Elderly Patients Clinical Trial
Official title:
Efficacy and Safety of Fospropofol Disodium Sedation for Same-day Bidirectional Endoscopy in Elderly Patients: a Prospective, Single-center, Randomized, Double-blind, Non-inferiority Trial
Verified date | February 2024 |
Source | Shanghai 6th People's Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Introduction: Fospropofol disodium is a novel prodrug that has improved pharmacokinetic and pharmacodynamic properties compared with propofol. This trial aims to compare the efficacy and safety of fospropofol versus propofol sedation for same-day bidirectional endoscopy in elderly patients. Methods and analysis: This is a prospective, single-center, double-blind, randomized, propofol-controlled, non-inferiority trial. A total of 256 adult patients scheduled for same-day bidirectional endoscopy under sedation will be randomly allocated, in a 1:1 ratio, to a fospropofol group or a propofol group (n=128 in each group). All patients will receive analgesic pretreatment with sufentanil 5 μg. Two minutes later, an initial bolus dose of fospropofol 6.5 mg/kg or 1.5 mg/kg propofol and supplemental doses of fospropofol 1.6 mg/kg or 0.5 mg/kg propofol will be titrated as needed to the target sedation levels during the procedures. The primary outcome is the success rate of same-day bidirectional endoscopy. Secondary outcomes include the time to successful induction of sedation, duration, time to being fully alert, time to patient discharge, endoscopist satisfaction, patient satisfaction, and the top-up frequency and dosage of sedative medications. The safety endpoints consist of adverse events (AEs) concerning cough reflex, gag reflexes, body movement, muscular tremor, pain on injection. Sedation-related AEs, including episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure ≥30% of baseline), and bradycardia, will be also recorded. Data will be analyzed on the intention-to-treat basis. Discussion: The investigators hypothesize that the efficacy and safety of fospropofol sedation for elderly patients undergoing same-visit bidirectional endoscopy will not be inferior to that of propofol. The findings will provide daily practice of sedation regimens for same-day bidirectional endoscopy in elderly patients.
Status | Not yet recruiting |
Enrollment | 256 |
Est. completion date | August 31, 2028 |
Est. primary completion date | May 31, 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - 65 years or older - American Society of Anesthesiologists (ASA) physical status I to III - Body mass index (BMI) 18-30 kg/m2 - Scheduled for same-day bidirectional endoscopy under sedation Exclusion Criteria: - Severe cardiovascular, pulmonary, renal, or liver diseases - Previous hypotension (systolic blood pressure =90 mmHg), bradycardia (heart rate <50 beats/min), or hypoxemia (SpO2 <90%) - Neurocognitive or psychiatric disorders - Contraindications to gastroscopy (gastric retention, long-term aspirin administration, etc.) - Hypersensitivity to study medications - Drug or alcohol misuse - Definite upper respiratory tract infection - Refusal for participation |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Shanghai 6th People's Hospital |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The success rate of same-day bidirectional endoscopy | The success rate of the gastrointestinal endoscopy was assessed according to the following criteria : 1) completion of the gastrointestinal endoscopy; 2) no need for rescue sedative/anesthetic, which means the top-up doses of the experimental drugs were administered no more than five times within any 15-min window from the initial administration to the end of the procedure. | Immediate time after sedation emergence | |
Secondary | The time to successful induction of sedation | the time counted from the start of drug administration to the achievement of a sedation score (MOAA/S ) = 1 | Immediate time after sedation emergence | |
Secondary | Time to being fully alert | the time from gastrointestinal endoscopy extraction or/and the time from the last drug administration to a MOAA/S score of 5 on three consecutive measurements; | Immediate time after sedation emergence | |
Secondary | Time to patient discharge | Time to patient discharge | Immediate time of hospital discharge | |
Secondary | Endoscopist's satisfaction questionnaire | Endoscopist's satisfaction | Immediate time after sedation procedure completion | |
Secondary | Patient's satisfaction questionnaire | Patient's satisfaction | Immediate time of hospital discharge | |
Secondary | The top-up frequency and dosage of sedative medications | The top-up frequency and dosage of sedative medications | Immediate time after sedation emergence | |
Secondary | Incidence of adverse events (AEs) at timepoint 1 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | baseline (Prior to sedation) | |
Secondary | Incidence of adverse events (AEs) at timepoint 2 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | Intraoperative (during sedation) | |
Secondary | Incidence of adverse events (AEs) at timepoint 3 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | Intraoperative (the timepoint of sedation emergence) | |
Secondary | Incidence of adverse events (AEs) at timepoint 4 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | 15 min in post-anesthesia care unit | |
Secondary | Incidence of adverse events (AEs) at timepoint 5 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | 30 min in post-anesthesia care unit | |
Secondary | Incidence of adverse events (AEs) at timepoint 6 | Episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in mean blood pressure =30% of baseline), and bradycardia. | Immediate time of hospital discharge |
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