Suspension af mekanisk ventilation ved ureteroskopisk litotripsi under generel anæstesi (TA-fURS)
Transient Apnea to Stabilize Renal Motion During Flexible Ureteroscopic Lithotripsy: A Randomized Controlled Trial of Efficiency and Physiological Safety
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Kina, 200433
- Changhai Hospital, Naval Medical University
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
ASA I~III generel anæstesi underskriver det informerede samtykke
Ekskluderingskriterier:
ASA IV eller V kvinde, der er gravid eller planlægger at blive født
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: Regular Mechanical Ventilation
Participants received regular mechanical ventilation during flexible ureteroscopic laser lithotripsy under general anesthesia.
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Standard controlled mechanical ventilation was maintained during the active lithotripsy phase according to routine anesthetic practice.
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Aktiv komparator: Small Tidal-Volume Ventilation
Participants received small tidal-volume controlled ventilation during active flexible ureteroscopic laser lithotripsy to reduce respiration-related renal motion while maintaining clinically acceptable oxygenation and ventilation.
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Controlled ventilation with a reduced tidal-volume strategy was applied during active lithotripsy under continuous anesthetic monitoring.
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Eksperimentel: Transient Apnea
Participants underwent transient apnea during active flexible ureteroscopic laser lithotripsy after adequate preoxygenation and confirmation of physiologic stability by the anesthesiologist.
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Transient apnea was applied during active laser lithotripsy to reduce respiration-related renal motion.
Apnea was initiated after adequate preoxygenation and confirmation of physiologic stability.
Apnea was terminated if SpO₂ was <90%, systolic blood pressure was >160 mmHg or <80 mmHg, heart rate was <50 beats/min, obvious arrhythmia occurred, hemodynamic instability developed, or the attending anesthesiologist had any safety concern.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Active lithotripsy efficiency
Tidsramme: Intraoperative
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Active lithotripsy efficiency was defined as CT-based stone volume divided by active lithotripsy time.
Stone volume was calculated from stone length, width, and depth using the ellipsoid formula.
Active lithotripsy time was defined as the duration of active laser fragmentation or dusting and excluded ureteral access, endoscopic inspection, stent placement, and other non-lithotripsy procedural time.
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Intraoperative
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Active lithotripsy time
Tidsramme: Intraoperative
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Active lithotripsy time was defined as the duration of active laser fragmentation or dusting during flexible ureteroscopic lithotripsy.
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Intraoperative
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Total operative time
Tidsramme: Intraoperative
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Total operative time was defined as the time from endoscope insertion to completion of the procedure.
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Intraoperative
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Stone-free status on postoperative day 1 CT
Tidsramme: Postoperative day 1
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Stone-free status was assessed using CT on postoperative day 1.
Non-stone-free status was defined as any residual fragment >2 mm.
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Postoperative day 1
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Arterial pH
Tidsramme: Baseline to 3 minutes after resumption of ventilation
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Arterial pH was measured at baseline, 3 minutes, 6 minutes, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation.
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Baseline to 3 minutes after resumption of ventilation
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Arterial carbon dioxide tension
Tidsramme: Baseline to 3 minutes after resumption of ventilation
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Arterial PaCO₂ was measured at baseline, 3 minutes, 6 minutes, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation.
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Baseline to 3 minutes after resumption of ventilation
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Arterial oxygen tension
Tidsramme: Baseline to 3 minutes after resumption of ventilation
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Arterial PaO₂ was measured at baseline, 3 minutes, 6 minutes, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation.
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Baseline to 3 minutes after resumption of ventilation
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Arterial lactate
Tidsramme: Baseline to 3 minutes after resumption of ventilation
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Arterial lactate was measured at baseline, 3 minutes, 6 minutes, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation.
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Baseline to 3 minutes after resumption of ventilation
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Base excess
Tidsramme: Baseline to 3 minutes after resumption of ventilation
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Base excess was measured at baseline, 3 minutes, 6 minutes, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation.
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Baseline to 3 minutes after resumption of ventilation
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Protocol-defined interruption of transient apnea
Tidsramme: Intraoperative
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Protocol-defined interruption was recorded when transient apnea was discontinued because of SpO₂ <90%, systolic blood pressure >160 mmHg or <80 mmHg, heart rate <50 beats/min, obvious arrhythmia, hemodynamic instability, or anesthesiologist concern.
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Intraoperative
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Postoperative complications
Tidsramme: Up to 3 months after surgery
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Postoperative complications were recorded and graded according to the Clavien-Dindo classification.
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Up to 3 months after surgery
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Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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varigheden af operationen
Tidsramme: fra operationens start til slutningen af operationen
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Vi registrerer varigheden af operationen
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fra operationens start til slutningen af operationen
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restitutionstid
Tidsramme: fra slutningen af anæstesien til tilbagevenden til bevidsthed
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Vi registrerer, hvor lang tid det vil tage for patienterne at handle efter vores ordre efter ophør af anæstesi.
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fra slutningen af anæstesien til tilbagevenden til bevidsthed
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intraoperativ bevidsthed
Tidsramme: fra påbegyndelse af anæstesi til slutningen af operationen
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Vi vil registrere, om patinetter har nogen hukommelse under operationen, nemlig intraoperativ bevidsthed.
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fra påbegyndelse af anæstesi til slutningen af operationen
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Anslået)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Mandlige urogenitale sygdomme
- Calculi
- Patologiske Tilstande, Anatomiske
- Nyresygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Urolithiasis
- Urinvejsregning
- Patologiske tilstande, tegn og symptomer
- Nyre Calculi
- Nephrolithiasis
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- SMV-312
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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