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A Study on the Effects of Midazolam on Delirium After Sevoflurane Anesthesia in Pediatric Strabismus Surgery

3. januar 2013 oppdatert av: Eun Jung Cho, Korea University Anam Hospital

Comparative Study on the Effects of Capacities of Midazolam on Delirium After Sevoflurane Anesthesia in Pediatric Strabismus Surgery : a Randomized Double- Blinded Trial

Sevoflurane with its rapid induction and emergence, hemodynamic stability, and nonirritating airway properties, has acquired widespread acceptance in children. However, sevoflurane has been reported to be associated with emergence agitation in children, with a reported incidence of up to 80%.

The purpose of this study is to verify that the prophylactic use of midazolam, which is a GABA A receptor inhibitor, given five minutes before the end of strabismus surgery reduces the incidence of emergence agitation after sevoflurane anesthesia in children. Simultaneously, this study aims to find out the proper dose of midazolam with minimum disturbance to patient's emergence time.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Sevoflurane is associated with a high incidence of emergence agitation in children. The etiology of emergence agitation is unclear. Some studies proposed that emergence agitation was related to a variable rate of neurologic recovery rate in different brain areas and immaturity of neurons. Inhalation anesthetics have been known to exert transient paradoxical excitatory effects in both animals and human patients, especially in children. The gamma(γ)-aminobutyric acid (GABA)A receptor is the target depressant effect site of most anesthetic drugs including sevoflurane. Midazolam acts on the benzodiazepine binding site of GABAA receptors and results in inhibitory effects on the central nervous system. The effect of midazolam premedication, as well as midazolam administration at the end of surgery, on suppressing emergence agitation has been studied. However, the effect of midazolam on emergence agitation is still controversial. This study aims to figure out the effect of midazolam at the end of surgery on emergence agitation during the recovery period, and find out the proper dose of midazolam with minimum disturbance to patient's emergence time.

Studietype

Intervensjonell

Registrering (Faktiske)

90

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Korea, Republikken
      • Seoul, Korea, Republikken, 136-705
        • Department of Anaesthesiology and Pain Medicine Department; Korea University Anam Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

1 år til 13 år (Barn)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • American Society of Anesthesiologists physical status I and II patients
  • Aged one to 13 years scheduled to undergo strabismus surgery under general anesthesia
  • Willing to be assigned to any of the study intervention groups

Exclusion Criteria:

  • Refusal by parents
  • Neurological disease
  • Developmental delay
  • History of any previous surgery
  • Airway disease
  • American Society of Anesthesiologists physical status score of III or IV

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Midazolam 0.03mg/kg
This group will be injected intravenous midazolam 0.03mg/kg five minutes before the end of surgery.
Legemiddel: Midazolam 0.03mg/kg

This group will be injected intravenous midazolam 0.03mg/kg five minutes before the end of surgery.

If emergence agitation is severe, the patients will be treated by psychological support from the parents or nurse and intravenous fentanyl 1㎍/kg.

Andre navn:
  • MIDAZOLAM BUKWANG INJ 5mg/5ml
Eksperimentell: Midazolam 0.05mg/kg
This group will be injected intravenous midazolam 0.05mg/kg five minutes before the end of surgery.
Legemiddel: Midazolam 0.05mg/kg

This group will be injected intravenous midazolam 0.05mg/kg five minutes before the end of surgery.

If emergence agitation is severe, the patients will be treated by psychological support from the parents or nurse and intravenous fentanyl 1㎍/kg.

Andre navn:
  • MIDAZOLAM BUKWANG INJ 5mg/5ml
Placebo komparator: Placebo
This group will be injected intravenous normal saline five minutes before the end of surgery.
Legemiddel: Placebo

This group will be injected intravenous normal saline five minutes before the end of surgery.

If emergence agitation is severe, the patients will be treated by psychological support from the parents or nurse and intravenous fentanyl 1㎍/kg.

Andre navn:
  • NORMAL SALINE INJ(Sodium chloride 9g/1000mL)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Time of emergence
Tidsramme: within the first 1hour after end of surgery
The time of emergence is defined as time interval from the time of discontinuation of sevoflurane to the time of extubation.
within the first 1hour after end of surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence of emergency agitation
Tidsramme: From just after extubation until the discharge of PACU, assessed up to 1 hour
Agitation is assessed immediately after extubation, and continuously thereafter until participants are calm. Emergence agitation is evaluated using the four-point emergence scale and the pediatric anesthesia emergence delirium scale. The highest scores are recorded.
From just after extubation until the discharge of PACU, assessed up to 1 hour

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Korea University Anam Hospital

Etterforskere

  • Hovedetterforsker: Eun Jung Cho, Resident, Department of Anaesthesiology and Pain Medicine Department, Korea University Anam Hospital
  • Studieleder: S.Z. Yoon, Professor, Department of Anaesthesiology and Pain Medicine Department, Korea University Anam Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. juli 2012

Primær fullføring (Faktiske)

1. november 2012

Studiet fullført (Faktiske)

1. november 2012

Datoer for studieregistrering

Først innsendt

28. august 2012

Først innsendt som oppfylte QC-kriteriene

4. september 2012

Først lagt ut (Anslag)

7. september 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

4. januar 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. januar 2013

Sist bekreftet

1. januar 2013

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • ECho2012

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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