- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07560722
The Effect of a Single Intravenous Injection of Esketamine During Cesarean Section on Postoperative Pruritus in Patients With Intrahepatic Cholestasis of Pregnancy
The Effect of a Single Intravenous Injection of Esketamine During Cesarean Section on Postoperative Pruritus in Patients With Intrahepatic Cholestasis of Pregnancy:A Single-center Randomized Controlled Trial
Przegląd badań
Status
Interwencja / Leczenie
Szczegółowy opis
Intrahepatic cholestasis of pregnancy (ICP) is an important obstetric complication that occurs in the middle and late stages of pregnancy, characterized mainly by pruritus and elevated serum total bile acid (TBA) levels.
Pruritus usually begins on the palms and soles of the feet and can gradually spread. It typically shows a 'lighter during the day and heavier at night' pattern, severely affecting the patient's quality of life. It can also lead to physical and psychological disorders, and even cause mental abnormalities and self-harming behaviors in patients.
Esketamine is the right-handed isomer of ketamine and is a non-competitive N-methyl-D-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 important role in the transmission of non-histaminergic itching. Eslicarbazepine acetate, as a highly selective NMDA receptor antagonist, may alleviate the transmission and propagation of itching. However, there are no reports on whether a single intravenous injection of esketamine can alleviate the pruritus symptoms of patients with pregnancy-induced intrahepatic cholestasis. This experiment aims to investigate the effect of a single intravenous injection of esketamine during cesarean section on postoperative pruritus in patients with pregnancy-induced intrahepatic cholestasis.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Guolin Wang
- Numer telefonu: +8615822855556
- E-mail: wangguolinghad@hotmail.com
Lokalizacje studiów
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Tianjin, Chiny, 300052
- Tianjin Medical University General Hospital
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Kontakt:
- Guolin Wang
- Numer telefonu: +8618604755166
- E-mail: wangguolinghad@hotmail.com
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Age: 18 - 40 years old; Gestational age: ≥ 35 weeks; Singleton pregnancy.
- Clear consciousness, able to cooperate with NRS scoring, laboratory tests and follow-up.
- Meet the diagnostic criteria of the "Clinical Diagnosis, Treatment and Management Guidelines for Intrahepatic Cholestasis of Pregnancy (2024 Edition)" : fasting serum TBA≥10 μmol/L or postprandial serum TBA≥19 μmol/L.
- Reporting pruritus NRS ≥ 4 points twice within one week.
- Planned to undergo cesarean section under intraspinal anesthesia.
- ASA classification: I - III grade.
Exclusion Criteria:
- Those who are known to be allergic to the drug components or have an allergic constitution.
- Related to the safe use of esketamine: history of mental illness; uncontrolled hypertension; uncontrolled hyperthyroidism; increased intracranial pressure, increased intraocular pressure; long-term alcohol consumption or drug abuse history.
- Those with severe organic diseases and liver diseases.
- Those with malignant tumors.
- Other pruritic diseases: uremic pruritus, true erythrocytosis, cutaneous T-cell lymphoma, eosinophilia, drug rash and drug-induced pruritus, and other pruritic diseases that are easily confused, such as atopic dermatitis, pemphigus, scabies, parasitic delusionism, artificial dermatitis, etc.
- Eclampsia and pre-eclampsia, HELLP syndrome; fetal developmental abnormalities, multiple pregnancies.
- ASA classification as grade IV.
- Those with poor compliance and unable to complete the trial according to the research protocol.
- Those who have participated in other drug clinical trials within the past 4 weeks.
Due to any reason, the researchers consider that there is any situation that is not suitable for inclusion.
