the Research of Analgesia and Sedation Effect of Remifentanil on ICU Short Operation
Primary Purpose
Critical Illness
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Remifentanil
Lidocaine
Remifentanil+Lidocaine
Midazolam
Sponsored by
About this trial
This is an interventional prevention trial for Critical Illness focused on measuring remifentanil, analgesia, intensive care units
Eligibility Criteria
Inclusion Criteria:
- critically ill patients need endotracheal intubation
- tracheotomy
- central venous puncture
- pleural puncture
- abdominal puncture
- lumbar puncture
- bone marrow puncture
- fiber bronchoscopic examination
- other small short-time operations
Exclusion Criteria:
- patients allergic to opioids
- in pregnancy or in feeding
- with myasthenia gravis
- with hypovolemia,
- take monoamine oxidase inhibitor(MAOI) in 14days
- in coma and GCS<8
- with bradycardia or hypotension
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Remifentanil
Lidocaine
Remifentanil+Lidocaine
Arm Description
injection form concentration 20μg/ml loading dose 1.0-2.0μg/kg intravenous injection slowly,time >1min,then 5μg/kg·h pumping until the operation is finished.
injection form concentration 10mg/ml loading dose 100-400mg local anesthesia
injection form concentration 20μg/ml loading dose 1.0-2.0μg/kg intravenous injection slowly,time >1min,then 5μg/kg·h pumping until the operation is finished + injection form concentration 10mg/ml loading dose 100-400mg local anesthesia
Outcomes
Primary Outcome Measures
vital signs change
heart rate, respiration rate
vital signs change
respiration rate
vital signs change
blood oxygen saturation of artery blood of finger(SpO2)
vital signs change
mean blood pressure
vital signs change
Critical-Care Observation Tool(CPOT)
vital signs change
Richmond Agitation-Sedation Scale(RASS)
Secondary Outcome Measures
number of adverse reaction
respiratory depression,skeletal muscle stiffness,nausea vomting and dizziness,hypertension,allergy,bradycardia etc.
Full Information
NCT ID
NCT02635802
First Posted
December 6, 2015
Last Updated
December 16, 2015
Sponsor
The First Affiliated Hospital of Zhengzhou University
Collaborators
Yichang Humanwell Pharmaceutical Co., Ltd., China
1. Study Identification
Unique Protocol Identification Number
NCT02635802
Brief Title
the Research of Analgesia and Sedation Effect of Remifentanil on ICU Short Operation
Official Title
the Research of Analgesia and Sedation Effect of Remifentanil on ICU Short Operation
Study Type
Interventional
2. Study Status
Record Verification Date
December 2015
Overall Recruitment Status
Unknown status
Study Start Date
December 2015 (undefined)
Primary Completion Date
June 2016 (Anticipated)
Study Completion Date
September 2016 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The First Affiliated Hospital of Zhengzhou University
Collaborators
Yichang Humanwell Pharmaceutical Co., Ltd., China
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Remifentanil is one kind of opiates with strong analgesic effect,which has the rapid onset and short lasting duration. Remifentanil usually is used to help reducing the pain of patients with mechanical ventilation in ICU. Maybe it can also be used to ease the pain in ICU small short time operation.The purpose of this study is to determine (1) whether remifentanil is effective in small short time operations in ICU or not, (2) the save range of remifentanil in small short time operations in ICU, (3) and the adverse reaction that happens in these operations.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Critical Illness
Keywords
remifentanil, analgesia, intensive care units
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
1500 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Remifentanil
Arm Type
Experimental
Arm Description
injection form concentration 20μg/ml loading dose 1.0-2.0μg/kg intravenous injection slowly,time >1min,then 5μg/kg·h pumping until the operation is finished.
Arm Title
Lidocaine
Arm Type
Experimental
Arm Description
injection form concentration 10mg/ml loading dose 100-400mg local anesthesia
Arm Title
Remifentanil+Lidocaine
Arm Type
Experimental
Arm Description
injection form concentration 20μg/ml loading dose 1.0-2.0μg/kg intravenous injection slowly,time >1min,then 5μg/kg·h pumping until the operation is finished
+ injection form concentration 10mg/ml loading dose 100-400mg local anesthesia
Intervention Type
Drug
Intervention Name(s)
Remifentanil
Intervention Description
a loading dose 1.0-2.0μg/kg remifentanil,intravenous injection slowly,time >1min,then 5μg/kg·h pumping if the operation can not be done in 5 minutes.
Critical-Care Observation Tool(CPOT) and Richmond Agitation-Sedation Scale(RASS) are assessed before and after the loading.We should maintain the CPOT≤2 and RASS 0~2,if it is not up to the standard,increasing the pumping rate 0.5 μg/kg·h every 2-5min.
Intervention Type
Drug
Intervention Name(s)
Lidocaine
Intervention Description
lidocaine 100-400mg,local anesthesia.Critical-Care Observation Tool(CPOT) and Richmond Agitation-Sedation Scale(RASS) are assessed before and after local anesthesia.We should maintain the CPOT≤2 and RASS 0~2.
Intervention Type
Drug
Intervention Name(s)
Remifentanil+Lidocaine
Intervention Description
a loading dose 1.0-2.0μg/kg remifentanil,intravenous injection slowly,time >1min,then 5μg/kg·h remifentanil pumping immediately if the operation can not be done in 5 minutes.then local anesthesia with lidocaine 100-400mg.Critical-Care Observation Tool(CPOT) and Richmond Agitation-Sedation Scale(RASS) are assessed before and after anesthesia.We should maintain the CPOT≤2 and RASS 0~2,if it is not up to the standard,increasing the pumping rate 0.5μg/kg·h every 2-5min.
