The Effect of Esketamine on Cough Reflex During Tracheal Extubation in Patients Undergoing Non-inflatable Transoral Endoscopic Thyroid Surgery
The Effect of Esketamine on Cough Reflex During Tracheal Extubation in Patients Undergoing Non-inflatable Transoral Endoscopic Thyroid Surgery: A Randomized Controlled Study.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Yun Wu
- Numero di telefono: 8613865958254
- Email: wuyunanyi@163.com
Luoghi di studio
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Anhui
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Hefei, Anhui, Cina
- Second Affiliated hospital of Anhui Medical University
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Contatto:
- Yun Wu
- Numero di telefono: 8613865958254
- Email: wuyunanyi@163.com
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Patients scheduled for endotracheal intubation-free thyroid surgery under oral endoscopy
- 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)
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Quadruplicare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: ESK iv group
During anesthesia induction, administer esketamine intravenously at 0.5 mg/kg.
Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray physiological saline (3 ml) above the glottis, at the glottis, and below the glottis.
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During anesthesia induction, administer esketamine intravenously at 0.5 mg/kg.
Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray physiological saline (3 ml) above the glottis, at the glottis, and below the glottis.
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Sperimentale: ESK spray group
During anesthesia induction, intravenously inject an equal amount of normal saline.
Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray esketamine at the supraglottic, glottic, and subglottic levels: 3 ml (0.5 mg/kg).
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During anesthesia induction, Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray esketamine at the supraglottic, glottic, and subglottic levels: 3 ml (0.5 mg/kg).
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Comparatore placebo: CON group
During anesthesia induction, intravenous injection of an equal amount of normal saline is administered.
After achieving muscle relaxation, under direct laryngoscopic view, spray normal saline over the supraglottic, glottic, and subglottic areas: 3 ml.
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During anesthesia induction, intravenous injection of an equal amount of normal saline is administered.
After achieving muscle relaxation, under direct laryngoscopic view, spray normal saline over the supraglottic, glottic, and subglottic areas: 3 ml.
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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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Incidence of coughing during tracheal extubation
Lasso di tempo: Perioperative (From the awakening period to immediately after tracheal extubation)
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0=None; 0 = Did not occur; 1 = Occurred;
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Perioperative (From the awakening period to immediately after tracheal extubation)
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Postoperative analgesic dosage
Lasso di tempo: Within day 2 after surgery
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Within day 2 after surgery
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Intraoperative doses of propofol
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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|
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Intraoperative doses of remifentanil
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
|
|
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Intraoperative doses of Non-Steroidal Anti-Inflammatory Drugs(NSAIDs)
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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|
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Intraoperative doses of sufentanil
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative fluid volume
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative blood loss
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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|
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Postoperative time to ambulation
Lasso di tempo: Perioperative (From the operating room to discharge)
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Perioperative (From the operating room to discharge)
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Length of postoperative hospital stay
Lasso di tempo: Perioperative (From the operating room to discharge)
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Perioperative (From the operating room to discharge)
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|
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Postoperative time to first water intake
Lasso di tempo: Perioperative (Time from returning to the ward to the first drink of water)
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Perioperative (Time from returning to the ward to the first drink of water)
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Severity of coughing during tracheal extubation
Lasso di tempo: Perioperative (From the awakening period to immediately after tracheal extubation)
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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.
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Perioperative (From the awakening period to immediately after tracheal extubation)
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Agitation score during tube removal
Lasso di tempo: Perioperative (From the awakening period to immediately after tracheal extubation)
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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.
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Perioperative (From the awakening period to immediately after tracheal extubation)
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Blood pressure
Lasso di tempo: Perioperative (From the induction period until 5 minutes after the completion of surgery)
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Baseline , post-induction, 1 minute after intubation, at the end of the surgery, 1 minute after extubation, and 5 minutes after extubation.
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Perioperative (From the induction period until 5 minutes after the completion of surgery)
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Airway pressure 5 minutes after intubation and at the end of surgery
Lasso di tempo: 5 minutes after intubation and at the end of the surgery.
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5 minutes after intubation and at the end of the surgery.
