Assessing Covert Consciousness During Dexmedetomidine and Ketamine Sedation: An fMRI Study
調査の概要
詳細な説明
Dexmedetomidine is an FDA-approved sedative agent and is used off-label in this study for controlled experimental modulation of consciousness under direct anesthesiology supervision. Ketamine is a FDA-approved anesthetic and analgesic agent and is used off-label in this study for controlled experimental modulation of consciousness under direct anesthesiology supervision.
Using fMRI and established cognitive paradigms, the proposed study will directly examine residual conscious processing under dexmedetomidine and ketamine and compare these findings with our existing propofol dataset from NCT03361605.
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究場所
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Michigan
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Ann Arbor、Michigan、アメリカ、48109
- University of Michigan
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参加基準
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
説明
Inclusion Criteria:
- Healthy study subjects with American Society of Anesthesiologists (ASA)-1 status
- Right-handed
- Body mass index (BMI) less than 30
- Participants will have the experience of playing tennis (or other racquet sport) at least 30 times in their lifetime
- English speaking
Exclusion Criteria:
- Medical contraindication to MRI scanning; are unable to undergo MRI scanning because of possible pregnancy or currently breastfeeding
- BMI greater than or equal to 30
- Metallic substances in the body
- claustrophobia, anxiety, or cardiopulmonary disease; or have an intracranial structural abnormality on T1-weighted MRI scans
- history of allergy to dexmedetomidine, ketamine, propofol, or any components of these medications, eggs or egg products, soybean or soybean products
- neurological, cardiovascular, or pulmonary illness
- significant head injury with loss of consciousness; learning disability or other developmental disorder
- sleep apnea or any severe snoring history
- gastroesophageal reflux disease (GERD) or heartburn; pancreatitis or a history of pancreatitis,
- sensory/motor loss sufficient to interfere with performance of the study
- epilepsy/seizure disorder (including a history of seizures) or stroke (including a history of stroke).
- history of schizophrenia spectrum disorder, bipolar disorder, other psychotic disorder, or any prior adverse psychiatric reaction to ketamine or similar drugs
- Participants taking medications that, in the judgment of the investigators or attending anesthesiologist, may interact with the study drugs or increase the risk of participation will also be excluded
- participants with hypertension or diabetes mellitus
- tattoos in the head or neck region will be excluded from study; other tattoos are subject to determination by investigators based on their assessment regarding participant safety
- recent food or liquid intake (within 8 hours)
- history of drug use, have a positive drug screen, are unwilling to abstain from alcohol for 24 hours prior to dosing, or have a current history of nicotine use.
- Potential participants who have participated in a clinical trial using an investigational drug or device within 30 days will be considered for enrollment after 30 days.
- History of a difficult airway with a previous anesthetic
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:基礎科学
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
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:Dexmedetomidine during fMRI
About 30 healthy participants will be randomized to this arm.
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Dexmedetomidine dosing will follow FDA-labeled parameters for procedural sedation, with a loading dose of 1 mcg/kg administered intravenously over 10 minutes, followed by maintenance infusion within the range of 0.2 to 1.0 mcg/kg/hr, titrated to clinical effect under anesthesiologist supervision.
Sedation depth will be assessed behaviorally using standardized squeeze-response testing to determine lost responsiveness (LOR).
If LOR is not achieved within labeled dexmedetomidine dosing limits, low-dose propofol will be conditionally added using a target-controlled infusion at an effect-site concentration of 0.5-1.5 μg/ml, which is below typical induction levels and intended to provide supplemental sedation while preserving spontaneous ventilation.
Once LOR is achieved, sedation will be maintained within the approved dexmedetomidine range, with adjunct propofol continued only as clinically indicated.
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実験的:Ketamine during fMRI
About 30 healthy participants will be randomized to this arm.
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participants will first receive a subanesthetic ketamine infusion of 0.5 mg/kg administered intravenously over 40 minutes.
After that, 1.5 mg/kg ketamine will be administered slowly as a bolus over 60 seconds.
Based on prior experience with this paradigm, most subjects who lose responsiveness do so for approximately 10 minutes following the bolus dose.
For a 70 kg healthy subject, the total ketamine dose in this paradigm is approximately 140 mg.
This dosing remains within the range of standard anesthetic induction dosing, which is typically 1.5 to 2 mg/kg in clinical practice.
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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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Blood Oxygen Level Dependent (BOLD) response to mental imagery tasks
時間枠:Up to approximately 130 minutes
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Three mental imagery tasks will be used: tennis imagery, navigation imagery, and hand-squeeze imagery
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Up to approximately 130 minutes
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Grip force (in mmHg) of participants' hand squeezing on a rubber ball in response to squeeze instructions
時間枠:Up to approximately 130 minutes
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Up to approximately 130 minutes
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Zirui Huang, PhD、University of Michigan
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
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
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- HUM00285398
- R01GM103894 (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
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
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
米国で製造され、米国から輸出された製品。
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