地塞米松联合综合穴位刺激对外周神经阻滞后反跳痛的影响

注册号:

Registration number:

ITMCTR2024000834

最近更新日期:

Date of Last Refreshed on:

2024-12-17

注册时间:

Date of Registration:

2024-12-17

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

地塞米松联合综合穴位刺激对外周神经阻滞后反跳痛的影响

Public title:

Effects of dexamethasone combined with auricular plaster therapy and transcutaneous electrical acupoint stimulation on rebound pain after peripheral nerve block

注册题目简写:

English Acronym:

研究课题的正式科学名称:

地塞米松联合综合穴位刺激对外周神经阻滞后反跳痛的影响

Scientific title:

Effects of dexamethasone combined with auricular plaster therapy and transcutaneous electrical acupoint stimulation on rebound pain after peripheral nerve block

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

刘帆

研究负责人:

龚兴瑞

Applicant:

Liu Fan

Study leader:

Gong Xingrui

申请注册联系人电话:

Applicant telephone:

15271125378

研究负责人电话:

Study leader's telephone:

15071551981

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

785833708@qq.com

研究负责人电子邮件:

Study leader's E-mail:

gongxrhbxy@sohu.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

湖北省襄阳市襄城区荆州街14号

研究负责人通讯地址:

湖北省襄阳市襄城区荆州街14号

Applicant address:

The 14th jingzhou street Xiangcheng district xiangyang city Hubei province

Study leader's address:

The 14th jingzhou street Xiangcheng district xiangyang city Hubei province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

襄阳市中心医院

Applicant's institution:

Xiangyang Central Hospital

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

2024-151-02

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

襄阳市中心医院伦理委员会

Name of the ethic committee:

Ethics Committee of Xiangyang Central Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2024/11/15 0:00:00

伦理委员会联系人:

应玉雯

Contact Name of the ethic committee:

Ying Yuwen

伦理委员会联系地址:

襄阳市东津新区楚山路19号襄阳市中心医院东津院区

Contact Address of the ethic committee:

The dongjin ward Xiang yang Central Hospital 19 chun yuan Road Dongjin New District Xiangyang city

伦理委员会联系人电话:

Contact phone of the ethic committee:

0710-3511354

伦理委员会联系人邮箱:

Contact email of the ethic committee:

54164161@qq.com

研究实施负责(组长)单位:

襄阳市中心医院

Primary sponsor:

Xiangyang Central Hospital

研究实施负责(组长)单位地址:

湖北省襄阳市襄城区荆州街14号

Primary sponsor's address:

The 14th jingzhou street Xiangcheng district xiangyang city Hubei province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

湖北省

市(区县):

襄阳市

Country:

China

Province:

HuBei

City:

Xiangyang

单位(医院):

襄阳市中心医院

具体地址:

湖北省襄阳市襄城区荆州街14号

Institution
hospital:

Xiangyang Central Hospital

Address:

The 14th jingzhou street Xiangcheng district xiangyang city Hubei province

经费或物资来源:

自筹

Source(s) of funding:

self-raising

研究疾病:

神经阻滞后反跳痛

研究疾病代码:

Target disease:

the rebound pain after peripheral nerve block

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

其它

Others

研究目的:

本研究拟探讨地塞米松联合综合穴位刺激对上肢外周神经阻滞后反跳痛的影响,并探讨其可能的机制。

Objectives of Study:

This study is proposed to explore the influence of dexamethasone in combination with comprehensive acupoint stimulation on the rebound pain after peripheral nerve block of the upper limb and to discuss its possible mechanisms.

药物成份或治疗方案详述:

