白内障監視麻酔治療 (MAC) の実現可能性パイロット研究 (CaTNAPS-1)
白内障手術のための鎮静法に対する 2 つの通常のアプローチの比較: 前向きで実現可能性のあるパイロット研究
調査の概要
詳細な説明
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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California
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San Francisco、California、アメリカ、94143
- University of California, San Francisco
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
包含基準:
- 65歳以上
- 英語によるインフォームドコンセントの提供と治験手続きができる方
- 自分自身の同意ができる
- 指示に従うことができる
- 立ち止まらずに階段を1階分登ることができる
- 新たに白内障と診断された
- 今後 6 か月以内に目の白内障手術を受ける予定です
除外基準:
- 過去の白内障手術歴
- 過去30日以内の入院
- 他の軽度の外来処置または画像検査中に鎮静するのが困難
- 局所麻酔薬に対するアレルギーまたは耐性
- 症状(呼吸困難、重度の背中の痛みなど)がなければ、仰向けに横たわることができない
- ベンゾジアゼピンの日常的な使用を必要とする重度の不安の病歴
- 重度の弁膜症(重篤な大動脈弁狭窄症など)
- ペースメーカー、除細動器、左心室補助装置などの植込み型心臓装置を必要とする心臓病(不整脈、うっ血性心不全など)
- 未治療の胸痛または狭心症
- 運動障害のある患者(パーキンソン病など)
- 脳血管障害(CVA)、一過性脳虚血発作(TIA)、または発作の病歴
- 安静時または運動時に在宅酸素(O2)が必要
- 透析を必要とする末期腎疾患(ESRD)
- 病的肥満 (BMI>35)
- 他の眼科手術と組み合わせて白内障手術を受ける患者
- 既存の白内障の根本的な特徴および/または計画された手術の予想される複雑さのため、白内障手術中に全身麻酔が必要な患者
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:ヘルスサービス研究
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:介入
手術前に患者様には経口鎮静剤が投与されます。
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術前に投与される抗不安薬の内服薬
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プラセボコンパレーター:プラセボ
処置の前に経口プラセボ錠剤が患者に投与されます。
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有効成分を含まないプラセボ錠剤を術前に投与する
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of Participants With High Satisfaction (ISAS Score ≥ 2)
時間枠:30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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The Iowa Satisfaction with Anesthesia Scale (ISAS) is an 11-item validated questionnaire assessing patient satisfaction with anesthesia care. Each item is scored from -3 to +3, and the total score is calculated as the mean of all items, resulting in a total score range of -3 to +3. Higher scores indicate greater satisfaction. For this analysis, high satisfaction is defined as an ISAS score ≥ 2. |
30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of Participants Meeting Eligibility Criteria at Screening
時間枠:At screening (prior to enrollment)
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Number of participants who met all eligibility criteria at the time of screening, out of the total number of participants assessed for eligibility
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At screening (prior to enrollment)
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Number of Participants Completing All Study Surveys at Each Timepoint
時間枠:30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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Number of participants who completed all required study surveys at each postoperative timepoint (PACU, POD1, POD7), out of the number of participants assigned to each study arm
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30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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Number of Participants Who Completed All Required Study Procedures
時間枠:From enrollment through final study follow-up (POD7)
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Number of participants who completed all required study procedures from enrollment through the final postoperative follow-up visit, out of the total number of participants enrolled in the study Instruments: Iowa Satisfaction with Anesthesia Scale (ISAS) Postoperative Quality of Recovery Scale (PQRS) Quality of Recovery-15 (QoR-15) Functional Recovery Index (FRI) |
From enrollment through final study follow-up (POD7)
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Number of Participants With Sedation-Related Complications During 30-Day Postoperative Follow-up
時間枠:From enrollment through 30 days after surgery
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Number of participants experiencing at least one sedation-related complication within 30 days after surgery, out of the total number of participants enrolled in the study
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From enrollment through 30 days after surgery
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Number of Participants Achieving Recovery on the Postoperative Quality of Recovery Scale (PQRS)
時間枠:30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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The Postoperative Quality of Recovery Scale (PQRS) assesses recovery across physiological, pain, emotional, cognitive, and activities of daily living domains. For this analysis, recovery is defined as meeting PQRS recovery criteria at each time point. Recovery is defined as a return to baseline performance in all assessed PQRS domains at each time point. |
30 minutes (PACU), 1 day (POD1), and 7 days after surgery (POD7)
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Quality of Recovery-15 (QoR-15) Total Score After Surgery
時間枠:1 day and 7 days after surgery
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The Quality of Recovery-15 (QoR-15) is a validated 15-item questionnaire assessing postoperative recovery across physical comfort, emotional state, psychological support, and physical independence.