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Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Podwójnie
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
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Komparator placebo: Placebo group of parturients with ICP and pruritus received normal saline
The equal volume of normal saline was injected intravenously after fetal delivery during the operation
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The same volume of normal saline was injected after fetal delivery during the operation
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Aktywny komparator: Group of parturients with ICP and pruritus received esketamine 0.3mg/kg
Esketamine 0.3mg/kg was injected intravenously after fetal delivery during the operation
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Esketamine 0.3mg/kg was given intravenously after fetal delivery during the operation
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
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NRS pruritus score at 24 hours after surgery
Ramy czasowe: 24 hours after the surgery
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The patient evaluated the intensity of pruritus with 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: Extremely severe itching.
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24 hours after the surgery
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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5-D itch scale at 72 hours after surgery
Ramy czasowe: 72 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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72 hours after surgery
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NRS pruritus score at 6 hours、12 hours、48 hours、72h ours and the seventh day after surgery
Ramy czasowe: 6 hours、12 hours、48 hours、72 hours and the seventh day after surgery
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The patient evaluated the intensity of pruritus with 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: Extremely severe itching.
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6 hours、12 hours、48 hours、72 hours and the seventh day after surgery
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The incidence of pruritus on the 24 hours after surgery
Ramy czasowe: 24 hours after surgery
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The NRS pruritus 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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Total bile acid at 24 hours after surgery
Ramy czasowe: 24 hours after surgery
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The patient's fasting total bile acid level was checked the day before the operation.
The investigators rechecked the fasting total bile acid levels 24 hours after the patient's surgery to assess the changes in total bile acid.
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24 hours after surgery
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Pain Score (NRS)
Ramy czasowe: 6 hours, 12 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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6 hours, 12 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
Ramy czasowe: the first、second and third nights after surgery
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The patient completed the Sleep Quality Scale (AIS,Athens Insomnia Scale) one day before the surgery.
There are a total of 8 items in the AIS, 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 AIS scores as statistical indicators.
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the first、second and third nights after surgery
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Postoperative anxiety
Ramy czasowe: 72 hours after the surgery
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The patient completed the Self-Rating Anxiety Scale (SAS, Self-Rating Anxiety Scale) one day before the surgery.
The SAS consists of 20 items.
Among them, 15 items are positive ratings (such as "I feel more nervous and anxious than usual"), and 5 items are negative ratings (such as "I feel everything is fine", which are the reverse items numbered 5, 9, 13, 17, and 19).
The content covers subjective feelings of anxiety and various physical symptoms.
The investigators asked the patient to fill out this questionnaire again 72 hours after the surgery to assess the changes in anxiety.
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72 hours after the surgery
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Postoperative depression
Ramy czasowe: 72 hours after the surgery
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The patient completed the Edinburgh Depression Scale (EPDS) one day before the surgery.
The EPDS consists of 10 items, covering aspects such as mood, anxiety, and self-blame.
Scores range from 0 to 9: within the normal range, no special intervention is required; 10-12: borderline range, suggesting a need for follow-up observation; 13-30: screening positive, indicating possible postpartum depression, and further assessment is necessary.
The investigators asked the patient to fill out this questionnaire again at the seventy-second hour after the surgery to assess the changes in depression.
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72 hours after the surgery
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Key time points of the surgery
Ramy czasowe: Perioperative period
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Perioperative period
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Intraoperative average blood pressure(mmHg)
Ramy czasowe: Perioperative period
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Perioperative period
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Intraoperative average heart rate(times per minute)
Ramy czasowe: Perioperative period
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Perioperative period
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Intraoperative average blood oxygen saturation(%)
Ramy czasowe: Perioperative period
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Perioperative period
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Intraoperative adverse reactions ( elevated blood pressure, tachycardia, hallucinations, nausea, vomiting, etc.)
Ramy czasowe: Perioperative period
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Perioperative period
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Adverse event
Ramy czasowe: Within 72 hours after the surgery
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All kinds of adverse events( nausea, vomiting, headache,etc) occurred in patients were recorded.
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Within 72 hours after the surgery
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Współpracownicy i badacze
Śledczy
- Dyrektor Studium: Guolin Wang, Tianjin Medical University General Hospital
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- IRB2026-YX-129-01
Plan dla danych uczestnika indywidualnego (IPD)
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Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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