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- Klinische proef NCT07597486
The Effect of Intraoperative Esketamine Infusion on Pruritus in Elderly Surgical Patients
18 mei 2026 bijgewerkt door: Guolin Wang, Tianjin Medical University General Hospital
The Effect of Intraoperative Esketamine Infusion on Pruritus in Elderly Surgical Patients: A Single-Center Randomized Controlled Trial
To explore the effect of intraoperative esketamine on pruritus in elderly patients undergoing elective general anesthesia for knee replacement surgery
Studie Overzicht
Toestand
Nog niet aan het werven
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Pruritus (itching) is one of the most common clinical conditions in the elderly population.
Its etiology is complex, and the prevalence gradually increases with age.
Pruritus in the elderly not only imposes a significant disease burden but also severely affects their sleep quality and daily life.
This chronic, persistent itching often disrupts the skin barrier function, easily creating a vicious itch-scratch cycle, which leads to multiple damages to the patient's quality of life.Esketamine is the right-handed isomer of ketamine and is a non-competitive N-methyHD-aspartate (NMDA) receptor antagonist.
It has the effects of rapid pain relief,rapid antidepressant action, sedation, and improvement of sleep.
Relevant studies have shown that the NMDA receptor may play an importantrole in the transmission of non-histaminergic itching.
However, there is still a lack of reports on whether it can relieve pruritus symptoms in elderly patients.
This experiment intends to investigate the effect of intraoperative esketamine infusion on skin pruritus in elderly surgical patients.
Studietype
Ingrijpend
Inschrijving (Geschat)
200
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.
Studiecontact
- Naam: Guolin Wang
- Telefoonnummer: 15822855556
- E-mail: wangguolinhad@hotmail.com
Studie Locaties
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Tianjin, China, 300052
- Tianjin Medical University General Hospital
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Contact:
- Guolin Wang
- Telefoonnummer: +8618604755166
- E-mail: wangguolinhad@hotmail.com
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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
- Oudere volwassene
Accepteert gezonde vrijwilligers
Nee
Beschrijving
Inclusion Criteria:
Meet the diagnostic criteria for senile pruritus:
- Aged ≥ 65 years old;
- Presenting with only skin pruritus without obvious primary skin lesions, with or without scratch-induced skin lesions;
- Daily or nearly daily pruritus lasting for more than 6 weeks.
- Patients undergoing elective general anesthesia for orthopedic knee arthroplasty.
- Patients aged ≥ 65 years old, with ASA physical status classification Ⅰ-Ⅲ; BMI ranging from 18 to 30 kg/m², with no restriction on gender.
- Patients have fully understood the nature of this study, are capable of understanding and completing evaluation scales preoperatively, voluntarily participate in this trial, and sign the informed consent form.
Exclusion Criteria:
- Those who are allergic to the pharmaceutical ingredients of this study or have an allergic constitution;
- Those with a history of allergy to general anesthetics, opioids, or non-steroidal anti-inflammatory drugs;
- Those with severe cognitive impairment, a history of neurological diseases, chronic pain, drug addiction, alcoholism, long-term opioid use, or administration of opioids within 48 hours before surgery;
- Patients with ASA physical status classification Grade IV-V;
- Those with severe coronary heart disease/arrhythmia/cardiac insufficiency, bronchial asthma, severe hypertension, severe hematopoietic system dysfunction, severe abnormal liver and kidney function, or significant electrolyte disorders;
- Those with a history of gastrointestinal diseases (peptic ulcer, Crohn's disease, ulcerative colitis);
- Those with respiratory insufficiency or respiratory failure;
- Those with BMI < 18 kg/m² or BMI > 30 kg/m²;
- Those with poor compliance who cannot complete the trial in accordance with the research protocol;
- Those who have participated in other clinical drug trials within the past 4 weeks;
- Those deemed unsuitable for enrollment by the researchers for any reason. -
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: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Placebo-vergelijker: Elderly patients with senile pruritus receive normal saline.
An equal volume of normal saline is intravenously administered 30 minutes prior to the completion of the operation.
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An equal volume of normal saline is intravenously administered 30 minutes prior to the completion of the operation.
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Actieve vergelijker: Elderly patients with pruritus receive esketamine at a dose of 0.2 mg/kg.
Esketamine 0.2 mg/kg is intravenously administered 30 minutes prior to the completion of the operation.
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Esketamine 0.2 mg/kg is intravenously administered 30 minutes prior to the completion of the operation.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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5D-IS score at 24 hours after surgery
Tijdsspanne: 24 hours after surgery
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The duration, severity, outcome trend, life impairment and pruritus site (5-D) were used to evaluate the patient's pruritus.Each dimension was scored from 1 to 5, with a total score ranging from 5 to 25.
The higher the score, the more severe the itching.
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24 hours after surgery
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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5D-IS score at 48 hours,72 hours and the seventh day after surgery
Tijdsspanne: 48 hours,72 hours and the seventh day after surgery
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The duration, severity, outcome trend, life impairment and pruritus site (5-D) were used to evaluate the patient's pruritus.Each dimension was scored from 1 to 5, with a total score ranging from 5 to 25.
