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Safety Study of Dexmedetomidine in Elderly Under General Anesthesia

Phase 4
Completed
Conditions
Hip Fractures
Hip Disease
Interventions
Registration Number
NCT05567523
Lead Sponsor
Zhenjiang First People's Hospital
Brief Summary

The purpose of this study is to find out appropriate dose range of dexmedetomidine to provide the elderly patients satisfactory sedation and analgesia with stable hemodynamics during perioperative period of hip replacement under general anesthesia.

Detailed Description

All patients will be screened to determine eligibility for study entry, and the patients who meet the eligibility requirements will be informed about the study and potential risks. After giving written informed consent, the patients will be randomized into different doses of dexmedetomidine groups and the comparative groups in a same ratio.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • age ≥65yr, American Society of Anesthesiologists (ASA) physical status scale grade I-III, ready for HP; body weight between 45 and 75kg, body mass index (BMI) between 18 and 24kg/m2;
  • the health conditions generally well according to medical history, physical examination, and laboratory tests;
  • no signs of difficult intubation;
  • no history of dementia and mental problems;
  • normal cognitive function, ability to understand and comply with study procedures.
Exclusion Criteria
  • Age <65 yr or >90 yr; BMI greater than 24 kg/m2; ASA grade higher than III;
  • Heart failure, severe arrhythmias, severe bradycardia (heart rate less than 40 beats/min), atrioventricular block of degree 2 or above, sick sinus syndrome, systolic blood pressure (SBP) ≥180 or <90 mmHg, diastolic blood pressure (DBP) ≥110 or <60 mmHg;
  • Severe liver or kidney dysfunction, severe infection, and other pathological conditions that interfere with study results.
  • Dementia, cerebrovascular accidents within 3 months, mental illness, epilepsy, and other adverse events that interfere with study results.
  • Patients with the conditions that block communication and preoperative assessment, such as serious hearing or visual impairment;
  • History of chronic analgesic use, long-term psychotropic medication use, alcohol or drug addiction.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group NS, Group MDNormal salineIn Group NS, patients will be pumped 0.1ml/kg of normal saline for 15min before anesthesia induction, following continuous infusion at the rate of 0.125ml/kg/h until the end of operation. In Group MD, patients will be administrated with midazolam 0.03mg/kg at the beginning of anesthesia induction.
Group NS, Group MDMidazolamIn Group NS, patients will be pumped 0.1ml/kg of normal saline for 15min before anesthesia induction, following continuous infusion at the rate of 0.125ml/kg/h until the end of operation. In Group MD, patients will be administrated with midazolam 0.03mg/kg at the beginning of anesthesia induction.
Group D0.25, Group D0.5, Group D0.75DexmedetomidineDexmedetomidine will be administered at different initial loading doses (0.25/0.5/0.75 μg/kg within 15min) following same maintained dosage ( 0.5μg/kg/h) in Group D0.25/D0.5/D0.75.
Primary Outcome Measures
NameTimeMethod
Changes of baseline blood pressureThrough the whole perioperative period, an average of 10 hours

Changes of baseline blood pressure in each group, including systolic blood pressure, diastolic blood pressure and mean arterial pressure

Changes of baseline heart rateThrough the whole perioperative period, an average of 10 hours

Changes of baseline heart rate in each group

Numbers of elderly patients with bradycardiaThrough the whole perioperative period, an average of 10 hours

Bradycardia is defined as heart rate \<50 beats/min or below \>20% of basal values.

Numbers of elderly patients with hypotensionThrough the whole perioperative period, an average of 10 hours

Hypotension is defined as systolic blood pressure \<90 mmHg or mean arterial pressure below \>20% of basal values.

Secondary Outcome Measures
NameTimeMethod
Sedation changes after general anesthesia using Richmond agitation-sedation scalebefore general anesthesia, up to 2 hours after general anesthesia

Sedation changes after general anesthesia using Richmond agitation-sedation scale(-5 to +4, 0 means awake and quiet) in each group

Pain changes after general anesthesia using visual analogue scalebefore general anesthesia, up to 2 hours after general anesthesia

Pain changes after general anesthesia using visual analogue scale(0 to 10,higher scores mean a worse outcome) in each group

Trial Locations

Locations (1)

Zhenjiang First People's Hospital

🇨🇳

Zhenjiang, Jiangsu, China

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