Effect of Dexmedetomidine on Tear Production in Angioplasty Patients
Effect of Dexmedetomidine Sedation on Tear Film in Patients Undergoing Angioplasty Under Local Anesthesia
During medical procedures performed under local anesthesia with sedation, such as angioplasty, the eyes may become dry because normal blinking and tear production can be reduced. Dexmedetomidine is a commonly used sedative that provides comfort and pain relief while allowing patients to breathe on their own. However, there is limited information about how dexmedetomidine affects tear production and eye comfort after procedures.
This study aims to evaluate whether sedation with dexmedetomidine affects tear production compared with standard sedative medications used during angioplasty. Adult patients undergoing angioplasty under local anesthesia will be randomly assigned to receive either dexmedetomidine sedation or standard sedation. Tear production will be measured using the Schirmer test before the procedure, shortly after the procedure, and 12 hours later. Patients will also be asked about eye dryness or discomfort, and any eye-related or sedation-related side effects will be recorded.
The results of this study may help improve eye safety and comfort in patients receiving sedation during angioplasty and guide the selection of sedative medications in clinical practice.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Samar R Amin, M.D.
- Phone Number: +201287793991
- Email: samar.rafik@gmail.com
Study Locations
-
-
Qalyubia Governorate
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Banhā, Qalyubia Governorate, Egypt, 13511
- Benha University Hospital
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Contact:
- Samar Amin
- Phone Number: +201287793991
- Email: samar.rafik@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Scheduled for elective angioplasty (coronary PCI or peripheral angioplasty) under local anesthesia with planned procedural sedation.
- Able to give informed consent and complete ocular symptom assessments.
- Baseline Schirmer I ≥1 mm (to exclude complete anatomic lacrimal failure; you may alter this cutoff).
Exclusion Criteria:
- Pre-existing moderate/severe dry eye disease or Sjögren's syndrome (history or OSDI >33).
- Ocular surgery within prior 3 months or active ocular infection.
- Contact lens use within 24 hours before baseline.
- Chronic systemic medications known to substantially alter lacrimation (recent anticholinergics, high-dose tricyclics) unless stable and documented.
- Known allergy to dexmedetomidine, midazolam, fentanyl, or propofol.
- Significant bradycardia (HR <50) or high-degree AV block without pacemaker.
- Pregnancy or breastfeeding.
- Any condition making study participation or follow-up impossible.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Dexmedetomidine Sedation
Participants in this arm will be sedated with intravenous dexmedetomidine during angioplasty performed under local anesthesia.
Dexmedetomidine will be administered as a loading dose (if clinically appropriate) followed by a continuous infusion titrated to achieve moderate sedation (RASS -2 to 0).
Rescue sedation with small propofol boluses may be used if needed and will be recorded.
|
Dexmedetomidine will be administered intravenously for procedural sedation during angioplasty under local anesthesia.
A loading dose of 0.4-0.6 µg/kg may be given over 10 minutes at the discretion of the anesthesiologist, followed by a continuous infusion of 0.2-0.7 µg/kg/hour titrated to achieve moderate sedation (RASS -2 to 0).
Rescue sedation with small propofol boluses may be used if required and will be documented.
|
|
Active Comparator: Standard Sedation
Participants in this arm will receive standard sedation according to routine clinical practice during angioplasty under local anesthesia.
Sedation may include intermittent intravenous boluses of midazolam with or without opioid analgesics (e.g., fentanyl) and/or small propofol boluses, titrated to achieve moderate sedation (RASS -2 to 0).
|
Standard sedation will be provided according to routine clinical practice during angioplasty under local anesthesia.
Sedation may include intermittent intravenous boluses of midazolam, with or without opioid analgesics (e.g., fentanyl), and/or small propofol boluses, titrated to achieve moderate sedation (RASS -2 to 0).
All administered drugs and cumulative doses will be recorded.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Tear Production Measured by Schirmer I Test
Time Frame: Baseline (30 minutes pre-procedure) to 30 minutes post-procedure
|
Change in tear production measured by the Schirmer I test (without topical anesthesia), calculated as the difference in millimeters (mm) between baseline (pre-procedure, awake) and immediate post-procedure measurement once the patient is responsive (Aldrete score ≥9).
Measurements will be performed in a standardized manner by a trained, blinded assessor.
|
Baseline (30 minutes pre-procedure) to 30 minutes post-procedure
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Immediate Post-Procedure Tear Production (Schirmer I Test)
Time Frame: 30-60 minutes after completion of the procedure
|
Tear production measured using the Schirmer I test (mm) immediately after the procedure, once the patient is responsive (Aldrete score ≥9), and compared between study groups.
|
30-60 minutes after completion of the procedure
|
|
Patient-Reported Dry Eye Symptoms
Time Frame: Baseline (pre-procedure), immediate post-procedure, and 12 hours post-procedure
|
Dry eye symptoms assessed using a visual analog scale (VAS) ranging from 0 to 10, where 0 = no dry eye symptoms and 10 = worst imaginable dry eye symptoms.
|
Baseline (pre-procedure), immediate post-procedure, and 12 hours post-procedure
|
|
Incidence of Ocular Adverse Events
Time Frame: From start of procedure to 12 hours post-procedure
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Occurrence of ocular adverse events, including corneal abrasion, corneal epithelial defects, conjunctival hyperemia, blurred vision, or severe dry eye requiring ophthalmologic consultation.
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From start of procedure to 12 hours post-procedure
|
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Total Dexmedetomidine Dose
Time Frame: During the procedure
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Total cumulative dose of dexmedetomidine administered during the procedure, expressed in micrograms (µg).
|
During the procedure
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Azoles
- Hydrocarbons
- Hydrocarbons, Cyclic
- Hydrocarbons, Aromatic
- Imidazoles
- Piperidines
- Phenols
- Benzene Derivatives
- Benzazepines
- Benzodiazepines
- Midazolam
- Dexmedetomidine
- Propofol
- Fentanyl
Other Study ID Numbers
Other Study ID Numbers
- RC.18.10.2025
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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