tDCS for Reducing the Incidence of OEI After Cesarean Section
2026年9月16日 更新者：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.
調査の概要
状態
募集
研究の種類
介入
入学 (推定)
104
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究連絡先
- 名前：Chao Chao Zhong, M.D.
- 電話番号：15152460489
- メール：zhong249767626@163.com
研究場所
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Jiangsu
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Nantong、Jiangsu、中国、226001
- 募集
- Affiliated Hospital of Nantong University
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コンタクト：
- Chao-Chao Zhong, M.D.;P.H.D
- 電話番号：15152460489
- メール：zhong249767626@163.com
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-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
健康ボランティアの受け入れ
いいえ
説明
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.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
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：防止
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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偽コンパレータ：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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実験的：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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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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Incidence of itching within 24 hours after surgery (defined as VAS itching score ≥1)
時間枠：24 hours after surgery
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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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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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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
時間枠：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
時間枠：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)
時間枠：Within 72 hours after surgery
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Within 72 hours after surgery
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Preoperative and postoperative 24h serum histaminelevels
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2026年5月10日
一次修了 (推定)
2026年12月31日
研究の完了 (推定)
2027年2月20日
試験登録日
最初に提出
2026年4月23日
QC基準を満たした最初の提出物
2026年4月29日
最初の投稿 (実際)
2026年5月6日
学習記録の更新
投稿された最後の更新 (実際)
2026年9月17日
QC基準を満たした最後の更新が送信されました
2026年9月16日
最終確認日
2026年9月1日
詳しくは
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。