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SPI-guided Analgesia During CEA Under RA (CEA)

31. juli 2020 oppdatert av: Michał Stasiowski, Medical University of Silesia

SPI-guided Analgesia in Patients Undergoing Carotid Endarterectomy Under Cervical Plexus Block

The aim of this randomized prospective trial is to assess the utility of Adequacy of Anaesthesia technique (Response Entropy and Surgical Pleth Index) for monitoring pain perception intraoperatively, maintainance of hemodynamic stability during anesthesia and its influence on postoperative outcomes, in patients undergoing carotid endarterectomy under cervical plexus block.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Carotid artery stenosis constitutes a major risk factor for ischemic stroke so carotid endarterectomy is performed to protects patients with severe atherosclerotic carotid artery stenosis against stroke.

Surgical Pleth Index (SPI) is reported to properly reflect nociception-antinociception balance in patients undergoing surgical procedures, where a value of 100 corresponds to a high stress level and a value of 0 to a low stress level; values near 50 or increase in value > delta 10 correspond to the stress level which is known to reflect requirement for rescue analgesia.

A randomized interventional trial to evaluate the effects of SPI-guided rescue analgesia on hemodynamic stability during anesthesia in patients undergoing carotid endarterectomy under cervical plexus block.

Studietype

Intervensjonell

Registrering (Forventet)

105

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiesteder

  • Polen
    • Silesia
      • Sosnowiec, Silesia, Polen, 41-200
        • Rekruttering
        • Medical University of Silesia
        • Ta kontakt med:
        • Ta kontakt med:

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

18 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

clinical diagnosis of stenosis of carotid artery written consent to participate in the study written consent to undergo carotid endarterectomy under regional anaesthesia of cervical plexus using Moore's technique general heath condition I-III of American Society of Anaesthesiology

Exclusion Criteria:

  • necessity of administration of vasoactive drugs influencing SPI monitoring pregnancy
  • anatomical malformation that make monitoring using SE sensor impossible
  • general atherosclerosis and heart rhythm disturbances impairing SPI monitoring
  • chronic medication using opioid drugs leading to resistancy to opioids.
  • farmacotherapy with anticoagulants
  • allergy to local anaesthetics

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: CPB
cervical plexus block was performed with 0,5% bupivacaine using Moore's technique
Legemiddel: infiltration rescue intraoperative analgesia
in the case of intraoperative pain perception, rescue infiltration analgesia using 1 % lidocaine administered by the operator into the operation field.
Andre navn:
  • rescue LA
Legemiddel: rescue IA
in the case of intraoperative pain perception, rescue intravenous analgesia using 50 mcg of fentanyl will be administered by anaesthesiologist
Legemiddel: rescue antyhypertensive medication
in the case of intraoperative hypertension reluctant to rescue analgesia, rescue intravenous antihypertensive medication using 10 mcg of urapidil will be administered by anaesthesiologist
Legemiddel: rescue antyemetic medication
in the case of postoperative nausea and vomitting, rescue intravenous antiemetic medication using 4 mg of ondansetron will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative hypotension, rescue intravenous antihypotensive medication using 10 mg of ephedrine will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative bradycardia, rescue intravenous antihypotensive medication using 500 mcg of atropine will be administered by anaesthesiologist
Eksperimentell: CPB with SPI guided analgesia
cervical plexus block was performed with 0,5% bupivacaine using Moore's technique alongside with SPI-guided rescue analgesia using 1% lidokaine and intravenous fentanyl
Legemiddel: infiltration rescue intraoperative analgesia
in the case of intraoperative pain perception, rescue infiltration analgesia using 1 % lidocaine administered by the operator into the operation field.
Andre navn:
  • rescue LA
Legemiddel: rescue IA
in the case of intraoperative pain perception, rescue intravenous analgesia using 50 mcg of fentanyl will be administered by anaesthesiologist
Legemiddel: rescue antyhypertensive medication
in the case of intraoperative hypertension reluctant to rescue analgesia, rescue intravenous antihypertensive medication using 10 mcg of urapidil will be administered by anaesthesiologist
Legemiddel: rescue antyemetic medication
in the case of postoperative nausea and vomitting, rescue intravenous antiemetic medication using 4 mg of ondansetron will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative hypotension, rescue intravenous antihypotensive medication using 10 mg of ephedrine will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative bradycardia, rescue intravenous antihypotensive medication using 500 mcg of atropine will be administered by anaesthesiologist
Eksperimentell: CPB plus SPI guided analgesia plus carotid artery block
cervical plexus block was performed with 0,5% bupivacaine using Moore's technique combined ith US-guided carotid artery block alongside with SPI-guided rescue analgesia using 1% lidokaine and intravenous fentanyl
Legemiddel: infiltration rescue intraoperative analgesia
in the case of intraoperative pain perception, rescue infiltration analgesia using 1 % lidocaine administered by the operator into the operation field.
Andre navn:
  • rescue LA
Legemiddel: rescue IA
in the case of intraoperative pain perception, rescue intravenous analgesia using 50 mcg of fentanyl will be administered by anaesthesiologist
Legemiddel: rescue antyhypertensive medication
in the case of intraoperative hypertension reluctant to rescue analgesia, rescue intravenous antihypertensive medication using 10 mcg of urapidil will be administered by anaesthesiologist
Legemiddel: rescue antyemetic medication
in the case of postoperative nausea and vomitting, rescue intravenous antiemetic medication using 4 mg of ondansetron will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative hypotension, rescue intravenous antihypotensive medication using 10 mg of ephedrine will be administered by anaesthesiologist
Legemiddel: rescue antyhypotensive medication
in the case of intraoperative bradycardia, rescue intravenous antihypotensive medication using 500 mcg of atropine will be administered by anaesthesiologist

