Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

Comparison of Analgesic Requirements in Patients Receiving Nuss Operation Using 2 Different Anesthetic Adjuvants (ARNRD)

18 maart 2020 bijgewerkt door: Jung Min Koo

Comparing Analgesic Requirements in Patients Receiving Nuss Operation Using Remifentanil or Dexmedetomidine as Anesthetic Adjuvants

Nowadays, general anaesthesia is carried under "balanced anesthesia technique" in which many anesthetic adjuvants are used simultaneously, including opioid analgesics in order to reduce the amount of inhalation agents. The most popular adjuvants used are remifentanil, which is an opioid analgesic, and dexmedetomidine. Both of these agents are short acting, can be infused with targeted concentrations, excreted shortly from the body with stable hemodynamics.

Remifentanil, when infused for more than 2 hours, causes hyperalgesia to increase the amount of pain postoperatively as well as the amount of opioid analgesics. However, dexmedetomidine does not cause hyperalgesia and is known to have an opioid -sparing effect. In our center.

In this study, we aim to compare the effects of remifentanil and dexmedetomidine on postoperative pain in patients undergoing Nuss procedure, which is a very painful operation on the chest wall.

Studie Overzicht

Toestand

Onbekend

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Verwacht)

62

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

20 jaar tot 60 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Adults aged >20
  2. Patients undergoing Nuss bar operation (pectus excavatum repair surgery)
  3. American Society of Anesthesiologists classification I ~ III

Exclusion Criteria:

  1. Drug abuse history
  2. Chronic pain in need of continuous opioid analgesics administration
  3. History of psychiatric diseases
  4. Preoperative bradycardia (heart rate < 50/min) or arrythmia
  5. Cardiac diseases other than diabetes or hypertension - coronary artery disease, ischemic heart disease
  6. Moderate liver or kidney dysfunction
  7. Pregnant or breast feeding women
  8. Hypersensitivity to the study drugs
  9. Patients who do not agree to participate

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verdrievoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Sham-vergelijker: Remifentanil group
In both interventional groups, Sevoflurane is used as an inhalational agent, in 0.5-1.5% age-adjusted Minimal Alveolar Concentration (MAC). As explained above, remifentanil is infused with Target Controlled Infusion pump, and concentration is adjusted so that Bispectral index (BIS) is maintained as 40-60, which means that the patients are maintained in general anesthesia. Remifentanil is usually infused with the effect site concentration of 2.0 to 6.0 ng/ml during general anesthesia. If bradycardia or hypotension develops due to remifentanil infusion, the infusion rate could be reduced, or inotropic, vasopressor, anticholinergic agents can be used (ephedrine, atropine, etc.) to correct the side effects of the drug, or the drug infusion can even be ceased. At the end of the surgery when skin closure starts, remifentanil infusion will be stopped.
Comparing effects of remifentanil versus dexmedetomidine
Andere namen:
  • Remifentanil
Actieve vergelijker: Dexmedetomidine group
In both interventional groups, Sevoflurane is used as an inhalational agent, in 0.5-1.5% age-adjusted MAC (Minimal Alveolar Concentration). As explained above, dexmedetomidine is infused with syringe pump, and concentration is adjusted so that Bispectral index (BIS) is maintained as 40-60, which means that the patients are maintained in general anesthesia. Dexmedetomidine is loaded for 10 minutes in 1mcg/kg, and then infusion rate is set between 0.4 to 0.6mcg/kg/hour for this study. If bradycardia or hypotension develops due to remifentanil infusion, the infusion rate could be reduced, or inotropic, vasopressor, anticholinergic agents can be used (ephedrine, atropine, etc.) to correct the side effects of the drug, or the drug infusion can even be ceased. At the end of the surgery when skin closure starts, dexmedetomidine infusion will be stopped.
Comparing effects of remifentanil versus dexmedetomidine
Andere namen:
  • Remifentanil