1)随机纳入2025.2-2026.2于襄阳市中心医院骨科拟在臂丛神经阻滞(肌间沟+腋路)下行单侧上肢(肱骨及以下部位)骨折切开复位内固定的患者90例。 2)术前:记录患者术前常规用药(包括镇痛药物);采用数字评分量表(numeric rating scale,NRS)评估患者术前一天疼痛评分(0分,不疼;1-3分轻度疼痛;4-6分中度疼痛;7-10重度疼痛);采用焦虑视觉模拟量表(Visual analog scale for anxiety,VAS-A;0,表示没有焦虑;10,表示最大焦虑)评估患者术前焦虑评分;采用NRS评分量表评估患者术前一天睡眠质量评分(0-10分;0分,睡眠质量最差,10分睡眠质量最好)。 3)术中:术前用药包括咪达唑仑1- 2 mg静脉注射和舒芬太尼5-10 μg静脉注射。臂丛神经阻滞由接受过技术培训的麻醉医师使用实时超声引导进行。肌间沟使用1%利多卡因+0.375%罗哌卡因20ml,10分钟后使用0.375%罗哌卡因(10-15ml)进行腋路臂丛阻滞,手术切皮前,在不同区域使用针刺疼痛刺激来评估臂丛神经阻滞的成功率。如果阻滞不完全,手术医生在手术切口附近追加2%利多卡因5-10ml,如果还不够,则对患者进行全身麻醉(踢出病例)。术中应用标准监测,包括ECG、BP、HR和SPO2。右美托咪定负荷剂量1 μg/kg,10min内静脉泵注,然后以0.5 μg·kg-1·h-1速率静注,直至术者完成内固定。手术结束前30min静脉注射阿扎司琼10 mg,氟比洛芬酯50mg。所有患者术后均不使用静脉镇痛泵,术后疼痛>3分于病房使用氟比洛芬酯静脉滴注或者双氯芬酸钠塞肛。 4)干预处理:在患者到达手术室的手术当天进行随机化。穴位刺激和安慰剂治疗均由同一研究者进行,不参与麻醉和手术。两组患者均于术前1h提前接至手术室预麻间,地塞米松联合综合穴位组于神经阻滞前给予耳穴贴压和经皮穴位电刺激。耳穴贴压应用于4个常见耳穴(神门、交感、皮质下、肾)和对应上肢穴位(手指、腕、肘、肩、锁骨),采用王不留行籽(中国北京)的埋籽方法对耳穴进行延长刺激。通过在穴位上涂抹粘合剂贴片( 0.5 cm、0.5 cm),将种子单侧放置。采用拇指和食指按压,每穴3 min。干预共11次,其中神经阻滞前30min、手术结束时、返回病房后2h、4h、睡前各 1次,术后第1天( 9AM、3PM、9PM) 3次,术后第2天( 9A

Description for medicine or protocol of treatment in detail:

纳入标准:

1: 襄阳市中心医院首次单侧上肢闭合性骨折(肱骨及以下部位)骨科患者,18-80岁,ASA I-III级,拟在臂丛神经阻滞(肌间沟+腋路)下行单侧上肢(肱骨及以下部位)骨折切开复位内固定术的患者。

Inclusion criteria

1: The orthopaedic patient with unilateral closed fracture of upper limb (humerus and below) in Xiangyang Central Hospital aged 18-80 years old ASA I-III grade who intend to undergo their first open reduction and internal fixation of unilateral fracture of upper limb (humerus and below) under brachial plexus block (intermuscular sulcus+axillary route).

排除标准:

1: 合并其它部位手术患者 2: 急诊患者 3: 周围神经病变、术前手术侧上肢合并神经损伤 4: 手术侧既往腋窝手术 5: 手术侧上肢多次手术(>1次) 6: 局麻药物过敏、术后镇痛药(如NSAID和扑热息痛)的禁忌症患者 7: 妊娠患者 8: 糖尿病和血管疾病患者 9: 长期服用阿片类药物、抗精神病、抗抑郁药物者 10: 注射部位感染、急性卟啉症或需要透析的肾病 11: 区域麻醉禁忌症,全身麻醉和神经阻滞不全辅助全身麻醉用药或更改全麻的患者 12: 慢性疼痛综合征患者 13: 无法理解围手术期问卷的患者(语言问题或认知障碍) 14: 既往三个月参与过类似的研究 15: 穴位电刺激禁忌症,植入心脏起搏器、心律转复器或除颤器;皮疹或局部感染超过穴位刺激皮肤区域;或患有任何可能影响耳部、手腕和手部敏感性的疾病

Exclusion criteria:

1: Patients with other site surgery 2: Emergency patients 3: Peripheral neuropathy preoperative operative upper limb with nerve injury 4: Previous axillary surgery on the operative side 5: Multiple operations on the upper limb of the surgical side (>1) 6: Patients with contraindications of local anesthesia drug allergy and postoperative analgesics (such as NSAID and paracetamol) 7: Pregnant patients 8: Patients with diabetes and vascular diseases; 9: long-term use of opioids antipsychotics antidepressants 10: Injection site infection acute porphyria or kidney disease requiring dialysis 11: Patients with contraindications to regional anesthesia general anesthesia and nerve block insufficiency to assist general anesthesia or change general anesthesia 12: Patients with chronic pain syndrome 13: Patients who are unable to understand the perioperative questionnaire (language problems or cognitive impairments) 14: Have participated in similar studies in the past three months

研究实施时间:

Study execute time:

From 2025-02-01

To      2026-09-01

征募观察对象时间:

Recruiting time:

From 2025-02-01

To      2026-02-01

干预措施:

