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90% Effective Infusion Time of Sufentanil to Prevent Induction Cough: A Biased Coin Sequential Study

19. August 2026 aktualisiert von: Shiyou Wei

Determination of the 90% Effective Infusion Time of Sufentanil to Prevent Sufentanil-Induced Cough During General Anesthesia Induction in Young and Elderly Patients: A Biased Coin Design Up-and-Down Sequential Study

This single-center, prospective biased coin up-and-down sequential study aims to determine the 90% effective infusion time (ET90) of sufentanil to prevent sufentanil-induced cough (SIC) during the induction phase of general anesthesia in adults undergoing endotracheal intubation. Two age cohorts are studied separately: younger adults (<65 years) and older adults (≥65 years). The trial does not test superiority or between-group differences as the primary objective.

All participants receive sufentanil via a peripheral intravenous pump. The total sufentanil dose is fixed within each age cohort (young: 0.40 μg/kg; elderly: 0.30 μg/kg), while the pump injection time is adjusted using the biased coin up-and-down allocation method. SIC success is defined as no audible cough within a prespecified observation window from the start of the infusion until 2 minutes after infusion ends.

The primary outcome is the ET90 of sufentanil and its 95% confidence interval for each age cohort, estimated using centered isotonic regression with bootstrap confidence intervals. Approximately 120 patients will be screened to obtain at least 54 evaluable participants per cohort.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

This is a single-center, prospective sequential study using a biased coin up-and-down allocation approach to determine the 90% effective infusion time (ET90) of sufentanil during the induction phase of general anesthesia to prevent sufentanil-induced cough (SIC). The study evaluates two age groups separately: younger adults (<65 years) and older adults (≥65 years).

Sufentanil will be administered intravenously via a infusion pump. Within each age cohort, the total sufentanil dose is predetermined, while the infusion time (rate) is adjusted based on the previous participant's outcome according to the biased coin up-and-down rule.

The primary success criterion is the absence of SIC during a prespecified observation period that starts at sufentanil infusion initiation and ends shortly after infusion completion during the induction phase. The primary outcome is the ET90, estimated for each age cohort with an appropriate statistical model using the observed infusion times and SIC outcomes.

Participants are screened before surgery based on age and general anesthesia requirements, and key comorbidities and contraindications are considered to reduce confounding. Safety is monitored throughout the induction phase and perioperative period, with attention to potential adverse events including hemodynamic instability and respiratory depression.

Approximately 120 patients are planned for enrollment to obtain sufficient evaluable participants in each cohort for ET90 estimation.

Studientyp

Interventionell

Einschreibung (Geschätzt)

120

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

    • Hunan
      • Shaoyang, Hunan, China, 422000
        • Shaoyang University Affiliated First Hospital
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • American Society of Anesthesiologists (ASA) physical status I-III
  • Aged ≥18 ears old
  • Scheduled for elective surgery requiring general anesthesia with tracheal intubation

Exclusion Criteria:

  • Resting vital signs upon operating-room arrival: systolic blood pressure ≥160 mmHg, or diastolic blood pressure ≥100 mmHg, or heart rate ≥110 beats per minute.
  • Anticipated difficult airway, requirement for rapid-sequence induction, or emergency surgery.
  • Chronic cough, asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, active pulmonary disease, or upper respiratory tract infection within the preceding 2 weeks.
  • Regular opioid use for more than 2 weeks within 6 months before surgery; or recent use of antitussive agents or other medications that may alter the cough reflex.
  • Known history of allergy to study drug (sufentanil citrate).
  • Pregnancy, lactation, psychiatric disorders, or individuals unable to communicate appropriately.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Verhütung
  • Zuteilung: N / A
  • Interventionsmodell: Sequenzielle Zuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Single Interventional Arm

All enrolled participants receive sufentanil citrate injection, infused via peripheral intravenous syringe pump during general anesthesia induction.

Two independent age-defined sequential sub-cohorts are included within this single arm:

  1. Younger adult sub-cohort (<65 years): fixed sufentanil total dose 0.40 μg/kg actual body weight.
  2. Older adult sub-cohort (≥65 years): fixed sufentanil total dose 0.30 μg/kg actual body weight.

Within each sub-cohort, the sufentanil infusion time is adjusted sequentially by biased-coin up-and-down rule according to the previous participant's sufentanil-induced cough (SIC) outcome. No other prophylactic anti-cough medications are given during the SIC observation window. After completion of the observation period, standard general anesthesia induction will be performed according to institutional routine.

Sufentanil citrate administered via peripheral intravenous syringe pump during general anesthesia induction. Fixed weight-based total dose within each age sub-cohort; infusion time varies according to biased-coin up-and-down sequential rules.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
90% effective infusion time (ET90) of sufentanil for preventing sufentanil-induced cough (SIC)
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
ET90 is defined as the shortest sufentanil infusion time achieving no SIC in 90% of participants, estimated separately for younger adults (<65 years) and older adults (≥65 years) using centered isotonic regression with bootstrap 95% confidence intervals. SIC is defined as any audible cough within the predefined observation window.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Incidence and severity of sufentanil-induced cough (SIC)
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
SIC severity graded: mild (1-2 coughs), moderate (3-4 coughs), severe (≥5 coughs). Count of cough episodes and SIC incidence at each infusion-time level, reported separately for two age sub-cohorts.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Peri-induction hemodynamic changes
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Hemodynamic changes recorded during sufentanil infusion observation window.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Hypotension
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Hypotension is defined as systolic blood pressure < 90 mmHg or mean arterial pressure (MAP) < 60 mmHg.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Bradycardia
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Bradycardia is defined as heart rate < 50 beats per minute.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Injection pain
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Pain induced by drug injection, assessed immediately after intravenous drug administration.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Chest wall rigidity
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Chest wall rigidity is defined as opioid-induced increased tone of thoracic and abdominal muscles leading to reduced chest-wall compliance and difficulty with manual or mechanical ventilation.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Respiratory depression
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Respiratory depression is defined as the presence of at least one of the following: respiratory rate (RR) < 8 breaths per minute in adults; arterial oxygen saturation (SpO₂) < 90 mmHg despite oxygen supplementation; shallow, slow and ineffective ventilation accompanied by somnolence or reduced level of consciousness (excessive sedation); arterial blood gas showing PaCO₂ >50 mmHg together with pH <7.30.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Allergic reaction
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Allergic reaction is defined as drug-mediated hypersensitivity manifestations occurring after intravenous injection, including skin rash, urticaria, flushing, bronchospasm, hypotension or other immune-mediated adverse events.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Dizziness
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Dizziness is defined as a subjective sensation of light-headedness or unsteadiness reported by the subject following study drug administration.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Palpitation
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Palpitation is defined as the subject-reported unpleasant awareness of abnormal or forceful heartbeats after study drug injection.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Hypoxemia
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Peripheral oxygen saturation SpO₂ <92% on pulse oximetry.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Pruritus
Zeitfenster: From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)
Subject reports generalized or local pruritus after sufentanil administration.
From start of sufentanil infusion until 2 minutes after the end of sufentanil infusion (anesthesia induction period)

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Ermittler

  • Hauptermittler: Xin Lv, Shanghai Pulmonary Hospital, School of Medicine, Tongji University

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. November 2026

Primärer Abschluss (Geschätzt)

25. Dezember 2026

Studienabschluss (Geschätzt)

30. Dezember 2026

Studienanmeldedaten

Zuerst eingereicht

19. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

19. August 2026

Zuerst gepostet (Tatsächlich)

21. August 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

21. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

19. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • Shaoyang-002

Plan für individuelle Teilnehmerdaten (IPD)

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NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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