持续泵注维持麻醉。在此基础上,对照组使用同等体积生理盐水持续泵注至手术结束前30分钟。麻醉深度维持BIS(脑电双频谱指数)在 40-60 之间。 术后镇痛:患者术后镇痛采用病人自控静脉镇痛(PCIA)模式。对照组药物配方:舒芬太尼 2μg/kg、盐酸帕洛诺司琼0.5mg,稀释至 150ml 生理盐水中;镇痛泵参数设置:首次剂量 2ml,背景剂量 2.5ml/h,病人自控镇痛(PCA)剂量 2ml,锁定时间为 30min。

干预措施代码:

Intervention:

Anesthesia maintenance: During the operation, sevoflurane was inhaled at a concentration of 1.5%-3% and remifentanil was continuously pumped with 0.01-0.02μg/(kg·min) to maintain anesthesia. On this basis, the control group was continuously pumped with the same volume of normal saline until 30 minutes before the end of the operation. Anesthesia depth maintenance BIS (EEG bispectral index) between 40-60. Postoperative analgesia: Postoperative analgesia for patients is performed in patient-controlled intravenous analgesia (PCIA) mode. Drug formulation for the control group: sufentanil 2μg/kg, palonosetron hydrochloride 0.5mg, diluted into 150ml normal saline; Analgesic pump parameter settings: first dose 2ml, background dose 2.5ml/h, patient-controlled analgesia (PCA) dose 2ml, lock-in time 30min.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川省 

市(区县):

 

Country:

China 

Province:

Sichuan Province 

City:

 

单位(医院):

中国人民解放军西部战区总医院 

单位级别:

三甲医院 

Institution
hospital:

General Hospital of Western Theater Command of PLA

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

蒙特利尔认知功能量表评分

指标类型:

主要指标

Outcome:

Montreal Cognitive Assessment 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:

简易精神状态量表评分

指标类型:

主要指标

Outcome:

Mini-mental State Examination 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:

血清学中白介素6表达水平

指标类型:

主要指标

Outcome:

Interleukin-6 expression levels in serology

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清学中S100β蛋白含量

指标类型:

主要指标

Outcome:

S100β protein content in serology

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肠道菌群

指标类型:

次要指标

Outcome:

Gut microbiota

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清胆汁酸定量

指标类型:

次要指标

Outcome:

Quantitative of serum bile acids

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:

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:

标本中文名:

粪便

组织:

Sample Name:

Feces

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 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):

由一名研究助理(P2)根据计算机软件(SPSS™27.0 (IBM, Chicago, IL, USA))产生的随机数字序列将符合纳排标准的患者进行完全随机分组。

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

A research assistant (P2) randomly assigned patients who met the inclusion and exclusion criteria to groups based on a random number sequence generated by computer software (SPSS™ 27.0 (IBM, Chicago, IL, USA)).

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:

双盲: 受试者、麻醉实施人员及结果评估者在整个试验过程中均对试验分组不知情。

Blinding:

Double-blind: Subjects, anesthesiologists, and outcome evaluators were unaware of the grouping throughout the trial.

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

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):

原始数据公开于临床试验公共管理平台 ResMan(http://www.medresman.org.cn)。

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

The original data is will public on website within six months after the trial complete: ResMan (http://www.medresman.org.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:

采用SPSS数据库和Excel、word等保存原始数据。

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

SPSS software, microsoft office excel and word.

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:

 2025-02-24 09:12:16