Interventions:

组别:

试验组

样本量:

45

Group:

Test group

Sample size:

干预措施:

地塞米松联合综合穴位刺激

干预措施代码:

Intervention:

Dexamethasone combined with comprehensive acupoint stimulation

Intervention code:

组别:

对照组

样本量:

45

Group:

Control group

Sample size:

干预措施:

地塞米松联合耳穴不埋籽和假穴弱电刺激

干预措施代码:

Intervention:

Dexamethasone combined with the acupoint stimulation at sham acupoints or without embedding seeds and pressure

Intervention code:

样本总量 Total sample size : 90

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

湖北省

市(区县):

襄阳市

Country:

China

Province:

HuBei

City:

Xiangyang

单位(医院):

襄阳市中心医院

单位级别:

襄阳市中心医院

Institution/hospital:

Xiangyang Central Hospital

Level of the institution:

Xiangyang Central Hospital

测量指标:

Outcomes:

指标中文名:

术后镇痛药物(阿片、NSAID)使用次数和剂量

指标类型:

次要指标

Outcome:

dosage of postoperative analgesics (opioids NSaids)

Type:

Secondary indicator

测量时间点:

术后1、2、3天

测量方法:

医嘱病历

Measure time point of outcome:

postoperative day 1,2 and 3

Measure method:

medical record

指标中文名:

术后第1、2、3天睡眠质量

指标类型:

次要指标

Outcome:

Quality of sleep day 12 and 3

Type:

Secondary indicator

测量时间点:

术后1、2、3天

测量方法:

数字评分量表

Measure time point of outcome:

postoperative day 12 and 3

Measure method:

numeric rating scale 0 to 10

指标中文名:

术后第1、2、3天NRS评分(静息疼痛、每天平均疼痛、最严重的疼痛以及夜间疼痛评分)

指标类型:

主要指标

Outcome:

NRS scores at 1 2 and 3 days after surgery (resting pain average daily pain most severe pain and night pain scores)

Type:

Primary indicator

测量时间点:

术后第1,2,3天

测量方法:

数字评分量表

Measure time point of outcome:

postoperative day 1,2 and 3

Measure method:

numerical rating scale 0 to 10

指标中文名:

术前、术后外周血中差异性基因的表达水平

指标类型:

次要指标

Outcome:

Expression levels of differential genes in peripheral blood before and after surgery

Type:

Secondary indicator

测量时间点:

术前和术后第一天

测量方法:

实时荧光定量PCR

Measure time point of outcome:

Before and the first day after surgery

Measure method:

Quantitative Real-time PCRqPCR

指标中文名:

第7、30天每天静息疼痛、平均疼痛、最严重的疼痛以及夜间疼痛评分

指标类型:

次要指标

Outcome:

Daily resting pain average pain most severe pain and nighttime pain scores at days 7 and 30

Type:

Secondary indicator

测量时间点:

术后7、30天

测量方法:

数字评分量表

Measure time point of outcome:

postoperative day 7 and 30

Measure method:

numerical rating scale 0 to 10

指标中文名:

神经阻滞镇痛持续时间和运动阻滞时间

指标类型:

次要指标

Outcome:

Duration of analgesia and motor block

Type:

Secondary indicator

测量时间点:

术后

测量方法:

疼痛日记

Measure time point of outcome:

postoperation

Measure method:

Pain diary

指标中文名:

术后第1、2、3天焦虑评分(VAS-A评分)

指标类型:

次要指标

Outcome:

Anxiety scores at 1 2 and 3 days after surgery

Type:

Secondary indicator

测量时间点:

术后1、2、3天

测量方法:

数字评分量表

Measure time point of outcome:

postoperative day 1,2 and 3

Measure method:

numeric rating scale 0 to 10

指标中文名:

术后第1、2、3天不良反应(头痛、头晕、恶心、呕吐)

指标类型:

次要指标

Outcome:

postoperative side effects(headache dizziness nausea vomiting)

Type:

Secondary indicator

测量时间点:

术后1、2、3天

测量方法:

术后床旁随访

Measure time point of outcome:

postoperative day 1,2 and 3

Measure method:

postoperative follow-up

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

外周血

组织:

Sample Name:

Peripheral blood

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大 80
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

简单随机,研究人员将根据计算机产生的随机数将患者分为试验组和对照组

Randomization Procedure (please state who generates the random number sequence and by what method):

he researchers will divide the patients into a test group and a control group based on random numbers generated by the computer

盲法:

Blinding:

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

CRF表格

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

CRF from the web

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF

数据管理委员会:

Data Managemen Committee:

Yes

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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