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The Effect of Esketamine on Cough Reflex During Tracheal Extubation in Patients Undergoing Open Thyroid Surgery

keskiviikko 3. kesäkuuta 2026 päivittänyt: Yun Wu, The Second Hospital of Anhui Medical University

The Effect of Esketamine on Cough Reflex During Tracheal Extubation in Patients Undergoing Open Thyroid Surgery: A Randomized Controlled Study

This study intends to conduct a prospective randomized controlled trial to implement esketamine-assisted anesthesia in patients undergoing open thyroidectomy, in order to observe the effect of esketamine on coughing during extubation in thyroidectomy patients.

Tutkimuksen yleiskatsaus

Tila

Ei vielä rekrytointia

Ehdot

Interventio / Hoito

Opintotyyppi

Interventio

Ilmoittautuminen (Arvioitu)

136

Vaihe

  • Ei sovellettavissa

Yhteystiedot ja paikat

Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.

Opiskeluyhteys

Opiskelupaikat

  • Kiina
    • Anhui
      • Hefei, Anhui, Kiina
        • Second Affiliated hospital of Anhui Medical University

Osallistumiskriteerit

Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.

Kelpoisuusvaatimukset

Opintokelpoiset iät

  • Aikuinen
  • Vanhempi Aikuinen

Hyväksyy terveitä vapaaehtoisia

Ei

Kuvaus

Inclusion Criteria:

  • Patients scheduled for elective open thyroid surgery
  • ASA class I-II
  • Voluntarily participate in the study and sign the informed consent form

Exclusion Criteria:

  • Body Mass Index > 30 kg/m²
  • Patients with unstable ischemic cardiomyopathy, pulmonary hypertension, poorly controlled or untreated hypertension (arterial hypertension, resting systolic/diastolic blood pressure >180/100 mmHg)
  • Hepatic or renal dysfunction
  • History of oral, maxillofacial, neck, or airway surgery, or pathological structural alterations
  • Respiratory diseases (COPD, asthma, inflammation, chronic cough)
  • Patients with elevated intracranial pressure
  • Patients undergoing repeat surgery
  • History of allergy to the investigational drug used in the study
  • Patients with psychiatric disorders or alcohol abuse (daily ethanol intake ≥40 g, or having experienced alcohol withdrawal within the past 6 months, or unable to control alcohol consumption)

Opintosuunnitelma

Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.

Miten tutkimus on suunniteltu?

Suunnittelun yksityiskohdat

  • Ensisijainen käyttötarkoitus: Ennaltaehkäisy
  • Jako: Satunnaistettu
  • Inventiomalli: Rinnakkaistehtävä
  • Naamiointi: Nelinkertaistaa

Aseet ja interventiot

Osallistujaryhmä / Arm
Interventio / Hoito
Kokeellinen: ESK iv group
After anesthesia induction, continue to administer esketamine by infusion at 0.1 mg/kg/h during the maintenance phase of anesthesia, and stop the infusion of esketamine during suturing.
Lääke: Esketamine
After anesthesia induction, continue to administer esketamine by infusion at 0.1 mg/kg/h during the maintenance phase of anesthesia, and stop the infusion of esketamine during suturing.
Placebo Comparator: CON group
After anesthetic induction, an equal amount of saline is continuously infused by pump during the maintenance phase of anesthesia, and the saline infusion is stopped during suturing;
Lääke: Normal Saline
After anesthetic induction, an equal amount of saline is continuously infused by pump during the maintenance phase of anesthesia, and the saline infusion is stopped during suturing;

Mitä tutkimuksessa mitataan?

Ensisijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Incidence of coughing during tracheal extubation
Aikaikkuna: perioperative (From the awakening period to immediately after tracheal extubation)
2 point scales; 0=None; 0 = Did not occur; 1 = Occurred;
perioperative (From the awakening period to immediately after tracheal extubation)

Toissijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Severity of coughing during tracheal extubation
Aikaikkuna: perioperative (From the awakening period to immediately after tracheal extubation)
4 grade scales; Grade 0: No choking cough; Grade 1: Single cough episode, considered mild choking cough; Grade 2: Intermittent cough, lasting less than 5 seconds, considered moderate choking cough; Grade 3: Continuous severe cough, lasting more than 5 seconds, considered severe choking cough. The higher the degree, the worse it is.
perioperative (From the awakening period to immediately after tracheal extubation)
Agitation score during tube removal
Aikaikkuna: perioperative (From the awakening period to immediately after tracheal extubation)
3-level scale; 1: Awake and calm; 2: Mild agitation but can be comforted; 3: Moderate agitation, difficult to comfort; 4: Severe agitation, cannot be comforted; The higher the degree, the worse the situation.
perioperative (From the awakening period to immediately after tracheal extubation)
Blood pressure
Aikaikkuna: From the induction period until 5 minutes after the completion of surgery
Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation
From the induction period until 5 minutes after the completion of surgery
Airway pressure 5 minutes after intubation and at the end of surgery
Aikaikkuna: 5 minutes after intubation and at the end of the surgery
5 minutes after intubation and at the end of the surgery
Intraoperative use rate and dosage of vasoactive drugs
Aikaikkuna: intraoperative (From the induction period to the end of anesthesia)
intraoperative (From the induction period to the end of anesthesia)
Sore throat score
Aikaikkuna: Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively
4-point scales; 0 = None; 1 = Mild, milder than a common cold; 2 = Moderate, like a sore throat from a common cold; 3 = Severe, more severe than a common cold; The higher the score, the greater the level of pain.
Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively
Hoarseness scores
Aikaikkuna: Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively
4-point scores; 0 = None; 1 = Transient hoarseness occurs; 2 = Patient perceives hoarseness during visit; 3 = Hoarseness is clearly noticeable; The higher the score, the more severe the hoarseness.
Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively
Surgical area pain scores
Aikaikkuna: Postoperative day 1 and day 2
Pain NRS scale score: 0 = no pain; 1-3 = mild pain; 4-6 = moderate pain; 7-10 = severe pain. The higher the score, the more severe the pain.
Postoperative day 1 and day 2
Incidence of adverse reactions within 48 hours postoperatively
Aikaikkuna: Within day 2 after surgery
Within day 2 after surgery
Postoperative nausea and vomiting(PONV) score
Aikaikkuna: Within day 2 after surgery

Vomiting: 0 = None; 1 = Once; 2 = Twice; 3 = Three times or more

Nausea, does it affect daily life: 0 = None; 1 = Sometimes; 2 = Often; 3 = Always
Within day 2 after surgery
Postoperative analgesic dosage
Aikaikkuna: Within day 2 after surgery
Within day 2 after surgery
Postoperative time to first food
Aikaikkuna: perioperative (Time from returning to the ward to the first food)
perioperative (Time from returning to the ward to the first food)
Upper Aerodigestive Symptoms After Thyroidectomy (UADS) questionnaire score
Aikaikkuna: Three month after surgery

Upper Aerodigestive Symptoms After Thyroidectomy Questionnaire; Instructions: 0=No problem, 1=Minor, 2=Moderate, 3=Major. Voice symptoms

