- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04935541
Dexmedetomidine vs. Remifentanil Undergoing Cataract Surgery in Geriatrics
The Comparison of Dexmedetomidine and Remifentanil Infusion in Geriatric Patients Undergoing Outpatient Cataract Surgery: A Prospective, Randomized, Blinded Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Dexmedetomidine is an α2 agonist and remifentanil is a short-acting μ, opioid agonist. The aim of this study was to compare dexmedetomidine and remifentanil infusions used for conscious sedation in geriatric patients undergoing outpatient cataract surgery in terms of sedation quality, hemodynamic stability, and surgeon satisfaction.
Eighty patients were divided into two groups according to the administration of dexmedetomidine (Group D) and remifentanil (Group R) infusion in this randomized, prospective, double-blinded study. In group D (n = 40), after a loading of 1 µg/kg dexmedetomidine in 10 minutes, 0.4 µg/kg/h-1 infusion was administered. In Group R (n = 40), remifentanil at a dose of 0.05 µg/kg-1 was administered for 10 minutes, and then 0.05 µg/kg/min-1 infusion was continued.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Sıhhiye
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Ankara, Sıhhiye, Turkey, 06100
- Hacettepe University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients between the ages of 65-80,
- Who will undergo cataract surgery,
- With the American Society of Anesthesiologists (ASA) score I-III.
Exclusion Criteria:
- Second or third-degree heart block,
- Chronic α2-agonist use,
- Inability to communicate with the patient,
- Uncontrolled systemic disease,
- Allergy to local anesthetics,
- Chronic analgesic or sedative drug use,
- History of alcohol or substance addiction.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Dexmedetomidine infusion
Dexmedetomidine (Precedex, Meditera, USA) was administered at a loading dose of 1 µg/kg for 10 minutes before local anesthesia to be applied to the eye by the surgeon.
During the surgical procedure, it was administered at a dose of 0.4 µg/kg/h-1 infusion.
|
After Dexmedetomidine infusion was given for 10 minutes, local anesthesia was applied by the surgeon.
Peribulbar block and periorbital infiltration application were performed by applying a mixture of lidocaine (Jetokain, Adeka, Turkey) and 1/200000 adrenaline.
After the local anesthetic agent was applied by the surgeon, orbital compression was provided for 5 minutes with maximum pressure to block the eyelid movements.
Cataract surgery procedures of all patients included in the study were performed by the same surgeon.
Other Names:
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Active Comparator: Remifentanil infusion
Remifentanil (Ultiva, Glaxo SmithKline, Turkey) infusion was started at a dose of 0.05 µg/kg/min-1, 10 minutes before the start of the surgery as baseline infusion and continued at the same infusion dose throughout the surgical procedure.
|
After Remifentanil infusion was given for 10 minutes, local anesthesia was applied by the surgeon.
Peribulbar block and periorbital infiltration application were performed by applying a mixture of lidocaine (Jetokain, Adeka, Turkey) and 1/200000 adrenaline.
After the local anesthetic agent was applied by the surgeon, orbital compression was provided for 5 minutes with maximum pressure to block the eyelid movements.
Cataract surgery procedures of all patients included in the study were performed by the same surgeon.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sedation quality
Time Frame: Time interval immediately after the start of the surgery and before the patient is transferred to the postoperative care unit.
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The Observer Assessment Warning/Sedation Scale (OAA/S) was used to determine the sedation quality of each patient.
The minimum and maximum values of OAA/S scale was between 0 and 5. Lower scores mean a better sedation quality.
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Time interval immediately after the start of the surgery and before the patient is transferred to the postoperative care unit.
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Sedation level
Time Frame: The time interval immediately after the surgery starts and immediately after the surgery ends.
|
Bispectral Index (BIS) was used to determine the sedation level of each patient.
The minimum and maximum values for BIS were between 0 and 100.
Lower scores mean a deep sedation level.
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The time interval immediately after the surgery starts and immediately after the surgery ends.
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Pain intensity
Time Frame: The time interval between the start of the surgery and the end of the surgery.
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The Verbal Rating Scale was used to determine severity of the pain in the perioperative period.
VRS is a 5-point scale including expressions defining the level of pain intensity (no pain, mild pain, moderate pain, intense pain and maximum pain).
Higher scores mean intense pain.
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The time interval between the start of the surgery and the end of the surgery.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Side effects
Time Frame: The time interval between the start and the end of the surgery.
|
The Vissual Analogue Scale (VAS) was used to measure the frequency and severity of nausea and vomiting in the perioperative period.
The VAS score is discovered by measuring the distance (mm) on the 100-mm line.
Patients scoring 75 mm or more were considered to have clinically significant nausea and vomiting.
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The time interval between the start and the end of the surgery.
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Surgeon's satisfaction
Time Frame: Immediately after the surgeon finishes the operation.
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The surgeon's satisfaction in terms of the patient's sedation level, cooperation, and anesthesia management was evaluated using a questionnaire.
The clinician satisfaction questionnaire was also classified as follows; 0: Not satisfied, 1: Less Satisfied, 2: Satisfied.
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Immediately after the surgeon finishes the operation.
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Pain intensity
Time Frame: Immediately after the surgical procedure is completed and the patient is transferred to the postoperative care unit and before the patient is transferred to the outpatient service.
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The Visual Analogue Scale (VAS) was used to determine the pain intensity in the postoperative period.
The pain score is discovered by measuring the distance (mm) on the 100-mm line.
Pain level was classified as follows; no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).
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Immediately after the surgical procedure is completed and the patient is transferred to the postoperative care unit and before the patient is transferred to the outpatient service.
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Nalan Celebi, Professor, Hacettepe University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Eye Diseases
- Lens Diseases
- Cataract
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Analgesics, Opioid
- Narcotics
- Hypnotics and Sedatives
- Remifentanil
- Dexmedetomidine
Other Study ID Numbers
- HEK 09/59-19
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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