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Effect of Vitamin C on Postoperative Pulmonary Complications After Intracranial Tumor Surgery

Phase 2
Not yet recruiting
Conditions
Humans
Ascorbic Acid
Neurosurgical Procedures
Ventilator-Induced Lung Injury
Postoperative Complications
Interventions
Registration Number
NCT06421688
Lead Sponsor
Qianfoshan Hospital
Brief Summary

The goal of this clinical trial is to investigate the effect of perioperative administration of vitamin C on postoperative pulmonary complications, with the aim of providing a safe and effective medication regimen for the prevention and treatment of postoperative pulmonary complications in patients undergoing surgery for craniocerebral tumors. The main questions it aims to answer are:

1. To determine whether vitamin C can reduce pulmonary complications after surgery for intracranial tumors.

2. Does intraoperative vitamin C improve the prognosis of surgical patients

Researchers will compare vitamin C to a placebo (saline) to see if vitamin C is effective for postoperative lung complications in patients undergoing surgery for cranial tumors.

1. Participants will be intravenously pumped with vitamin C for two hours after induction of anesthesia.

2. Participants will have intraoperative plasma sampling and recording of ventilator parameters, monitor parameters and perioperative data.

3. Participants will be followed up until discharge from the hospital to record symptoms and adverse events, and will be called at six months to check on their prognosis.

Detailed Description

Neurosurgery has a high incidence of postoperative pulmonary complications, increasing patient costs and affecting patient prognosis. Neurosurgery often requires hyperventilation to reduce intracranial pressure, so methods to reduce postoperative pulmonary complications such as small tidal volumes cannot be used routinely, and larger tidal volumes often result in injury to pulmonary endothelial cells, which leads to increased permeability of the pulmonary microvasculature, resulting in mechanically ventilated lung injury. Of course surgical injuries and mechanical ventilation can also cause oxidative stress injury to the lungs. Vitamin C is a common antioxidant drug and cofactor in the synthesis of many substances in the body, and many studies have shown that vitamin C prevents the increase in endothelial barrier permeability due to many causes. During the COVID-19 epidemic, vitamin C is seen as an important adjunct in preventing and ameliorating symptoms of COVID-19 patients. not only that, but vitamin C also assisted in postoperative analgesia and promote incision healing, so investigators would like to observe that by giving vitamin C during the surgery is able to prevent the occurrence of postoperative pulmonary complications or improve the prognosis of participants.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
86
Inclusion Criteria
  1. Patients who need craniotomy treatment due to intracranial tumors;
  2. age 18-75 years old;
  3. American Society of Anesthesiologists classification: 1~3;
  4. Patients and their families agree to participate in the study and sign the informed consent form.
Exclusion Criteria
  1. Patients with severe pulmonary infection or respiratory failure prior to surgery;
  2. Patients with previous history of neurological or psychiatric diseases;
  3. Patients with cardiac, hepatic and renal insufficiency;
  4. patients who are receiving parenteral nutrition;
  5. pregnant patients;
  6. Patients ruled out by medication instructions;
  7. Patients who require emergency surgery;
  8. patients with combination of other malignant tumors;
  9. patients who have participated in other clinical studies of drugs within 3 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ascorbic acid groupAscorbic acidPatients received 50 mg/kg of Ascorbic acid after induction of anesthesia
Control comparator groupSalinePatients receive 50ml saline after induction of anesthesia
Primary Outcome Measures
NameTimeMethod
incidence of postoperative pulmonary complicationsAbout 10 days

This will be assessed using the Postoperative Pulmonary Complications Score, which ranges from 0 to 5, with a score of ≥3 being considered positive for postoperative pulmonary complications. It was assessed every day before discharge and the highest score that occurred was recorded.

Secondary Outcome Measures
NameTimeMethod
Oxygenation indexOne hour postoperative

PaO2/FiO2, in millimeters of mercury

pulmonary complianceLast hour of surgery.

lung compliance in Milliliter/ centimeter water column

Interleukin-61 day, 3 days, 7 days postoperative

The level of Interleukin-6 in the blood, in nanograms per liter

superoxide dismutase (SOD)1 day, 3 days, 7 days postoperative

Blood levels of superoxide dismutase, in units per milliliter

body temperature1 day, 3 days, 7 days postoperative

Postoperative body temperature in degrees Celsius

Pain scores1 day, 3 days, 7 days postoperative

Patient's postoperative pain level; Using a "Pain Visual Analogue Scale", a 10-centimeter-long ruler was used, with 0 indicating no pain and 10 representing the most intense pain that was intolerable. During the test, the participant points to the scale that best represents the level of pain, and the researcher assigns the participant a score based on the location of the point.

Neuron-specific enolase levelsPost operative day 1

Plasma levels of neuron-specific enolase, unit is ng/ml

blood pressureAbout 10 days

Systolic and diastolic blood pressure,In millimeters of mercury

Length of hospitalizationAbout 10 days

Length of time between participant's completion of surgery and discharge

Brain-specific cardiolipinAbout 3 days

Plasma levels of brain-specific cardiolipin

neutrophilAbout 10 days

Levels of neutrophils in the blood, measured in units per liter.

C-reactive protein1 day, 3 days, 7 days postoperative

Level of C-reactive protein in the blood in milligrams per liter

Trial Locations

Locations (1)

The First Affiliated Hospital of Shandong First Medical University

🇨🇳

Jinan, Shandong, China

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