The Study of Different Sedative Medications in Monitored Anesthesia Care During Eye Surgery With Local Anesthesia

NCT ID: NCT04018703

Last Updated: 2020-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-01

Study Completion Date

2021-12-31

Brief Summary

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Due to the delicacy and long duration of the procedure, ophthalmic surgery put forward higher requirements to anesthesia management:

1. The patient with local anesthesia without sedation is in a state of awareness, which will cause intense stress resulting in increased blood pressure, heart rate, muscle tension and even sense of pain;
2. Traction of extraocular muscles and eyeballs can induce oculocardiac reflex, followed by bradycardia, atrial or ventricular arrhythmia, conduction block, and even more worsen, life-threatening cardiac arrest may occur;
3. With the increase in average life expectancy and the improvement of quality of life requirements, the number of elderly patients in ophthalmic surgery is also increasing. These elderly patients are often combined with hypertension, diabetes, etc. and decreased tolerance of with general anesthesia;
4. For some retinal detachment surgery with difficulty in resetting, the patients will be required to change to the prone position immediately after surgery to improve the success rate of resetting. Conventional general anesthesia management are cumbersome and costly, which may not be likely to achieve the swift emergence.

Nowadays, monitoring Anesthesia Care (MAC) has developed into a flexible and unique anesthesia technology combining intravenous anesthesia with regional block anesthesia. MAC provides reasonable balance between economy, comfort and safety, efficiency by continuous monitoring of changes in respiratory and circulatory system, during process of sedation and analgesia. Airway management will be another issue as surgeons operate on the side of head and face. Studies have shown that MAC can achieve adequate sedation and analgesia to decrease blood pressure, provide acceptable surgical fields and reduce adverse reactions such as perioperative stress, pain and anxiety. Meanwhile, MAC make patients comfortable enough to cooperate with the surgeons, easy to be awakened with relatively short operation duration and improvement of perioperative safety.

Detailed Description

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The allocation sequence is generated by computer random number generation, and the allocation is placed in sequentially numbered opaque sealed envelopes by a non-investigator. Enrolment and data collection are performed by trained research staff who are not involved in the care of the patients. The treating clinicians are not possible to be blinded to the assignment group, but all other staff involved in both the collection and collation of data, and administration of neurocognitive testing, are blinded to group allocation.

Conditions

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Balanced Anesthesia Adjuvants,Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Dexmedetomidine

Dexmedetomidine will be used for perioperative sedation.

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

loading dose 0.5-2.5ug/kg followed by continuous infusion 0.2-0.5ug/kg/h

Midazolam

Midazolam will be used for perioperative sedation.

Group Type EXPERIMENTAL

Midazolam

Intervention Type DRUG

loading dose 30-50ug/kg followed by continuous infusion 10-30ug/kg/h

Interventions

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Dexmedetomidine

loading dose 0.5-2.5ug/kg followed by continuous infusion 0.2-0.5ug/kg/h

Intervention Type DRUG

Midazolam

loading dose 30-50ug/kg followed by continuous infusion 10-30ug/kg/h

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients scheduled for ophthalmic surgery with retrobulbar nerve block

Exclusion Criteria

* Patients with severe cardiac, pulmonary, hepatic, or renal dysfunction. Patients with a preoperative history of mental disorder, hearing disorder, II-III degree atrioventricular block, known allergy or hypersensitivity to a2 receptor agonists and refusal of (or contraindications to) PNB. Patients with anticipated difficult airway.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eye & ENT Hospital of Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Hui Qiao

Attending Anesthesiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wenxian Li, M.D. Ph.D.

Role: STUDY_DIRECTOR

Eye and ENT Hospital of Fudan University

Locations

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Eye, Ear, Nose and Throat Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Hui Qiao, M.D. Ph.D.

Role: CONTACT

8615900598163

Weihong Yang, M.D.

Role: CONTACT

8618917785802

Facility Contacts

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Hui Qiao, Doctor

Role: primary

021-64377134

Other Identifiers

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MAC in Eye Surgery

Identifier Type: -

Identifier Source: org_study_id