Paracetamol and Mannitol Injection and Postoperative Delirium
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Acetaminophen group, Sufentanil group.
- Кому может быть актуально
- Состояния в реестре: Postoperative Delirium, Elderly, Non Cardiac Surgery. Базовые параметры: от 60 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Китай
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Impact of Paracetamol and Mannitol Injection Analgesia on Postoperative Delirium in Elderly Patients After Non-cardical Surgery: A Randomized Controlled Trial
Обзор
The aim of this multi-center RCT is to investigate the effect of intravenous acetaminophen (paracetamol and mannitol injection) on postoperative delirium, comparing with intravenous sufentanil, in elderly noncardiac surgical patients admitted to ICU.
Подробное описание
Delirium is a common complication after surgery. It is associated with increased morbidity and mortality, longer intensive care unit (ICU) and hospital stay, prolonged mechanical ventilation, higher risk of institutionalization, and higher healthcare cost. Depending on patient population and screening method, the incidence of delirium in elderly patients admitted to ICU can be as high as 58-76%. The choice of analgesics and the adequacy of pain control are among the modifiable precipitating factors for postoperative delirium (POD). Whether the use of intravenous acetaminophen decreases the occurrence of POD in elderly noncardiac surgical patients admitted to ICU remains inadequately studied.
Objectives: To investigate the effect of intravenous acetaminophen (paracetamol and mannitol injection) on postoperative delirium, comparing with intravenous sufentanil, in elderly noncardiac surgical patients admitted to ICU.
Study design: A randomized controlled trial. Setting: 34 ICUs from different regions across China. Patients: 1092 elderly patients (≥ 60 years), having noncardiac surgery and admitted to ICU after surgery, are eligible.
Intervention: Patients are randomly assigned to intravenous acetaminophen or sufentanil groups. Intravenous acetaminophen is the analgesic of choice for patients in the acetaminophen group. Intravenous sufentanil is the analgesic of choice for patients in the sufentanil group (control).
Outcomes: The primary endpoint is the incidence of delirium within the first 5 days after surgery. Delirium is assessed using the confusion assessment method for the intensive care unit (CAM-ICU). The secondary endpoints include the level of pain assessed using the Numeric Rating Scale (NRS) on postoperative day 1 to 5 and day 30, 30-day mortality, length of ICU and hospital stay, quality of life assessed on postoperative day 30, cognitive function assessed on postoperative day 30, and biomarkers and neurofunctional testing for delirium.
Predicted duration of the study: 24 months.
Вмешательства
- Препарат Acetaminophen group
The pain in this group is controlled using acetaminophen (Paracetamol and Maninitol Injection, Yichang Renfu Medicine Co., Ltd., China), 500 mg, intravenous bolus, every 6 hours for the first 48 hours postoperatively. The severity of pain is assessed using NRS every 15 minutes during the first hour following ICU admission and then once every 12 hours needed. - Препарат Sufentanil group
he pain in this group is controlled using sufentanil (Yichang Renfu Medicine Co., Ltd., China) intravenous infusion with a rate of 0.05 μg/kg/h. The severity of pain is assessed using NRS every 15 minutes during the first hour following ICU admission and then once every 12 hours needed.
Первичные конечные точки
- Rate of delirium [Срок оценки: postoperative 1- 5 days]
Вторичные конечные точки (7)
- All-cause mortality [Срок оценки: 30-day after surgery]
- Severity of pain [Срок оценки: postoperative days 1-5]
- Length of ICU stay [Срок оценки: immediately after surgery]
- Length of hospital stay [Срок оценки: immediately after surgery]
- Quality of life of 30-day survivors [Срок оценки: day 30 after surgery]
- Cognitive function of 30-day survivors [Срок оценки: day 30 after surgery]
- Incidence of non-delirium-related complications [Срок оценки: 30 days after surgery]
Критерии участия
Критерии включения
- Age ≥ 60 years;
- Admitted to ICU after a noncardiac surgical procedure
- Moderate to severe acute pain, with a postoperative pain score ≥ 5 based on the 11-point Numerical Pain Rating Scale (NPRS)
- Signed informed consent form
Критерии исключения
- Preoperative medical history: schizophrenia, epilepsy, Parkinson's disease, or severe myasthenia gravis
- History of psychiatric disease or significant neurocognitive disorder such as dementia or retardation, making POD assessment impossible
- Language or communication barrier making POD assessment impossible
- Intracranial surgery
- Severe hepatic dysfunction prohibiting the use of acetaminophen per the standard of care
- Participation in a competing study within 30d
- Patients experienced intraoperative or postoperative complications, and the investigator determined the subject was unsuitable to continue participation in the study
- Intolerant to paracetamol or opioid drugs
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Двойное слепое
- Основная цель
- Профилактика
Центры проведения
Китай · 1 центр
- Xiangya hospital — Чанша
Идентификаторы
NCT: NCT07235995 · 202510115 · 202510115