Dexmedetomidine Nasal Spray on Postoperative Delirium in Elderly Thoracoscopic Lung Resection Patients
The Effect of Dexmedetomidine Nasal Spray on Postoperative Delirium in Elderly Patients Undergoing Thoracoscopic Lung Resection
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 4
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Peng LI
- Numero di telefono: +86 13668169590
- Email: lipengmazui@163.com
Backup dei contatti dello studio
- Nome: Shaomao Jia
- Numero di telefono: +86 13419213559
- Email: 670979499@qq.com
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- American Society of Anesthesiologists (ASA) physical status II-III.
- Age ≥ 65 years, with no gender restriction.
- Patients scheduled for elective thoracoscopic lung resection under general anesthesia, with an expected operative duration of 1-4 hours.
- Body mass index (BMI) between 18 kg/m² and 30 kg/m².
Exclusion Criteria:
- Known hypersensitivity to dexmedetomidine hydrochloride or any of the excipients in the investigational product.
- Pre-existing nasal conditions, nasal surgery, or nasal allergies that may significantly impair nasal drug absorption (e.g., chronic nasal congestion, rhinorrhea, epistaxis, nasal anatomical abnormalities, or mucosal pathology affecting absorption).
- History of cranial trauma.
- Pre-existing diagnosis or clinical suspicion of neurocognitive impairment, defined as a Mini-Mental State Examination (MMSE) score < 24.
- History of schizophrenia, epilepsy, Parkinson's disease, or myasthenia gravis.
- History of alcohol or substance abuse/dependence.
- Left ventricular ejection fraction < 30%; sick sinus syndrome; severe sinus bradycardia (< 50 bpm); or second- or higher-degree atrioventricular block without permanent pacemaker implantation.
- History of myocardial infarction, unstable angina, severe cardiac arrhythmia, or decompensated cardiac insufficiency.
- Asthma, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease (COPD) considered inappropriate for study participation by the investigator.
- Severe hepatic impairment (Child-Pugh Class C).
- Severe renal dysfunction requiring preoperative dialysis.
- Inability to provide valid informed consent due to cultural background, language barrier, or cognitive impairment.
- Refusal to sign the informed consent form.
- Other conditions deemed inappropriate for study participation by the investigator.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Doppio
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: The nasal spray group (Group D) :Dexmedetomidine hydrochloride nasal spray 100μg
In the nasal spray group (Group D), the investigational product is dexmedetomidine hydrochloride nasal spray with a strength of 25 μg per spray.
Two sprays will be administered into each nostril, resulting in a total dexmedetomidine dose of 100 μg.
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The nasal spray group (Group D) trial medication specification is dexmedetomidine hydrochloride nasal spray at 25μg per spray.
Two sprays are administered into each nostril, totalling 100μg of dexmedetomidine.
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Comparatore placebo: The control group (Group C):Placebo nasal spray 100μg
The control group (Group C) received a placebo as the test drug, administered as two sprays into each nostril, totalling 100 μg of placebo.
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The control group (Group C) received a placebo as the test drug, administered as two sprays into each nostril, totalling 100 μg of placebo.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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The incidence of postoperative delirium (POD) within the first 3 days after surgery
Lasso di tempo: postoperative days 1 through 3
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Patients will be assessed twice daily using the 3-Minute Delirium Assessment Scale (3D-CAM) on postoperative days 1 through 3.
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postoperative days 1 through 3
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Time from End of Surgery to Tracheal Extubation (Minutes)
Lasso di tempo: From the immediate end of surgery until successful tracheal extubation, assessed up to 2 hours after surgery completion (prior to discharge from the Post-Anesthesia Care Unit [PACU]).
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The time interval, measured in minutes, between the surgeon's confirmed end of surgery (defined as completion of final wound closure) and complete removal of the tracheal tube from the patient's airway, documented via the official electronic anesthesia record.
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From the immediate end of surgery until successful tracheal extubation, assessed up to 2 hours after surgery completion (prior to discharge from the Post-Anesthesia Care Unit [PACU]).
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Duration of Post-Anesthesia Care Unit (PACU) Stay (Minutes)
Lasso di tempo: From patient admission to the PACU (immediately post-surgery) until PACU discharge, assessed up to 24 hours after PACU admission.
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The time interval, measured in minutes, between two standardized, timestamped endpoints: 1. Start point: The time of patient admission to the PACU, defined as the time when the patient is transferred into the PACU and connected to standard vital sign monitoring; 2. End point: The time of patient discharge from the PACU, defined as the time when the patient physically exits the PACU after meeting institutional discharge criteria.
Data is prospectively documented in the official electronic anesthesia/PACU medical record.
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From patient admission to the PACU (immediately post-surgery) until PACU discharge, assessed up to 24 hours after PACU admission.
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Incidence of adverse events
Lasso di tempo: From administration of the investigational product up to 7 days postoperatively.
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Incidence of adverse events following administration of the investigational product.
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From administration of the investigational product up to 7 days postoperatively.
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Subjective sleep quality
Lasso di tempo: postoperative days 1 through 3
|
Patient-reported subjective sleep quality, assessed daily using the 11-point Numerical Rating Scale (NRS, 0 = best sleep, 10 = worst sleep) on postoperative days 1-3.
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postoperative days 1 through 3
|
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NRS pain score
Lasso di tempo: Before discharge from the PACU and on postoperative days 1 through 3.
|
Pain score will be assessed using the Numerical Rating Scale (NRS) before discharge from the post-anesthesia care unit (PACU) and daily on postoperative days 1-3.
(0 = no pain, 1-3 = mild pain, 4-6 = moderate pain, 7-10 = severe pain)
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Before discharge from the PACU and on postoperative days 1 through 3.
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The severity of postoperative delirium
Lasso di tempo: postoperative days 1 through 3
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Delirium severity will be assessed using the Memorial Delirium Assessment Scale (MDAS) in patients with positive delirium on postoperative days 1-3.
The MDAS consists of 10 items with a total score of 30; the severity of delirium is defined as the maximum MDAS score obtained during postoperative days 1-3.
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postoperative days 1 through 3
|
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Duration of delirium
Lasso di tempo: Time from delirium onset to resolution, assessed up to 7 days postoperatively.
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The period commencing from the day delirium was first assessed as positive until delirium was assessed as negative or the patient was discharged.
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Time from delirium onset to resolution, assessed up to 7 days postoperatively.
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Duration of Postoperative Hospital Stay (Days)
Lasso di tempo: From the day of surgery until formal hospital discharge, assessed up to 30 days after surgery.
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Defined as the total number of calendar days from the day of index surgery to the day of hospital discharge.
Discharge is defined as the time when the patient is formally discharged and physically leaves the hospital facility, recorded in the electronic hospital medical record.
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From the day of surgery until formal hospital discharge, assessed up to 30 days after surgery.
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Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- SPPH2025585
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