The higher the score, the more severe the itching.
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48 hours,72 hours and the seventh day after surgery
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The incidence of pruritus on the 24 hours after surgery
Tijdsspanne: 24 hours after surgery
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The 5D-IS score was completed by the patient 24 hours after the operation.
The investigators recorded this score as a statistical indicator.
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24 hours after surgery
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NRS pruritus score at 24 hours,48 hours and 72 hours after surgery
Tijdsspanne: 24 hours,48 hours and 72 hours after surgery
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The patient evaluated the intensiy of prurtus wth 11 numbers ranging from 0 to 10,and the higher the number, the more severe the condition.
The higher the number, the more severe the itching.
0: No sensation.
1-3: Mild itching.
4-6 Moderate itching 7-9: Severe itching.
10; Extrermely severe itching.
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24 hours,48 hours and 72 hours after surgery
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Pain Score (NRS)
Tijdsspanne: 1 hours, 24 hours, 48 hours, 72 hours after the surgery
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The pain score at rest or after movement was evaluated by pain 11-point numerical rating scale (NRS): 0= no pain, 10 = greatest imaginable pain.
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1 hours, 24 hours, 48 hours, 72 hours after the surgery
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The incidence of postoperative sleep disturbance on the first. second and third postoperative nights
Tijdsspanne: the first,second and third nights after surgery
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The patient completed the Sleep Quality Scale (AlS, Athens Insomnia Scale) one day before the surgery, There are a totat of 8 items in the AlS,with the score ranging from 0 to 24.
A total score of 6 or above indicates a diagnosis of insomnia.
We asked the patients to fill out this questionnaire after the first,second and third postoperative nights to evaluate the changes in sleep quality.
The investigators recorded AlS scores as statistical indicators.
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the first,second and third nights after surgery
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Montreal Cognitive Assessment (MoCA)
Tijdsspanne: 24 hours, 48 hours, 72 hours after the surgery
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The Montreal Cognitive Assessment consists of 7 items, which evaluate visuospatial and executive function (5 points), naming (3 points), attention (6 points), language (3 points), abstract thinking (2 points), delayed recall (5 points), and orientation (6 points) respectively.
A total score of ≥26 points indicates basically normal cognitive function; a total score of <25 points suggests cognitive decline.
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24 hours, 48 hours, 72 hours after the surgery
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Confusion Assessment Method (CAM)
Tijdsspanne: 24 hours, 48 hours, 72 hours after the surgery
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Confusion Assessment Method CAM is assessed based on four core features.
Feature 1: Acute onset or fluctuating course; Feature 2: Inattention; Feature 3: Disorganized thinking; Feature 4: Altered level of consciousness.
The diagnosis of delirium requires a positive result for Feature 1 + a positive result for Feature 2 + a positive result for either Feature 3 or Feature 4.
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24 hours, 48 hours, 72 hours after the surgery
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Intraoperative Anesthesia Information
Tijdsspanne: Perioperative period
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Duration of anesthesia (minutes)
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Perioperative period
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Intraoperative Vital Signs
Tijdsspanne: Perioperative period
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Intraoperative average heart rate
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Perioperative period
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Adverse Event
Tijdsspanne: 1 hour, 24 hours, 48 hours and 72 hours after surgery
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All kinds of adverse events(nausea, vomiting, respiratory depression, headache, dizziness, chills, delayed recovery from anesthesia) occurred in patients were recorded.
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1 hour, 24 hours, 48 hours and 72 hours after surgery
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Intraoperative Anesthesia Information
Tijdsspanne: Perioperative period
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Duration of surgery (minutes)
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Perioperative period
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Intraoperative Anesthesia Information
Tijdsspanne: Perioperative period
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Intraoperative dosage of Sufentanil (μg)
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Perioperative period
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Intraoperative Anesthesia Information
Tijdsspanne: Perioperative period
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Intraoperative dosage of Remifentani (mg)
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Perioperative period
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Intraoperative Vital Signs
Tijdsspanne: Perioperative period
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intraoperative average blood oxygen saturation
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Perioperative period
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Intraoperative Vital Signs
Tijdsspanne: Perioperative period
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Mean Arterial Pressure(MAP)
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Perioperative period
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Onderzoekers
- Studie directeur: Guolin Wang, Tianjin Medical University General Hospital
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 (Geschat)
15 mei 2026
Primaire voltooiing (Geschat)
20 juni 2027
Studie voltooiing (Geschat)
30 september 2027
Studieregistratiedata
Eerst ingediend
7 mei 2026
Eerst ingediend dat voldeed aan de QC-criteria
18 mei 2026
Eerst geplaatst (Werkelijk)
19 mei 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
19 mei 2026
Laatste update ingediend die voldeed aan QC-criteria
18 mei 2026
Laatst geverifieerd
1 mei 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- IRB2025-YX-498-01
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
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 .
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