Short-term use of remifentanil during endotracheal extubation for prophylactic analgesia in neurosurgical patients after craniotomy (SURE after Craniotomy Study): a study protocol and statistical analysis plan for a randomised controlled trial.
BMJ Open
; 4(9): e005635, 2014 Sep 29.
Article
em En
| MEDLINE
| ID: mdl-25270857
ABSTRACT
INTRODUCTION:
Acute pain is common during the endotracheal extubation period, and is related to complications and adverse outcomes. Patients with delayed extubation after craniotomy are vulnerable to pain and complications of extubation. However, pain control during extubation is still inadequate. Remifentanil, a new opioid with rapid onset and short duration of action, provides adequate analgesia during procedures with minimal effect of respiratory depression. METHODS ANDANALYSIS:
The study is a prospective, randomised, double-blinded, controlled parallel-group design. Patients with delayed extubation after intracranial surgery are screened daily. Adult patients ready for extubation are enrolled and assigned randomly to one of the two treatment study groups, labelled as the 'Remi group' or 'Saline group'. Patients in the Remi group receive an intravenous bolus dose of remifentanil 0.5â µg/kg over 60â s followed by a continuous infusion 0.05â µg/kg/min for 20â min. Patients in the Saline group receive an intravenous infusion of 0.9% sodium chloride at a volume and rate equal to that of remifentanil. Pain intensity is measured by the visual analogue scale (VAS) pain score. Adverse events during drug infusion are documented and reported. Patients will be followed up until hospital discharge, death or 60â days after the trial intervention on a first come, first served basis. Details of the incidence of reintubation and reoperation within 72â h after extubation, length of stay in the intensive care unit and hospital and mortality are collected. The primary end point is the incidence of severe pain (defined as a VAS pain score more than 5â cm) during the periextubation period (defined as the period of time from immediately before extubation to 20â min after extubation). ETHICS AND DISSEMINATION The study was approved by the Institutional Review Board (IRB) of the Beijing Tiantan Hospital, Capital Medical University. The study findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ClinicalTrials (NCT) ChiCTR-PRC-13003879.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
8_ODS3_consumo_sustancias_psicoactivas
Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
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Piperidinas
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Craniotomia
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Extubação
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Analgesia
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Analgésicos Opioides
Tipo de estudo:
Clinical_trials
Aspecto:
Ethics
Limite:
Adolescent
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Adult
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Aged
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Humans
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Middle aged
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2014
Tipo de documento:
Article