The Effect of Intraoperative Esketamine Infusion on Pruritus in Elderly Surgical Patients
The Effect of Intraoperative Esketamine Infusion on Pruritus in Elderly Surgical Patients: A Single-Center Randomized Controlled Trial
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Guolin Wang
- Numero di telefono: 15822855556
- Email: wangguolinhad@hotmail.com
Luoghi di studio
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Tianjin, Cina, 300052
- Tianjin Medical University General Hospital
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Contatto:
- Guolin Wang
- Numero di telefono: +8618604755166
- Email: wangguolinhad@hotmail.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
Meet the diagnostic criteria for senile pruritus:
- Aged ≥ 65 years old;
- Presenting with only skin pruritus without obvious primary skin lesions, with or without scratch-induced skin lesions;
- Daily or nearly daily pruritus lasting for more than 6 weeks.
- Patients undergoing elective general anesthesia for orthopedic knee arthroplasty.
- Patients aged ≥ 65 years old, with ASA physical status classification Ⅰ-Ⅲ; BMI ranging from 18 to 30 kg/m², with no restriction on gender.
- Patients have fully understood the nature of this study, are capable of understanding and completing evaluation scales preoperatively, voluntarily participate in this trial, and sign the informed consent form.
Exclusion Criteria:
- Those who are allergic to the pharmaceutical ingredients of this study or have an allergic constitution;
- Those with a history of allergy to general anesthetics, opioids, or non-steroidal anti-inflammatory drugs;
- Those with severe cognitive impairment, a history of neurological diseases, chronic pain, drug addiction, alcoholism, long-term opioid use, or administration of opioids within 48 hours before surgery;
- Patients with ASA physical status classification Grade IV-V;
- Those with severe coronary heart disease/arrhythmia/cardiac insufficiency, bronchial asthma, severe hypertension, severe hematopoietic system dysfunction, severe abnormal liver and kidney function, or significant electrolyte disorders;
- Those with a history of gastrointestinal diseases (peptic ulcer, Crohn's disease, ulcerative colitis);
- Those with respiratory insufficiency or respiratory failure;
- Those with BMI < 18 kg/m² or BMI > 30 kg/m²;
- Those with poor compliance who cannot complete the trial in accordance with the research protocol;
- Those who have participated in other clinical drug trials within the past 4 weeks;
- Those deemed unsuitable for enrollment by the researchers for any reason. -
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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Comparatore placebo: Elderly patients with senile pruritus receive normal saline.
An equal volume of normal saline is intravenously administered 30 minutes prior to the completion of the operation.
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An equal volume of normal saline is intravenously administered 30 minutes prior to the completion of the operation.
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Comparatore attivo: Elderly patients with pruritus receive esketamine at a dose of 0.2 mg/kg.
Esketamine 0.2 mg/kg is intravenously administered 30 minutes prior to the completion of the operation.
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Esketamine 0.2 mg/kg is intravenously administered 30 minutes prior to the completion of the operation.
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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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5D-IS score at 24 hours after surgery
Lasso di tempo: 24 hours after surgery
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The duration, severity, outcome trend, life impairment and pruritus site (5-D) were used to evaluate the patient's pruritus.Each dimension was scored from 1 to 5, with a total score ranging from 5 to 25.
The higher the score, the more severe the itching.
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24 hours after surgery
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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5D-IS score at 48 hours,72 hours and the seventh day after surgery
Lasso di tempo: 48 hours,72 hours and the seventh day after surgery
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The duration, severity, outcome trend, life impairment and pruritus site (5-D) were used to evaluate the patient's pruritus.Each dimension was scored from 1 to 5, with a total score ranging from 5 to 25.
The higher the score, the more severe the itching.
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48 hours,72 hours and the seventh day after surgery
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The incidence of pruritus on the 24 hours after surgery
Lasso di tempo: 24 hours after surgery
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The 5D-IS score was completed by the patient 24 hours after the operation.
The investigators recorded this score as a statistical indicator.
