Dexmedetomidine in Patients After Intracranial Surgery
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Purpose
Dexmedetomidine is a highly selective a2-adrenoreceptor agonist that produces dose-dependent sedation and analgesia without respiratory depression. Dexmedetomidine has been used in critically ill medical, surgical, and pediatric patients. No study has been designed specifically to evaluate dexmedetomidine uses in the neurocritical care population. The primary objective is to evaluate the safety and efficacy of dexmedetomidine for prophylactic analgesia and sedation in patients after intracranial surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Central Nervous System Diseases |
Drug: Dexmedetomidine Drug: Normal saline |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Use of Dexmedetomidine for Prophylactic Analgesia and Sedation in Patients After Intracranial Surgery (Prophylactic Analgesia and Sedation Trial, PASTrial) |
- Mean percentage of hours of optimal sedation. [ Time Frame: 24 hours postoperative ] [ Designated as safety issue: No ]Optimal sedation is defined as SAS score 4.
- Percentage of patients with agitation and receiving additional sedatives. [ Time Frame: During the first 24 hours postoperatively ] [ Designated as safety issue: No ]Agitation is defined as SAS above 4. Patients are given midazolam as agitation.
- Percentage of patients with adverse events. [ Time Frame: During the first 24 hours postoperatively ] [ Designated as safety issue: Yes ]Adverse events include hypotension, bradycardia, airway obstruction, apnea, and consciousness disorders
| Estimated Enrollment: | 170 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | February 2013 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Dexmedetomidine group |
Drug: Dexmedetomidine
Intravenous infusion at rate of 0.4μg/kg/h, during the first 24 hours postoperatively
|
| Placebo Comparator: Placebo group |
Drug: Normal saline
as placebo
|
Detailed Description:
The PASTrial is a non-commercial, multi-center, randomized, placebo-controlled, double blinded clinical trial. The study compares dexmedetomidine versus normal saline (placebo) in patients after intracranial surgery with delayed extubation. In dexmedetomidine group, infusion (0.4μg/kg/h) is started when patients are admitted to neuro-intensive care unit for postoperative recovery. In control group, patients receive normal saline infusion at the same rate and volume in dexmedetomidine group. The patient's level of sedation is assessed by Sedation-Agitation Scale (SAS) per hour. Midazolam is administered in 0.3-0.5 mg bolus or continuous infusion as SAS above 4. The study is designed primarily to compare the percentage of patients with agitation and requiring midazolam infusion in the 2 study arms.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adult patients after intracranial surgery with delayed extubation
Exclusion Criteria:
- emergency operation
- brain stem operation
- preoperative consciousness disorders or epilepsy
- bradycardia, hypotension, acute myocardial infarction, second- or third degree heart block, or need continuous infusions of vasopressor before the start of study drug infusion
- patients enrolled in another trial
Contacts and Locations| Contact: Jian-Xin Zhou, MD | 8610 67098019 | zhoujx.cn@gmail.com |
| China, Beijing | |
| Neuro-ICU, Beijing Tiantan Hospital, Capital Medical University | Recruiting |
| Beijing, Beijing, China, 100050 | |
| Contact: Jian-Xin Zhou, MD 8610 67098019 zhoujx.cn@gmail.com | |
| Study Chair: | Jian-Xin Zhou, MD | Neuro-ICU, Beijing Tiantan Hospital, Capital Medical University |
More Information
No publications provided
| Responsible Party: | Jian-Xin Zhou, Professor, Capital Medical University |
| ClinicalTrials.gov Identifier: | NCT01445639 History of Changes |
| Other Study ID Numbers: | BTH-NICU-2011-02, 2009-03-28 |
| Study First Received: | September 30, 2011 |
| Last Updated: | October 22, 2012 |
| Health Authority: | China: Ministry of Health |
Keywords provided by Capital Medical University:
|
dexmedetomidine sedation neurosurgery postoperative care |
Additional relevant MeSH terms:
|
Central Nervous System Diseases Nervous System Diseases Dexmedetomidine Hypnotics and Sedatives Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Analgesics, Non-Narcotic |
Analgesics Sensory System Agents Peripheral Nervous System Agents Adrenergic alpha-2 Receptor Agonists Adrenergic alpha-Agonists Adrenergic Agonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 16, 2013