tDCS for Reducing the Incidence of OEI After Cesarean Section
30 juin 2026 mis à jour par: Chaochao Zhong, Affiliated Hospital of Nantong University
Study on the Preventive and Therapeutic Effects and Mechanism of Transcranial Direct Current Stimulation on Morphine-Induced Itching After Cesarean Section: A Randomized Clinical Controlled Trial
Cesarean section is the most common obstetric surgery worldwide.
Epidural anesthesia has become the preferred anesthesia method for cesarean sections due to its definite analgesic effect and minimal impact on mother and baby.
To ensure postoperative analgesia, intrathecal administration of morphine (the preferred opioid for obstetric intrathecal analgesia) is a routine clinical protocol, but morphine-induced postoperative pruritus is a common adverse reaction.
A study targeting the cesarean section population confirmed that the incidence of pruritus after epidural morphine administration is as high as 40%-75%.Transcranial direct current stimulation (tDCS) can enhance the activity of GABAergic inhibitory interneurons in the spinal dorsal horn through the cortical-spinal descending pathway, reverse the inhibitory effect of morphine on them, and restore negative feedback regulation of itch-specific GRPR⁺ neurons; at the same time, it downregulates the phosphorylation level and membrane expression of μ-opioid receptors in the spinal dorsal horn, weakening the receptor activation efficiency of morphine.
On the other hand, tDCS can reduce peripheral nerve excitability, decrease mast cell degranulation in the skin, and reduce the release of histamine and tryptase; simultaneously, it inhibits the activation of glial cells in the spinal cord/cortex, decreases the secretion of pro-inflammatory factors such as TNF-α and IL-6, and blocks the vicious cycle of 'inflammation-receptor upregulation-itch exacerbation,' thereby reducing the occurrence of itch.This study aims to explore the effect of transcranial direct current stimulation (tDCS) on the incidence of morphine-induced itching after cesarean section by inhibiting the central itch perception circuits in cesarean section patients and antagonizing the disinhibitory effects mediated by μ-opioid receptors in the spinal dorsal horn.
Aperçu de l'étude
Statut
Pas encore de recrutement
Type d'étude
Interventionnel
Inscription (Estimé)
104
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: chao chao zhong, Doctor of Medicine
- Numéro de téléphone: 15152460489
- E-mail: zhong249767626@163.com
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
Accepte les volontaires sains
Non
La description
Inclusion Criteria:
- Age 18-40 years, gestational age 37-41 weeks, singleton full-term pregnancy;
- Planned elective or emergency cesarean section, using epidural anesthesia (0.1~0.2 mg/kg of morphine administered intrathecally during surgery);
- American Society of Anesthesiologists (ASA) classification I-III;
- Conscious and able to cooperate to complete scale assessments, serum sample collection, and postoperative follow-up;
- Voluntarily participate in the study and sign the informed consent form.
Exclusion Criteria:
- Presence of contraindications for tDCS (such as skull defects, intracranial metal implants, history of epilepsy, coagulation disorders);
- Allergy to opioids or a history of severe OEI;
- Presence of skin diseases (such as eczema, urticaria), liver diseases (cholestasis), mental disorders, or cognitive impairments;
- Coexisting pregnancy complications (preeclampsia, gestational diabetes, autoimmune diseases);
- Use of medications within the past week that may affect itch assessment, such as antihistamines, 5-HT3 receptor antagonists, or anti-inflammatory drugs.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Tripler
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur factice: control group (sham stimulation group)
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Sham stimulation group (control group): The anode of the electrical stimulator is placed on the left dorsolateral prefrontal cortex (F3 region) and the cathode on the right mastoid area.
A current of 1.5 mA is applied only during the first 30 seconds after the start of stimulation, after which the current is reduced to 0 mA.
All other procedures (electrode placement, stimulation duration, intervention frequency) are the same as those in the experimental group.
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Expérimental: Case group (tDCS group)
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Patients in the transcranial direct current stimulation (tDCS) group had the anode of the tDCS device placed on the left dorsolateral prefrontal cortex (F3 area) and the cathode on the right mastoid.
The tDCS was administered on the day of surgery (starting within 5 minutes after delivery of the fetus and ending upon transfer to the PACU after surgery).
The current intensity was 1.5 mA.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Incidence of itching within 24 hours after surgery (defined as VAS itching score ≥1)
Délai: 24 hours after surgery
|
The VAS scoring standard for the degree of itching is a tool used to assess the severity of itching.
VAS stands for Visual Analog Scale.
The following are the standards for VAS scoring of itching severity: 0 points: No itching.
1-3 points: Mild itching, does not affect daily life.
4-6 points: Moderate itching, somewhat affects daily life.
7-9 points: Severe itching, seriously affects daily life, requires active treatment.
10 points: Extremely severe itching, unbearable, requires immediate treatment.
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24 hours after surgery
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Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
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Incidence of itching at 12 and 48 hours postoperatively; VAS scores for itching at each time point; duration of itching and time of peak appearance
Délai: 12 hours post-operation and 48 hours post-operation
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12 hours post-operation and 48 hours post-operation
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Number of times the analgesic pump was pressed and the doses of additional morphine within 48 hours postoperatively; VAS pain scores at 12, 24, and 48 hours postoperatively
Délai: 12 hours, 24 hours, and 48 hours after surgery
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12 hours, 24 hours, and 48 hours after surgery
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Maternal adverse reactions (nausea and vomiting, drowsiness, dizziness, ear pain, skin erythema) incidence; neonatal 1-minute and 5-minute Apgar scores, birth weight, complications within 72 hours (jaundice, shortness of breath, feeding difficulties)
Délai: Within 72 hours after surgery
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Within 72 hours after surgery
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Preoperative and postoperative 24h serum histaminelevels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Preoperative and postoperative 24h trypsin-like enzymelevels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Preoperative and postoperative 24h TNF-α levels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Preoperative and postoperative 24h IL-6 levels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Preoperative and postoperative 24h β-endorphin levels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Preoperative and postoperative 24h gastrin-releasing peptide precursor (ProGRP) levels
Délai: 24 hours before surgery and 24 hours after surgery
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24 hours before surgery and 24 hours after surgery
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Estimé)
15 juin 2026
Achèvement primaire (Estimé)
31 décembre 2026
Achèvement de l'étude (Estimé)
20 février 2027
Dates d'inscription aux études
Première soumission
23 avril 2026
Première soumission répondant aux critères de contrôle qualité
29 avril 2026
Première publication (Réel)
6 mai 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
2 juillet 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
30 juin 2026
Dernière vérification
1 avril 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 2026-K102-01
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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