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Intraoperative use rate and dosage of vasoactive drugs
Lasso di tempo: Intraoperative (From the induction period to the end of anesthesia)
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Intraoperative (From the induction period to the end of anesthesia)
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Sore throat score
Lasso di tempo: Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively.
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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.
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Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively.
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Surgical area pain scores
Lasso di tempo: Postoperative 24 hours and 48 hours.
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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.
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Postoperative 24 hours and 48 hours.
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Incidence of adverse reactions
Lasso di tempo: Within 48 hours after surgery
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Within 48 hours after surgery
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Postoperative nausea and vomiting(PONV) score
Lasso di tempo: Within 48 hours after surgery.
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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
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Within 48 hours after surgery.
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Postoperative time to first food
Lasso di tempo: Perioperative (Time from returning to the ward to the first food)
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Perioperative (Time from returning to the ward to the first food)
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Upper Aerodigestive Symptoms After Thyroidectomy (UADS) questionnaire score
Lasso di tempo: One month after surgery
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Upper Aerodigestive Symptoms After Thyroidectomy Questionnaire; Instructions: 0=No problem, 1=Minor, 2=Moderate, 3=Major. Voice symptoms
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One month after surgery
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Heart rate
Lasso di tempo: From the induction period until 5 minutes after the completion of surgery.
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Baseline, post-induction, 1 minute after intubation, at the end of the surgery, 1 minute after extubation, and 5 minutes after extubation.
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From the induction period until 5 minutes after the completion of surgery.
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Oxygen saturation
Lasso di tempo: Intraoperative (From the induction period until 5 minutes after the completion of surgery)
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Baseline , post-induction, 1 minute after intubation, at the end of the surgery, 1 minute after extubation, and 5 minutes after extubation.
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Intraoperative (From the induction period until 5 minutes after the completion of surgery)
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Anesthesia time
Lasso di tempo: Time from induction to discontinuation of anesthetic agents.
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Time from induction to discontinuation of anesthetic agents.
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Surgery time
Lasso di tempo: From the start of surgery to the end of surgery.
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From the start of surgery to the end of surgery.
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Endotracheal tube indwelling time
Lasso di tempo: Perioperative (Time from intubation to extubation)
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Perioperative (Time from intubation to extubation)
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Awakening time
Lasso di tempo: Perioperative (Stop the anesthesia drug injection until awakening time)
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Perioperative (Stop the anesthesia drug injection until awakening time)
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Extubation time
Lasso di tempo: Perioperative (The time from discontinuation of anesthetic drugs to extubation)
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Perioperative (The time from discontinuation of anesthetic drugs to extubation)
|
|
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Post-anesthesia care unit (PACU) stay time
Lasso di tempo: Perioperative (Duration from entering the PACU to leaving the PACU)
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Perioperative (Duration from entering the PACU to leaving the PACU)
|
|
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Hoarseness scores
Lasso di tempo: Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively.
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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.
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Baseline, Immediately postoperatively, 0.5 hours postoperatively, 2 hours postoperatively, 24 hours postoperatively, 48 hours postoperatively.
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Sleep scores
Lasso di tempo: Postoperative 24 hours and 48 hours.
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1 = Good sleep; 2 = Restless sleep; 3 = Dreamy sleep; 4 = Insomnia; The higher the score, the poorer the sleep.
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Postoperative 24 hours and 48 hours.
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Numbness scores
Lasso di tempo: Postoperative 24h and 48h.
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Numbness Score: 0 = None; 1-3: Mild numbness, occasionally perceived, does not affect daily activities; 4-6: Moderate numbness, persistent numbness with slight discomfort, affecting some eating/speaking; 7-10: Severe numbness, strong numbness or complete loss of sensation, severely affecting daily life.
The higher the score, the greater the level of numbness.
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Postoperative 24h and 48h.
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PACU RASS score
Lasso di tempo: Perioperative (Record once every ten minutes from the time of entering the post-anesthesia care unit until leaving the recovery room)
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Perioperative (Record once every ten minutes from the time of entering the post-anesthesia care unit until leaving the recovery room)
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Postoperative analgesic dosage
Lasso di tempo: Within 48 hours after surgery
|
Within 48 hours after surgery
|
Collaboratori e investigatori
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- YX2026-095(F1)
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