  1. Vocal fatigue
  2. Difficulty speaking loudly
  3. Roughness
  4. Voice in low pitch
  5. Can"t speak in high pitch

  6. Voice in high pitch

    Swallowing/pharyngeal symptoms

  7. Burning during swallowing
  8. Pharyngeal bolus
  9. Pain during deglutition
  10. Pharyngeal pain
  11. Choking
  12. Dry throat
  13. Discomfort during swallowing
  14. Throat clearing
  15. Neck scar retraction during deglutition
  16. Foreign body sensation in pharynx
  17. Strangling sensation during swallowing
  18. Coughing during swallowing
  19. Foreign body in pharynx; The higher the score, the more severe it is.
Three month after surgery
Heart rate
Aikaikkuna: Time Frame: From the induction period until 5 minutes after the completion of surgery
Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation
Time Frame: From the induction period until 5 minutes after the completion of surgery
Oxygen saturation
Aikaikkuna: Time Frame: From the induction period until 5 minutes after the completion of surgery
Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation
Time Frame: From the induction period until 5 minutes after the completion of surgery
Anesthesia time
Aikaikkuna: perioperative (Time from induction to discontinuation of anesthetic agents)
perioperative (Time from induction to discontinuation of anesthetic agents)
Surgery time
Aikaikkuna: From the start of surgery to the end of surgery
From the start of surgery to the end of surgery
Extubation time
Aikaikkuna: perioperative (The time from discontinuation of anesthetic drugs to extubation)
perioperative (The time from discontinuation of anesthetic drugs to extubation)
Duration of tracheal tube placement
Aikaikkuna: perioperative (Time from intubation to )
perioperative (Time from intubation to )
Awakening time
Aikaikkuna: perioperative (Stop the anesthesia drug injection until awakening time)
perioperative (Stop the anesthesia drug injection until awakening time)
Post-anesthesia care unit (PACU) stay time
Aikaikkuna: perioperative (Duration from entering the PACU to leaving the PACU)
perioperative (Duration from entering the PACU to leaving the PACU)
PACU RASS score
Aikaikkuna: perioperative (Record once every ten minutes from the time of entering the post-anesthesia care unit until leaving the recovery room.)
  • 4: Combative
  • 3: Very agitated
  • 2: Agitated

  • 1: Restless 0: Alert and calm

    • 1: Drowsy
    • 2: Light sedation
    • 3: Moderate sedation
    • 4: Deep sedation
    • 5: Unarousable
perioperative (Record once every ten minutes from the time of entering the post-anesthesia care unit until leaving the recovery room.)
Intraoperative doses of propofol
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Intraoperative doses of remifentanil
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Intraoperative doses of Non-Steroidal Anti-Inflammatory Drugs(NSAIDs)
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Intraoperative doses of sufentanil
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Intraoperative fluid volume
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Intraoperative blood loss
Aikaikkuna: Intraoperative (From the induction period to the end of anesthesia)
Intraoperative (From the induction period to the end of anesthesia)
Sleep scores
Aikaikkuna: Postoperative 24 hours and 48 hours
4 point scores; 1 = Good sleep; 2 = Restless sleep; 3 = Dreamy sleep; 4 = Insomnia; The higher the score, the poorer the sleep.
Postoperative 24 hours and 48 hours
Antiemetic drug dosage
Aikaikkuna: Within day 2 after surgery
Within day 2 after surgery
Postoperative time to ambulation
Aikaikkuna: Perioperative (From the operating room to discharge)
Perioperative (From the operating room to discharge)
Length of postoperative hospital stay
Aikaikkuna: Perioperative (From the operating room to discharge)
Perioperative (From the operating room to discharge)
Postoperative time to first water intake
Aikaikkuna: Perioperative (Time from returning to the ward to the first drink of water)
Perioperative (Time from returning to the ward to the first drink of water)

Yhteistyökumppanit ja tutkijat

Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.

Sponsori

The Second Hospital of Anhui Medical University

Opintojen ennätyspäivät

Nämä päivämäärät seuraavat ClinicalTrials.gov-sivustolle lähetettyjen tutkimustietueiden ja yhteenvetojen edistymistä. National Library of Medicine (NLM) tarkistaa tutkimustiedot ja raportoidut tulokset varmistaakseen, että ne täyttävät tietyt laadunvalvontastandardit, ennen kuin ne julkaistaan ​​julkisella verkkosivustolla.

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Tähän tutkimukseen liittyvät termit

Muita asiaankuuluvia MeSH-ehtoja

Muut tutkimustunnusnumerot

  • YX2026-124

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