Conscious Sedation Clinical Trial
Official title:
A Post-Marketing, Open-Label, Randomized, Comparative Study Comparing the Usefulness of Dexmedetomidine at the Time of Extubation and Post Extubation Period to Other Sedative Management in Post-Operative Patients
Verified date | June 2015 |
Source | Hospira, now a wholly owned subsidiary of Pfizer |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of this study is to assess efficacy and safety of dexmedetomidine at the time of extubation and after extubation, in patients requiring postoperative sedation in the ICU.
Status | Completed |
Enrollment | 85 |
Est. completion date | August 2006 |
Est. primary completion date | August 2006 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 20 Years and older |
Eligibility |
Inclusion Criteria: - Patient or legally acceptable representative (if acceptable by Institutional Review Board/Ethics Committee) has signed and dated the Informed Consent after the study has been fully explained. - Patient is male or female; at least 20 years of age. - Patient who is in condition of American Society of Anesthesiology (ASA) I to III Class preoperatively - Patient is orally intubated and anticipated to require sedation for mechanical ventilation for a minimum period of 4 hours following open-heart surgery, coronary artery bypass grafting (CABG), or major vascular surgery - If patient is female with child bearing potential, she is to be non-pregnant, and not lactating Exclusion Criteria: - Patient with serious disturbance of the central nervous system (disturbance of consciousness). - Patient has undergone or requires intracranial surgery during current hospitalization - Patient requires muscle relaxant drugs after admission to the ICU (except when an endotracheal tube is reinserted). - Patient requires epidural or intrathecal administration of analgesia/anesthesia after surgery and during their ICU stay. - Patients for whom propofol or opioids are contraindicated. - Patient has known or suspected allergies to any medication that might be administered during the course of the study. - Patient is obese (body mass index >35) - Patient was recently hospitalized for drug overdose - Patient for whom alpha-2 antagonists or alpha-2 agonists are contraindicated - Patient is currently or previously treated, within 30 days before the start of the study, with an alpha-2 antagonist or alpha-2 receptor agonist. - Patient has participated in another clinical study within 30 days prior to admission to the ICU and patient is currently participating in another clinical study. - Patient was diagnosed with severe symptoms and judged likely to die within 24 hours. - Patient is considered unable to undergo all procedures required by the protocol. - Patient with excessive bleeding that is likely require reoperation. - Patient with an ejection fraction of < 30%. - Patient, in the opinion of the investigator or subinvestigator in the post-marketing clinical study, that has symptoms or factors that may increase his/her risk as a result of the clinical study, or that may not provide sufficient study data. |
Country | Name | City | State |
---|---|---|---|
Japan | Nippon Medical School Hospital | Bunkyo-ku | Tokyo |
Japan | Hamamatsu University Hospital | Hamamatsu-City | Shizuoka |
Japan | Kyushu University Hospital | Higashi-ku | Fukuoka |
Japan | Hirosaki University Hospital | Hirosaki-shi | Aomori |
Japan | Kagoshima University Medical and Dental Hospital | Kagoshima | |
Japan | Osaka City General Hospital | Miyakojima-ku | Osaka |
Japan | Nagasaki University Hospital of Medicine and Dentistry | Nagasaki | |
Japan | Okayama University Hospital of Medicine and Dentistry | Okayama | |
Japan | Kinki University Hospital | Osaka-Sayama-Shi | Osaka |
Japan | Kyoto University Hospital | Sakyoku | Kyoto |
Japan | Showa University Hospital | Shinagawa-ku | Tokyo |
Japan | Tokyo Women's Medical University Hospital | Shinjuku-ku | Tokyo |
Japan | Osaka University Hospital | Suita | Osaka |
Lead Sponsor | Collaborator |
---|---|
Hospira, now a wholly owned subsidiary of Pfizer | Maruishi Pharmaceutical |
Japan,
Aitkenhead AR. Analgesia and sedation in intensive care. Br J Anaesth. 1989 Aug;63(2):196-206. Review. — View Citation
Costas Katsanoulas. Concluding Remarks: Redefining Intensive Care Unit Sedation, International Congress and Symposium Series 221, 83-88
Greenblatt DJ, Divoll M, Abernethy DR, Ochs HR, Shader RI. Clinical pharmacokinetics of the newer benzodiazepines. Clin Pharmacokinet. 1983 May-Jun;8(3):233-52. Review. — View Citation
Hewitt PB. Subjective follow-up of patients from a surgical intensive therapy ward. Br Med J. 1970 Dec 12;4(5736):669-73. — View Citation
Hidekazu Yukioka, et.al. Current status of analgesic and sedation control in ICU. Japan ICU Treatment Association's Magazine 1:13-19, 1994
Ikuto Yoshiya. Section 4; Pharmacology for Anesthesia, Introduction to Anesthesiology, 7th edition, Nagai Shoten,pp439-447, 1993
Ikuto Yoshiya: Sedation and Analgesia for Intensive Care Patients. Anesthesia 21(2):2-6, 333-337, 2000
Mantz,J., Singer,M. Importance of Patient Orientation and Rousability as Components of Intensive Care Unit Sedation, International Congress and Symposium Series 221, 23-29
Masayoshi Hyodo et.al. Anesthetic Science, 10th edition, Kinpodo, ppl 213-219
Megumu Tagami et.al. Post-operative analgesic and sedation control,
Minoru Kaneshiro. Analgesic and Sedatin during mechanical ventilation, ICU and CCU 14:14643-648,1990
Syu Matsukawa, et.al.Sedation during ventilation control, ICU and CCU 14:603-608,1990
* Note: There are 12 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percentage of patients who maintained a Richmond Agitation-Sedation score =0, -1, -2 | Continuously from 1 hour before extubation or end of propofol infusion before extubation, whichever is later, to 1 hour after extubation | ||
Secondary | Variations in vital signs (blood pressure and heart rate) in patients | From 10 minutes before extubation to 10 minutes after extubation | ||
Secondary | Percentage of patients who required analgesia and received supplemental fentanyl before and after extubation | From 7 days prior to surgery to the start of surgery, and from the end of surgery to 48 hrs after the start of infusion | ||
Secondary | Percentage of patients with a total score of 3 on the Behavioral Pain Scale just before extubation | 10±2 minutes before extubation, 2±1 minutes after extubation | ||
Secondary | Percentage of patients who required supplemental sedation after extubation | After extubation to 24 hours after the start of study drug infusion. | ||
Secondary | Percentage of patients who require post-extubation analgesia and who received supplemental fentanyl after extubation | After extubation to 24 hours after the start of study drug infusion. | ||
Secondary | Amount of supplemental fentanyl required after extubation | After extubation to 24 hours after the start of study drug infusion. | ||
Secondary | Ratio of time with a Richmond Agitation-Sedation score =+1 | From 1 hour before extubation or the end of propofol infusion before extubation, whichever was later, to 1 hour after extubation | ||
Secondary | Distribution of Richmond Agitation-Sedation score most frequently recorded while intubated | From the start of study drug administration to 1 hour before the expected time of extubation. | ||
Secondary | Ease of patient management on the basis of a questionnaire to physicians and nurses | Conducted to the greatest possible extent, at ICU discharge or at 36 hours after the start of drug administration, whichever is earlier (in Part II only). | ||
Secondary | Assessment of interactions between dexmedetomidine and propofol or fentanyl | After propofol or fentanyl administration (Pre-dose and Post dose [5 and 10 minutes]) | ||
Secondary | Patient self-evaluation of experiences during their stay in the ICU | Conducted to the greatest possible extent, at ICU discharge or at 36 hours after the start of drug administration, whichever is earlier (in Part II only). |
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