Perioperative Multimodal Analgesia Protocol for Supratentorial Craniotomy

NCT ID: NCT06406829

Last Updated: 2025-02-13

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

2000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-01

Study Completion Date

2027-12-31

Brief Summary

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Supratentorial craniotomy is one of the most common neurosurgical procedures, with severe perioperative pain. Inadequate perioperative pain relief has been associated with increased blood pressure and intracranial pressure, favoring bleeding and cerebral cerebral hypoperfusion. The ideal analgesia for neurosurgery requires complete pain relief, eliminates the side effects of opioid drugs and no influence for neurological function. Previous studies have proposed a multimodal analgesic strategy, combining analgesics and local anaesthesia, it is expected to achieve the above benefits.

Detailed Description

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The trial has been designed to analyze the efficacy of local analgesic techniques and dexmedetomidine in the treatment of postoperative acute pain in craniotomy. This randomized clinical trial aims to enroll 2000 patients, which will be randomized to one of 4 groups.

Conditions

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Postoperative Pain Analgesia Supratentorial Brain Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Local analgesic techniques + dexmedetomidine group

The patients in this group will be received scalp nerve block before surgery with 0.5% ropivacaine. The patients also will be given dexmedetomidine intravenously at a rate of 0.4 μg/kg/h from skin incision until the beginning of dura mater closure, and will be adjusted to 0.05 μg/kg/h for 48 hours after surgery.

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

The 200ug dexmedetomidine will be diluted into a 50ml syringe and administered with 0.4ug/kg/h intraoperatively and 0.05 μg/kg/h for 48 hours after surgery.

Local analgesic techniques

Intervention Type OTHER

The 10ml 1% ropivacaine will be diluted into a 20ml syringe . As for scalp nerve block, each nerve will be blocked separately with 1-2 mL 0.5% ropivacaine.

Local analgesic techniques and placebo dexmedetomidine group

The patients in this group will be received scalp nerve block before surgery with 0.5% ropivacaine. For dexmedetomidine placebo group, normal saline will be infused at the same rate as dexmedetomidine during surgery and for 48 hours after surgery.

Group Type EXPERIMENTAL

Normal saline

Intervention Type DRUG

In the placebo group, the 0.9% saline is administered with the same volume at the same speed as the dexmedetomidine group

Local analgesic techniques

Intervention Type OTHER

The 10ml 1% ropivacaine will be diluted into a 20ml syringe . As for scalp nerve block, each nerve will be blocked separately with 1-2 mL 0.5% ropivacaine.

Placebo local analgesic techniques and dexmedetomidine group

The patients in this group will not receive scalp nerve block. The patients will be given dexmedetomidine intravenously at a rate of 0.4 μg/kg/h from skin incision until the beginning of dura mater closure, and will be adjusted to 0.05 μg/kg/h for 48 hours after surgery.

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

The 200ug dexmedetomidine will be diluted into a 50ml syringe and administered with 0.4ug/kg/h intraoperatively and 0.05 μg/kg/h for 48 hours after surgery.

no Local analgesic techniques

Intervention Type OTHER

No Local analgesic techniques will be given.

Placebo local analgesic techniques and placebo dexmedetomidine group

The patients in this group will not receive scalp nerve block before surgery . For dexmedetomidine placebo group, normal saline will be infused at the same rate as dexmedetomidine group during surgery and for 48 hours after surgery.

Group Type PLACEBO_COMPARATOR

Normal saline

Intervention Type DRUG

In the placebo group, the 0.9% saline is administered with the same volume at the same speed as the dexmedetomidine group

no Local analgesic techniques

Intervention Type OTHER

No Local analgesic techniques will be given.

Interventions

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Dexmedetomidine

The 200ug dexmedetomidine will be diluted into a 50ml syringe and administered with 0.4ug/kg/h intraoperatively and 0.05 μg/kg/h for 48 hours after surgery.

Intervention Type DRUG

Normal saline

In the placebo group, the 0.9% saline is administered with the same volume at the same speed as the dexmedetomidine group

Intervention Type DRUG

Local analgesic techniques

The 10ml 1% ropivacaine will be diluted into a 20ml syringe . As for scalp nerve block, each nerve will be blocked separately with 1-2 mL 0.5% ropivacaine.

Intervention Type OTHER

no Local analgesic techniques

No Local analgesic techniques will be given.

Intervention Type OTHER

Other Intervention Names

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DEX NS LAT NLAT

Eligibility Criteria

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Inclusion Criteria

* Aged from 18 to 65 years
* American Society of Anesthesiologists physical status I to III
* Scheduled to undergo elective supratentorial tumor resection

Exclusion Criteria

* Incision-area skin infection
* A history of previous craniotomy
* Allergy to study medications
* A history of preoperative change in consciousness or cognitive function
* Severe hepatic or renal dysfunction
* Severe bradycardia (heart rate\<40 beats/min)
* Sick sinus syndrome or second- to-third degree atrioventricular block
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Beijing Tiantan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Yuming Peng

Deputy chief of Department of Anesthesiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yuming Peng, Dr

Role: PRINCIPAL_INVESTIGATOR

Beijing Tiantan Hospital

Central Contacts

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Yuming Peng, Dr

Role: CONTACT

8610-59976658

Min Zeng, Dr

Role: CONTACT

15810617027

Other Identifiers

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2024007

Identifier Type: -

Identifier Source: org_study_id

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