Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Delirium and Negative Emotions in Patients Undergoing Cardiac Surgery
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: Active taVNS, Sham taVNS Group.
- Кому может быть актуально
- Состояния в реестре: Postoperative Delirium (POD), Postoperative, Anxiety, Depression. Базовые параметры: 18 лет — 85 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
Effect of Intraoperative Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Delirium and Negative Emotional States in Patients Undergoing Cardiac Surgery: A Multicenter, Randomized, Double-Blind, Sham-Controlled Trial
Обзор
A multicenter, randomized, double-blind, sham-controlled trial to investigate the effects of intraoperative transcutaneous auricular vagus nerve stimulation (taVNS) on the incidence of postoperative delirium and negative emotional states (anxiety, depression) in patients undergoing elective cardiac surgery.
Подробное описание
Cardiac surgery is associated with a high risk of postoperative neurocognitive disorders, including delirium and negative emotional states such as anxiety and depression, which significantly impact patient recovery and long-term outcomes. This study aims to evaluate whether intraoperative taVNS, a non-invasive neuromodulation technique, can reduce the incidence and severity of these complications. Patients will be randomized to receive either active taVNS or sham stimulation during surgery. Outcomes including delirium, anxiety, depression, pain, sleep quality, recovery quality, and relevant biomarkers will be assessed postoperatively.
Вмешательства
- Устройство Active taVNS
Stimulation parameters: Amplitude 20 (mA), Frequency 20Hz, Pulse width 200μs, asymmetric biphasic square wave. The current is gradually increased from 10mA to a level slightly below the individual's "prickling" sensation threshold (20-60mA). Stimulation is applied to the left auricular concha for 30 minutes after anesthesia induction and for another 30 minutes after cardiopulmonary bypass weaning. - Устройство Sham taVNS Group
The sham device is identical in appearance, weight, indicator lights, and operation sounds to the active device but delivers no effective electrical current. It is applied to the left auricular concha at the same time points as the active group (30 minutes after induction and 30 minutes after CPB weaning).
Первичные конечные точки
- Incidence of Postoperative Delirium [Срок оценки: Within 7 days after surgery]
Вторичные конечные точки (11)
- Incidence and Severity of Postoperative Depression [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
- Incidence and Severity of Postoperative Anxiety [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
- Incidence and Severity of Postoperative Depression [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
- Incidence and Severity of Postoperative Anxiety (HADS-A) [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
- Postoperative Agitation Score [Срок оценки: At the time of extubation (within 24 hours post-surgery)]
- Postoperative Nausea and Vomiting (PONV) [Срок оценки: Within 3 days after extubation]
- Postoperative Pain Score [Срок оценки: Postoperative day 1, 2, 3, 7, and 30]
- Postoperative Sleep Quality [Срок оценки: Postoperative day 1, 2, 3, 7, and 30]
- Postoperative Recovery Quality [Срок оценки: Postoperative day 7 and 30]
- Incidence and Severity of Postoperative Anxiety (GAD-7) [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
- Incidence and Severity of Postoperative Anxiety (SAS) [Срок оценки: Preoperative day, Postoperative day 1, 2, 3, 7, and 30]
Критерии участия
Критерии включения
- Aged 18 to 85 years. Scheduled for elective cardiac surgery (e.g., CABG, valve replacement/repair). NYHA cardiac function class I-III. Willing and able to provide informed consent. Expected surgery duration ≥ 2 hours.
Критерии исключения
- Preoperative MMSE score < 24; severe communication barriers. History of diagnosed delirium, dementia, Parkinson's disease, schizophrenia, bipolar disorder, major depressive disorder, or long-term use of psychotropic drugs.
Skin lesions, infection, or deformity of bilateral ears; history of ear surgery or nerve injury; allergy to electrode materials.
Severe arrhythmia; implanted electronic devices (e.g., pacemaker, ICD). Participation in another interventional trial within 3 months. Other conditions deemed unsuitable by investigators.
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
- Тройное слепое
- Основная цель
- Лечение
Центры проведения
Китай · 1 центр
- First Medical Center of Chinese PLA General Hospital, Beijing, China. — Пекин
Идентификаторы
NCT: NCT07476742 · PLAGH-RCT-taVNS-Cardiac