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Visual Analogue Scale
Tijdsspanne: Between 1~6 hours postoperatively.
Pain scale ranges from 0 to 10. 0 means no pain at all, and 10 being the most severe pain anyone can imagine.
Between 1~6 hours postoperatively.
Visual Analogue Scale
Tijdsspanne: Between 6~12 hours postoperatively.
Pain scale ranges from 0 to 10. 0 means no pain at all, and 10 being the most severe pain anyone can imagine.
Between 6~12 hours postoperatively.
Visual Analogue Scale
Tijdsspanne: Between 12~24 hours postoperatively.
Pain scale ranges from 0 to 10. 0 means no pain at all, and 10 being the most severe pain anyone can imagine.
Between 12~24 hours postoperatively.
Visual Analogue Scale
Tijdsspanne: Between 24~48 hours postoperatively.
Pain scale ranges from 0 to 10. 0 means no pain at all, and 10 being the most severe pain anyone can imagine.
Between 24~48 hours postoperatively.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Amount of postoperative intravenous patient controlled analgesics (PCA) used
Tijdsspanne: At 60 minutes after the end of surgery
At 60 minutes after the end of surgery
Amount of fentanyl used postoperatively at the recovery unit
Tijdsspanne: At 60 minutes after the end of surgery
Amount in micgrograms per wegith in kilograms (migrogram/kilogram)
At 60 minutes after the end of surgery
Time needed for postoperative rescue opioid analgesics
Tijdsspanne: At 60 minutes after the end of surgery
At 60 minutes after the end of surgery
Amount of remifentanil or dexmedetomidine used intraoperatively
Tijdsspanne: Immediately at the end of the surgery
Immediately at the end of the surgery
Intraoperative hemodynamic change: Systolic blood pressure
Tijdsspanne: 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
Intraoperative hemodynamic change: Diastolic blood pressure
Tijdsspanne: 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
Intraoperative hemodynamic change: mean blood pressure
Tijdsspanne: 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room
Intraoperative hemodynamic change: heart rate
Tijdsspanne: 30 minutes after the induction of anesthesia
30 minutes after the induction of anesthesia
Intraoperative hemodynamic change: mean blood pressure
Tijdsspanne: At the end of the surgery, average of 90minutes after the induction of anesthesia
At the end of the surgery, average of 90minutes after the induction of anesthesia
Intraoperative hemodynamic change: heart rate
Tijdsspanne: At the end of the surgery, average of 90minutes after the induction of anesthesia
At the end of the surgery, average of 90minutes after the induction of anesthesia
Intraoperative hemodynamic change: Systolic blood pressure
Tijdsspanne: At the end of the surgery, average of 90minutes after the induction of anesthesia
At the end of the surgery, average of 90minutes after the induction of anesthesia
Intraoperative hemodynamic change: Diastolic blood pressure
Tijdsspanne: At the end of the surgery, average of 90minutes after the induction of anesthesia
At the end of the surgery, average of 90minutes after the induction of anesthesia
Rescue drugs (inotropics or vasopressors) used in order to correct hypotension or bradycardia
Tijdsspanne: Intraoperatively
Intraoperatively
Postoperative complications
Tijdsspanne: Between 1~6 hours postoperatively
Number of events that happened to the patient: e.g. Yes or No, and how many times. Nausea/vomiting, hypotension, respiratory depression, urinary retension, dizziness, transient cease in use of intravenous patient controlled analgesics (PCA)
Between 1~6 hours postoperatively
Postoperative complications
Tijdsspanne: Between 12~24 hours postoperatively
Number of events that happened to the patient: e.g. Yes or No, and how many times. Nausea/vomiting, hypotension, respiratory depression, urinary retension, dizziness, transient cease in use of intravenous patient controlled analgesics (PCA)
Between 12~24 hours postoperatively
Postoperative complications
Tijdsspanne: Between 24~48 hours postoperatively
Number of events that happened to the patient: e.g. Yes or No, and how many times. Nausea/vomiting, hypotension, respiratory depression, urinary retension, dizziness, transient cease in use of intravenous patient controlled analgesics (PCA)
Between 24~48 hours postoperatively

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Jung Min Koo, M.D, Data recruitment

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

2 september 2019

Primaire voltooiing (Verwacht)

21 februari 2021

Studie voltooiing (Verwacht)

28 februari 2021

Studieregistratiedata

Eerst ingediend

20 augustus 2019

Eerst ingediend dat voldeed aan de QC-criteria

27 augustus 2019

Eerst geplaatst (Werkelijk)

29 augustus 2019

Updates van studierecords

Laatste update geplaatst (Werkelijk)

20 maart 2020

Laatste update ingediend die voldeed aan QC-criteria

18 maart 2020

Laatst geverifieerd

1 maart 2020

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

product vervaardigd in en geëxporteerd uit de V.S.

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Klinische onderzoeken op Borstwandstoornis

Klinische onderzoeken op Dexmedetomidine

Abonneren