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The Clinical Study of Dexmedetomidine and Esketamine Combined Infusion Undergoing Modified Radical Mastectomy

Registration Number
NCT05283408
Lead Sponsor
Anqing Municipal Hospital
Brief Summary

BACKGROUND: Some studies have revealed that intravenous dexmedetomidine and esketamine alleviated postoperative pain and improve the quality of recovery after surgery. The investigators investigated whether co-administration dexmedetomidine and esketamine could better alleviated postoperative pain and improve the the quality of recovery after modified radical mastectomy.

METHODS: One hundred and thirty-five women with elective modified radical mastectomy were randomly divided into 3 groups: Patients in group D received dexmedetomidine (0.5 µg/kg over 10 min before the induction of anesthesia), and then dexmedetomidine was infused at a rate of 0.4 μg/kg/h until 20 min before the end of operation. Patients in group DE1 received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 2 µg/kg/min until 20 min before the end of operation, respectively. Patients in group DE2 received received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 4 µg/kg/min until 20 min before the end of operation, respectively. Primary outcome was the quality of recovery (QoR-15) at 1 day after sugery and 3 day after sugery. The secondary outcomes included perioperative remifentanil consumption, postoperative VAS pain scores, side effects such as the incidence of postoperative nausea, vomiting and bradycardia, hallucination, nightmare, as well as postoperative rescue analgesics and anti-emetics, recovery time, and extubation time.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
135
Inclusion Criteria
  • American Society of Anesthesiologists (ASA) physical status Ⅰ- Ⅱ
  • Scheduled for elective modified radical mastectomy
Exclusion Criteria
  • Severe respiratory disease
  • Renal or hepatic insufficiency
  • History of preoperative psychiatric
  • Preoperative bradycardia
  • Preoperative atrioventricular block
  • Preoperative hypertension
  • BMI>30

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dexmedetomidine infusion on recovey quality with radical mastectomyDexmedetomidine infusionDrug: Dexmedetomidine infusion Patients received dexmedetomidine (0.5 µg/kg over 10 min before the induction of anesthesia), and then dexmedetomidine was infused at a rate of 0.4 μg/kg/h until 20 min before the end of operation
Co-administration dexmedetomidine and low-dose esketamine on recovey quality with radical mastectomyDexmedetomidine infusionDrug: Dexmedetomidine and low-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 2 µg/kg/min until 20 min before the end of operation, respectively.
Dexmedetomidine infusion on recovey quality with radical mastectomyCo-administration dexmedetomidine and high-dose esketamine infusionDrug: Dexmedetomidine infusion Patients received dexmedetomidine (0.5 µg/kg over 10 min before the induction of anesthesia), and then dexmedetomidine was infused at a rate of 0.4 μg/kg/h until 20 min before the end of operation
Combined dexmedetomidine and high-dose esketamine on recovey quality with radical mastectomyCo-administration dexmedetomidine and low-dose esketamine infusionDrug: Dexmedetomidine and high-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 4 µg/kg/min until 20 min before the end of operation, respectively.
Combined dexmedetomidine and high-dose esketamine on recovey quality with radical mastectomyCo-administration dexmedetomidine and high-dose esketamine infusionDrug: Dexmedetomidine and high-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 4 µg/kg/min until 20 min before the end of operation, respectively.
Co-administration dexmedetomidine and low-dose esketamine on recovey quality with radical mastectomyCo-administration dexmedetomidine and high-dose esketamine infusionDrug: Dexmedetomidine and low-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 2 µg/kg/min until 20 min before the end of operation, respectively.
Dexmedetomidine infusion on recovey quality with radical mastectomyCo-administration dexmedetomidine and low-dose esketamine infusionDrug: Dexmedetomidine infusion Patients received dexmedetomidine (0.5 µg/kg over 10 min before the induction of anesthesia), and then dexmedetomidine was infused at a rate of 0.4 μg/kg/h until 20 min before the end of operation
Co-administration dexmedetomidine and low-dose esketamine on recovey quality with radical mastectomyCo-administration dexmedetomidine and low-dose esketamine infusionDrug: Dexmedetomidine and low-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 2 µg/kg/min until 20 min before the end of operation, respectively.
Combined dexmedetomidine and high-dose esketamine on recovey quality with radical mastectomyDexmedetomidine infusionDrug: Dexmedetomidine and high-dose eskeamine combined infusion Patients received a bolus infusion of dexmedetomidine (0.5 µg/kg) and esketamine (0.5 mg/kg)over 10 min before the induction of anesthesia, and then dexmedetomidine were infused at a rate of 0.4 µg/kg/h and 4 µg/kg/min until 20 min before the end of operation, respectively.
Primary Outcome Measures
NameTimeMethod
Quality of recovery scores(QoR-15)1 day after operation

Our primary outcome was quality of recovery scores(QoR-15) 1 day after operation

Secondary Outcome Measures
NameTimeMethod
Intraoperative remifentanil total doseIntraoperative

Secondary Outcome Measure was remifentanil total dose during the perioperative period

Pain visual analogue scale scoresThe first 48 hours after operation

Secondary Outcome Measure was pain visual analogue scale scores

incidence of PONVThe first 48 hours after operation

Secondary Outcome Measure was incidence of PONV

Trial Locations

Locations (1)

Department of Anqing Hospital Anesthesiology

🇨🇳

Anqing, Anhui, China

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