- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05276648
Efficacy of Erector Spinae Plane Block on Postoperative Delirium in Patients Undergoing Lumbar Spine Surgery
Lumbar vertebra surgery is one of the most common surgical procedures.Delirium is common in geriatric patients after lumbar spinae surgery.postoperative delirium usually occurs in the early postoperative period and delays patient mobilization and thus lengthens hospital stay.
The aim of this study was to investigate the effect of this field block on postoperative delirium in patients undergoing ESP with lomber vertebra surgery and with ultrasound guidance for postoperative analgesia.
Study Overview
Status
Conditions
Detailed Description
Postoperative delirium (PD) and postoperative cognitive dysfunction (POCD) are extremely common in geriatric surgical patients. After elective major joint replacement or other types of major surgery, about 5% to 15% of elders develop delirium and 25% to 40% and 12% to 15% developearly or late POCD. PDand POCD are associated with prolonged length of stay, discharge to a place other than home and higher 1 year mortality. In addition, delirium is associated with an accelerated trajectory of cognitive decline to dementia (1). The etiologies of both PD and POCD remain unknown. Controversy exists over whether delirium is a marker or risk factor for subsequent persistent cognitive impairment . The PD is an acute impairment of cognitive and or spatial/temporal perception,that can be diagnosed at the bedside with dedicated diagnostic tools. It has an acute onset and a fluctuating course, and therefore can be missed if not systematically tested. It is defined by three principal characteristics: altered consciousness; changes in cognitive abilities; recent and rapid onset . The POCD affects global cognitive functions for several months/years after surgery and anesthesia, diagnosis requires detailed neuropsychological testing.
Surgical interventions have been associated with severe pain and discomfort in the immediate perioperative period. Surgical anesthesia and the perioperative analgesic regimen aim toward complete intra-operative amnesia, profound analgesia, effective control of autonomic responses and rapid emergence. However, anesthesia, analgesia and sedation all utilize medications that might be implicated in the development of central nervous system (CNS) dysfunction. Elderly patients are more sensitive to the CNS effects of barbiturates, inhalationalanesthetics, benzodiazepines and opioids. Some medications frequently associated with delirium with or without POCD include opioids, anxiolytics, antidepressants, and corticosteroids.
There are studies regarding the effect of erektor spina field block on postoperative pain in vertebra surgery.The investigators will compare the effect on postoperative delirium of patients who underwent erector spina plane block after spinal surgery with those who did not.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: bulut polat
- Phone Number: +905058228095
- Email: bulut.plt@gmail.com
Study Contact Backup
- Name: sinem sari öztürk
- Phone Number: +905075396313
- Email: sarisinem@yahoo.com
Study Locations
-
-
Efeler
-
Aydın, Efeler, Turkey, 09100
- Recruiting
- Adnan Menderes University
-
Contact:
- bulut polat
- Phone Number: +905058228095
- Email: bulut.plt@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 60 and older
- ASA Physical Status 1-3;
- Scheduled for elective hip surgery under spinal anesthesia
- MMSE ≥ 20 (to exclude dementia)
Exclusion Criteria:
- Severe visual or auditory disorder/handicaps
- Bipolar disorder
- major depression
- schizophrenia
- Alzheimer
- Dementia
- ASA physical status IV or V
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ESP BLOCK
erector spina plane block applied
|
CAM ICU for delirium
MOCA for cognitif disfonction
BRİEF PAİN for chronic pain
VAS scale for acute pain
|
Active Comparator: no ESP BLOCK
those who did not apply erector spina plan block
|
CAM ICU for delirium
MOCA for cognitif disfonction
BRİEF PAİN for chronic pain
VAS scale for acute pain
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Comparison of the effect of postoperative delirium (determined by CAM ICU test) in patients who underwent erector spina block after spinal surgery and those who did not.
Time Frame: Change from baseline postoperative delirium at five days
|
CAM ICU IS THE TEST USED TO MEASURE DELIRIUM
|
Change from baseline postoperative delirium at five days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
postoperative chronic pain assessment.we will use brief pain scoring
Time Frame: 3 month later (one time)
|
brief pain scoring is the test used to measure chronic pain
|
3 month later (one time)
|
postoperative cognitive dysfunction assessment.we will use montreal cognitive assesment test
Time Frame: 3 month later (one time)
|
montreal cognitive assesment is the test used to measure postoperative cognitive dysfunction
|
3 month later (one time)
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Sinem Sari öztürk, Aydin Adnan Menderes University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2021/05
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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