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24 hours after surgery
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NRS pruritus score at 24 hours,48 hours and 72 hours after surgery
Lasso di tempo: 24 hours,48 hours and 72 hours after surgery
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The patient evaluated the intensiy of prurtus wth 11 numbers ranging from 0 to 10,and the higher the number, the more severe the condition.
The higher the number, the more severe the itching.
0: No sensation.
1-3: Mild itching.
4-6 Moderate itching 7-9: Severe itching.
10; Extrermely severe itching.
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24 hours,48 hours and 72 hours after surgery
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Pain Score (NRS)
Lasso di tempo: 1 hours, 24 hours, 48 hours, 72 hours after the surgery
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The pain score at rest or after movement was evaluated by pain 11-point numerical rating scale (NRS): 0= no pain, 10 = greatest imaginable pain.
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1 hours, 24 hours, 48 hours, 72 hours after the surgery
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The incidence of postoperative sleep disturbance on the first. second and third postoperative nights
Lasso di tempo: the first,second and third nights after surgery
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The patient completed the Sleep Quality Scale (AlS, Athens Insomnia Scale) one day before the surgery, There are a totat of 8 items in the AlS,with the score ranging from 0 to 24.
A total score of 6 or above indicates a diagnosis of insomnia.
We asked the patients to fill out this questionnaire after the first,second and third postoperative nights to evaluate the changes in sleep quality.
The investigators recorded AlS scores as statistical indicators.
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the first,second and third nights after surgery
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Montreal Cognitive Assessment (MoCA)
Lasso di tempo: 24 hours, 48 hours, 72 hours after the surgery
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The Montreal Cognitive Assessment consists of 7 items, which evaluate visuospatial and executive function (5 points), naming (3 points), attention (6 points), language (3 points), abstract thinking (2 points), delayed recall (5 points), and orientation (6 points) respectively.
A total score of ≥26 points indicates basically normal cognitive function; a total score of <25 points suggests cognitive decline.
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24 hours, 48 hours, 72 hours after the surgery
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Confusion Assessment Method (CAM)
Lasso di tempo: 24 hours, 48 hours, 72 hours after the surgery
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Confusion Assessment Method CAM is assessed based on four core features.
Feature 1: Acute onset or fluctuating course; Feature 2: Inattention; Feature 3: Disorganized thinking; Feature 4: Altered level of consciousness.
The diagnosis of delirium requires a positive result for Feature 1 + a positive result for Feature 2 + a positive result for either Feature 3 or Feature 4.
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24 hours, 48 hours, 72 hours after the surgery
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Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Intraoperative Anesthesia Information
Lasso di tempo: Perioperative period
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Duration of anesthesia (minutes)
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Perioperative period
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Intraoperative Vital Signs
Lasso di tempo: Perioperative period
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Intraoperative average heart rate
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Perioperative period
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Adverse Event
Lasso di tempo: 1 hour, 24 hours, 48 hours and 72 hours after surgery
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All kinds of adverse events(nausea, vomiting, respiratory depression, headache, dizziness, chills, delayed recovery from anesthesia) occurred in patients were recorded.
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1 hour, 24 hours, 48 hours and 72 hours after surgery
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Intraoperative Anesthesia Information
Lasso di tempo: Perioperative period
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Duration of surgery (minutes)
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Perioperative period
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Intraoperative Anesthesia Information
Lasso di tempo: Perioperative period
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Intraoperative dosage of Sufentanil (μg)
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Perioperative period
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Intraoperative Anesthesia Information
Lasso di tempo: Perioperative period
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Intraoperative dosage of Remifentani (mg)
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Perioperative period
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Intraoperative Vital Signs
Lasso di tempo: Perioperative period
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intraoperative average blood oxygen saturation
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Perioperative period
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Intraoperative Vital Signs
Lasso di tempo: Perioperative period
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Mean Arterial Pressure(MAP)
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Perioperative period
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: Guolin Wang, Tianjin Medical University General Hospital
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Primo inviato
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Primo inviato che soddisfa i criteri di controllo qualità
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- IRB2025-YX-498-01
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