Dexmedetomidin for intraoperativ skjelving ved planlagt elektiv keisersnitt
Dexmedetomidin for behandling av skjelving under planlagt elektiv keisersnitt: Bestemmelse av den optimale dosen
The purpose of this study is to determine the optimum dose of Dexmedetomidine to stop shivering in 90% of patients who experience shivering during scheduled elective cesarean deliveries.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Potential subjects will consist of parturients who present for scheduled elective cesarean deliveries. Patients will be recruited and consented for the study pre-operatively and if they display Grade 3 or 4 shivering at the time of delivery then they will be enrolled in the study. Doses of dexmedetomidine will be selected according to a sequential up-and-down method, using a biased coin design to find the estimated dose at which 90% of patients would have desired effect - cessation of shivering within 5 minutes of medication administration. An anesthesia physician not involved in patient care or assessment will prepare the dexmedetomidine for intravenous use. Anesthesia will be initiated with spinal anesthesia with our institution's typical dosing of 1.6 mL 0.75% bupivacaine with dextrose, 15 mcg fentanyl, and 150 mcg morphine.
Shivering will be graded using a five-point scale as outlined by Crossley and Mahajan. Members of the anesthesia team caring for women in the study will be educated on the grading scales.
- Grade 0: no shivering;
- Grade 1: one or more of the following: piloerection, peripheral vasoconstriction, peripheral cyanosis, but without visible muscle activity; Grade 2: visible muscle activity confined to one muscle group;
- Grade 3: visible muscle activity in more than one muscle group;
- Grade 4: gross muscle activity involving the whole body
Studietype
Fase
- Fase 4
Kontakter og plasseringer
Studiesteder
-
-
Minnesota
-
Rochester, Minnesota, Forente stater, 55905
- Mayo Clinic in Rochester
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Women presenting for planned cesarean delivery.
- American Society of Anesthesiology Physical Classification Status 2 or 3; without major medical co-morbidities.
- Singleton gestation in the 3rd trimester (28-42 weeks gestation).
- Spinal anesthesia technique Women presenting for planned cesarean delivery.
- American Society of Anesthesiology Physical Classification Status 2 or 3; without major medical co-morbidities.
- Singleton gestation in the 3rd trimester (28-42 weeks gestation).
- Spinal anesthesia technique.
Exclusion Criteria:
- Any contraindication to spinal anesthesia technique.
- Allergy or intolerance to dexmedetomidine or clonidine.
- Oral temperature < 36° Celsius prior to procedure.
- Unable to give personal consent.
- PPROM or concern for infection (e.g., chorioamnionitis).
- Conversion to General Anesthesia prior to randomization.
- Sedative medications (e.g., fentanyl, midazolam, ketamine, nitrous oxide) administered prior to randomization.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Dexmedetomidine
IV administration of Dexmedetomidine, using an Up-Down method utilizing a biased coin design to determine that next patient's dose. Initial dose will be 10mcg. |
Doses of dexmedetomidine will be selected according to a sequential up-and-down method, using a biased coin design to find the estimated dose at which 90% of patients would have desired effect |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Shivering will be graded using a five-point scale as outlined by Crossley and Mahajan
Tidsramme: 5 minutes after administration of the drug
|
Cessation of shivering |
5 minutes after administration of the drug
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Maternal Heart Rate
Tidsramme: During intraoperative course
|
Determination of the effect of varying doses of dexmedetomidine on maternal heart rate. |
During intraoperative course
|
|
Doses of dexmedetomidine
Tidsramme: During intraoperative course
|
Determination of the effect of varying doses of dexmedetomidine on maternal sedation. |
During intraoperative course
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Hans Sviggum, MD, Mayo Clinic
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 20-004712
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
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. .