Intervention Type
Drug
Intervention Name(s)
Midazolam
Intervention Description
midazolam is an adjuvant drug.we should maintain the CPOT≤2 and RASS 0~2,if lidocaine is already used up to 400mg or the pumping rate of remifentanil is already 7.5μg/kg·h,then we should use midazolam 3mg, intravenous injection slowly.
Primary Outcome Measure Information:
Title
vital signs change
Description
heart rate, respiration rate
Time Frame
baseline, intraoperative and 10mins after operation
Title
vital signs change
Description
respiration rate
Time Frame
baseline, intraoperative and 10mins after operation
Title
vital signs change
Description
blood oxygen saturation of artery blood of finger(SpO2)
Time Frame
baseline, intraoperative and 10mins after operation
Title
vital signs change
Description
mean blood pressure
Time Frame
baseline, intraoperative and 10mins after operation
Title
vital signs change
Description
Critical-Care Observation Tool(CPOT)
Time Frame
baseline, intraoperative and 10mins after operation
Title
vital signs change
Description
Richmond Agitation-Sedation Scale(RASS)
Time Frame
baseline, intraoperative and 10mins after operation
Secondary Outcome Measure Information:
Title
number of adverse reaction
Description
respiratory depression,skeletal muscle stiffness,nausea vomting and dizziness,hypertension,allergy,bradycardia etc.
Time Frame
baseline,intraoperative,10mins after operation,30mins after operation
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
critically ill patients need endotracheal intubation
tracheotomy
central venous puncture
pleural puncture
abdominal puncture
lumbar puncture
bone marrow puncture
fiber bronchoscopic examination
other small short-time operations
Exclusion Criteria:
patients allergic to opioids
in pregnancy or in feeding
with myasthenia gravis
with hypovolemia,
take monoamine oxidase inhibitor(MAOI) in 14days
in coma and GCS<8
with bradycardia or hypotension
12. IPD Sharing Statement
Citations:
PubMed Identifier
9291773
Citation
Evane TN, Park GR. Remifentanil in the critically ill. Anaesthesia. 1997 Aug;52(8):800-1. No abstract available.
Results Reference
result
PubMed Identifier
11573581
Citation
Soltesz S, Biedler A, Silomon M, Schopflin I, Molter GP. Recovery after remifentanil and sufentanil for analgesia and sedation of mechanically ventilated patients after trauma or major surgery. Br J Anaesth. 2001 Jun;86(6):763-8. doi: 10.1093/bja/86.6.763.
Results Reference
result
PubMed Identifier
10525595
Citation
Wilhelm W, Dorscheid E, Schlaich N, Niederprum P, Deller D. [The use of remifentanil in critically ill patients. Clinical findings and early experience]. Anaesthesist. 1999 Sep;48(9):625-9. doi: 10.1007/s001010050762. German.
Results Reference
result
PubMed Identifier
18495056
Citation
Wilhelm W, Kreuer S. The place for short-acting opioids: special emphasis on remifentanil. Crit Care. 2008;12 Suppl 3(Suppl 3):S5. doi: 10.1186/cc6152. Epub 2008 May 14.
Results Reference
result
PubMed Identifier
20237760
Citation
Casey E, Lane A, Kuriakose D, McGeary S, Hayes N, Phelan D, Buggy D. Bolus remifentanil for chest drain removal in ICU: a randomized double-blind comparison of three modes of analgesia in post-cardiac surgical patients. Intensive Care Med. 2010 Aug;36(8):1380-5. doi: 10.1007/s00134-010-1836-2. Epub 2010 Mar 18.
Results Reference
result
PubMed Identifier
23052952
Citation
Chalumeau-Lemoine L, Stoclin A, Billard V, Laplanche A, Raynard B, Blot F. Flexible fiberoptic bronchoscopy and remifentanil target-controlled infusion in ICU: a preliminary study. Intensive Care Med. 2013 Jan;39(1):53-8. doi: 10.1007/s00134-012-2697-7. Epub 2012 Sep 28.
Results Reference
result
PubMed Identifier
21040558
Citation
Al MJ, Hakkaart L, Tan SS, Bakker J. Cost-consequence analysis of remifentanil-based analgo-sedation vs. conventional analgesia and sedation for patients on mechanical ventilation in the Netherlands. Crit Care. 2010;14(6):R195. doi: 10.1186/cc9313. Epub 2010 Nov 1.
Results Reference
result
PubMed Identifier
21971434
Citation
Futier E, Chanques G, Cayot Constantin S, Vernis L, Barres A, Guerin R, Chartier C, Perbet S, Petit A, Jabaudon M, Bazin JE, Constantin JM. Influence of opioid choice on mechanical ventilation duration and ICU length of stay. Minerva Anestesiol. 2012 Jan;78(1):46-53. Epub 2011 Nov 5.
Results Reference
result
PubMed Identifier
16526829
Citation
Battershill AJ, Keating GM. Remifentanil : a review of its analgesic and sedative use in the intensive care unit. Drugs. 2006;66(3):365-85. doi: 10.2165/00003495-200666030-00013.
Results Reference
result
PubMed Identifier
15312228
Citation
Karabinis A, Mandragos K, Stergiopoulos S, Komnos A, Soukup J, Speelberg B, Kirkham AJ. Safety and efficacy of analgesia-based sedation with remifentanil versus standard hypnotic-based regimens in intensive care unit patients with brain injuries: a randomised, controlled trial [ISRCTN50308308]. Crit Care. 2004 Aug;8(4):R268-80. doi: 10.1186/cc2896. Epub 2004 Jun 28.
Results Reference
result
Learn more about this trial
the Research of Analgesia and Sedation Effect of Remifentanil on ICU Short Operation
We'll reach out to this number within 24 hrs