Dexmedetomidine for the prevention of postoperative delirium in liver transplant recipients : A Randomized control study
试验速览
- 阶段
- 4 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 78
- 试验地点
- 1
- 主要终点
- To compare the incidence of postoperative delirium on postoperative days 1 to 7 using CAM-ICU score
研究概览
简要总结
The incidence of delirium after liver transplant varies from 10 to 47 percent .
As a potent a2 adrenergic agonist, Dexmedetomidine acts on the locus coeruleus of the brain and stimulates the presynaptic a2- adrenoceptors, thus inhibiting the release of noradrenaline at the sympathetic synapses.
The reduction in norepinephrine induces the release of inhibitory neurotransmitters,including g-aminobutyric acid (GABA ) and galanin by the ventrolateral preoptic nucleus.
These neurotransmitters further inhibit norepinephrine release by the locus ceruleus and suppress histamine secretion by the tuberomamillary nucleus.
Reducing the release of histamine is beneficial to inflammation caused by tissue damage.Dexmedetomidine possesses an anti-inflammatory effect reducing reducing the central sympathetic outflow and surgical stress response.
All these findings indicate that the intraoperative use of Dexmedetomidine can reduce the incidence of delirium after surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant, Investigator and Outcome Assessor Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 60.00 Year(s)（—）
- 性别
- All
入选标准
- •Age 18 -60 Chronic liver disease patient undergoing elective allogenic liver transplantation Giving informed written consent.
排除标准
- •Severe circulatory instability Patients having hepatic encephalopathy on the morning of surgery Severe renal dysfunction undergoing renal replacement therapy before surgery Known allergy to the medication Transplant for acute liver Failure , acute on chronic liver failure Patients not giving consent.
结局指标
主要结局
To compare the incidence of postoperative delirium on postoperative days 1 to 7 using CAM-ICU score
时间窗: To compare the incidence of postoperative delirium on postoperative days 1 to 7 using CAM-ICU score
次要结局
- To compare the incidence of postoperative cognitive dysfunction on day 7 using Mini Mental State Exam(To compare the mean hemodynamic parameters during the various phases of liver transplant surgery)
研究者
Dr Manikandan G
INSTITUTE OF LIVER AND BILIARY SCIENCES