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
haemodynamic stability
Tidsramme: intraoperatively
variations of haemodynamic parametres will be analysed
intraoperatively

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
pain perception using SPI value variations
Tidsramme: intraoperatively
pain perception using SPI value variations will be analysed
intraoperatively

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
ischaemic stroke
Tidsramme: from beginning of operation till discharge from hospital
presence of ischaemic stroke will be observed
from beginning of operation till discharge from hospital
dysarthria
Tidsramme: from beginning of operation till discharge from hospital, approximately 2 - 14 days
presence of dysarthria will be observed
from beginning of operation till discharge from hospital, approximately 2 - 14 days
limb paresis
Tidsramme: from beginning of operation till discharge from hospital, approximately 2 - 14 days
presence of limb paresis will be observed
from beginning of operation till discharge from hospital, approximately 2 - 14 days
hoarseness
Tidsramme: from beginning of operation till discharge from hospital, approximately 2 - 14 days
presence of hoarseness will be observed
from beginning of operation till discharge from hospital, approximately 2 - 14 days
face semiparesis
Tidsramme: from beginning of operation till discharge from hospital, approximately 2 - 14 days
presence of semiparesis will be observed
from beginning of operation till discharge from hospital, approximately 2 - 14 days
postoperative nausea and vomitting
Tidsramme: from beginning of operation till discharge from hospital, approximately 2 - 14 days
presence of postoperative nausea and vomitting will be observed
from beginning of operation till discharge from hospital, approximately 2 - 14 days

Samarbeidspartnere og etterforskere

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

Sponsor

Medical University of Silesia

Samarbeidspartnere

Silesian University of Medicine

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

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 (Faktiske)

1. oktober 2015

Primær fullføring (Forventet)

1. oktober 2020

Studiet fullført (Forventet)

1. oktober 2020

Datoer for studieregistrering

Først innsendt

14. april 2019

Først innsendt som oppfylte QC-kriteriene

31. juli 2020

Først lagt ut (Faktiske)

5. august 2020

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. august 2020

Siste oppdatering sendt inn som oppfylte QC-kriteriene

31. juli 2020

Sist bekreftet

1. juli 2020

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • SilesianMUKOAiIT4

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

Ja

IPD-planbeskrivelse

publication in AiIT

IPD-delingstidsramme

within a year

Tilgangskriterier for IPD-deling

on a reasonable request

IPD-deling Støtteinformasjonstype

  • Informert samtykkeskjema (ICF)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

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. .

Kliniske studier på Halspulsårestenoser

Kliniske studier på infiltration rescue intraoperative analgesia

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Sponsorer og samarbeidspartnere

Medisinsk tilstand

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