Each item is scored from 0 to 10, and the total score is calculated by summing all items, resulting in a total score range of 0 to 150.
Higher scores indicate better recovery.
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1 day and 7 days after surgery
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Functional Recovery Index (FRI) Total Score After Surgery
時間枠:1 day and 7 days after surgery
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The Functional Recovery Index (FRI) is a validated 14-item questionnaire assessing postoperative functional recovery, including mobility and activities of daily living.
Each item is scored and summed to produce a total score ranging from 0 to 100.
Lower scores indicate better functional recovery.
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1 day and 7 days after surgery
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協力者と研究者
捜査官
- 主任研究者:Catherine L Chen, M.D.、University of California, San Francisco
出版物と役立つリンク
一般刊行物
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- Norregaard, J. C. Results from the International Cataract Surgery Outcomes Study. Acta Ophthalmologica Scandinavica 85, 5-32, doi:10.1111/j.1600-0420.2007.00937.x (2007).
- Kent, C. Cataract Surgery: Is an anesthesiologist necessary?, <https://www.reviewofophthalmology.com/article/cataract-surgery-is-an-anesthesiologist-necessary> (2009).
- Andrews, M. Anthem Calls On Eye Surgeons To Monitor Anesthesia During Cataract Surgery, <https://khn.org/news/anthem-calls-on-eye-surgeons-to-monitor-anesthesia-during-cataract-surgery/> (2018).
- Zakrzewski PA, Friel T, Fox G, Braga-Mele R. Monitored anesthesia care provided by registered respiratory care practitioners during cataract surgery: a report of 1957 cases. Ophthalmology. 2005 Feb;112(2):272-7. doi: 10.1016/j.ophtha.2004.08.016.
- Kent-Smith BT, Wallace GM. Routine cataract surgery without the presence of an anaesthetist. Clin Exp Ophthalmol. 2007 Aug;35(6):589. doi: 10.1111/j.1442-9071.2007.01553.x. No abstract available.
- Murray P, Adams K, Haddad P, Murray N, O'Rourke M. The routine requirement for anaesthetists in local anaesthetic cataract surgery. Clin Exp Ophthalmol. 2007 Mar;35(2):195-6. doi: 10.1111/j.1442-9071.2006.01441.x. No abstract available.
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- Basta B, Gioia L, Gemma M, Dedola E, Bianchi I, Fasce F, Beretta L. Systemic adverse events during 2005 phacoemulsifications under monitored anesthesia care: a prospective evaluation. Minerva Anestesiol. 2011 Sep;77(9):877-83.
- Koolwijk J, Fick M, Selles C, Turgut G, Noordergraaf JI, Tukkers FS, Noordergraaf GJ. Outpatient cataract surgery: incident and procedural risk analysis do not support current clinical ophthalmology guidelines. Ophthalmology. 2015 Feb;122(2):281-7. doi: 10.1016/j.ophtha.2014.08.030. Epub 2014 Oct 22.
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- Fukuoka H, Afshari NA. The impact of age-related cataract on measures of frailty in an aging global population. Curr Opin Ophthalmol. 2017 Jan;28(1):93-97. doi: 10.1097/ICU.0000000000000338.
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- Hubbard RE, Story DA. Patient frailty: the elephant in the operating room. Anaesthesia. 2014 Jan;69 Suppl 1:26-34. doi: 10.1111/anae.12490.
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研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 23-40367
- 5K23AG072035-03 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。