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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04018703
Other study ID # MAC in Eye Surgery
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date November 1, 2019
Est. completion date December 31, 2021

Study information

Verified date November 2020
Source Eye & ENT Hospital of Fudan University
Contact Hui Qiao, M.D. Ph.D.
Phone 8615900598163
Email theyellow@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

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.


Description:

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.


Recruitment information / eligibility

Status Recruiting
Enrollment 150
Est. completion date December 31, 2021
Est. primary completion date July 31, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility 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.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Dexmedetomidine
loading dose 0.5-2.5ug/kg followed by continuous infusion 0.2-0.5ug/kg/h
Midazolam
loading dose 30-50ug/kg followed by continuous infusion 10-30ug/kg/h

Locations

Country Name City State
China Eye, Ear, Nose and Throat Hospital Shanghai Shanghai

Sponsors (1)

Lead Sponsor Collaborator
Eye & ENT Hospital of Fudan University

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Perioperative change of Observer's Assessment of Alertness/Sedation scale (OAA/S) Conventional subjective sedation scales with 1 to 5. Successful sedation was defined as an OAA/S scale score between 1 and 3, while failure was defined as an OAA/S score of more than 3. OAA/S score will be recorded from patient arrival in the operating room to about 30 minutes after surgery at following time points: before sedative administration, before skin incision, every 5 minutes intraoperatively and every 10 minutes in PACU.
Primary Numerical rating scale (NRS) The surgeons rated anesthesia management on a numerical rating scale (NRS), ranging from 0 to 10, with 10 defined as the best condition and 0 as the worst. Immediately after surgery, the surgeons report NRS only once
Secondary Intraocular pressure Measured with Tono-Pen tonometer Intraocular pressure will be measured at two time points: before sedative medication administration and before skin incision.
Secondary Bispectral index (BIS) Anesthesia depth index Bis will be continuously recorded with BIS monitor from arrival in the operating room to discharge to ward (about 30 minutes after surgery).
Secondary Visual analogue scale (VAS) Patient self-report pain score ranging from 0 to 10, with 0 defined as no pain at all and 10 as the intolerable pain. VAS will be recorded at the following time points until 1h postoperatively: before sedative medication administration, before skin incision, every 10 minutes intraoperatively and 1h postoperatively
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