基本情報/Basic information |
一般向け試験名/Public title |
帝王切開を対象とした脊髄くも膜下麻酔におけるオピオイド添加高比重ブピバカインの指摘投与量に関する、前向き二重遮蔽、用量範囲探索ランダム化比較試験 |
Optimal dose of intrathecal hyperbaric bupivacaine with opioids for cesarean delivery:a prospective, randomized, double-blinded, dose-ranging study
|
一般向け試験名略称/Acronym |
帝王切開を対象とした脊髄くも膜下麻酔におけるオピオイド添加高比重ブピバカインの至適投与量 |
Optimal dose of intrathecal hyperbaric bupivacaine with opioids for cesarean delivery |
科学的試験名/Scientific Title |
帝王切開を対象とした脊髄くも膜下麻酔におけるオピオイド添加高比重ブピバカインの指摘投与量に関する、前向き二重遮蔽、用量範囲探索ランダム化比較試験 |
Optimal dose of intrathecal hyperbaric bupivacaine with opioids for cesarean delivery:a prospective, randomized, double-blinded, dose-ranging study
|
科学的試験名略称/Scientific Title:Acronym |
帝王切開を対象とした脊髄くも膜下麻酔におけるオピオイド添加高比重ブピバカインの至適投与量 |
Optimal dose of intrathecal hyperbaric bupivacaine with opioids for cesarean delivery |
試験実施地域/Region |
|
介入/Intervention |
群数/No. of arms |
7 |
介入の目的/Purpose of intervention |
治療・ケア/Treatment |
介入の種類/Type of intervention |
|
介入1/Interventions/Control_1 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン6mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 6mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入2/Interventions/Control_2 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン7mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 7mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入3/Interventions/Control_3 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン8mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 8mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入4/Interventions/Control_4 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン9mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 9mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入5/Interventions/Control_5 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン10mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 10mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入6/Interventions/Control_6 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン11mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 11mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入7/Interventions/Control_7 |
フェンタニル100μgと塩酸モルヒネ75μを高比重ブピバカイン12mgに加えて、脊髄くも膜下麻酔を行う |
intrathecal 12mg hyperbaric bupivacaine co-administered with fentanyl 15 mcg and morphine 75 mcg |
介入8/Interventions/Control_8 |
|
|
介入9/Interventions/Control_9 |
|
|
介入10/Interventions/Control_10 |
|
|
適格性/Eligibility |
年齢(下限)/Age-lower limit |
|
年齢(上限)/Age-upper limit |
|
性別/Gender |
女/Female |
選択基準/Key inclusion criteria |
1. 米国麻酔学会 PS 1 - 2
2. 身長140cm以上180cm以下
3.単胎
4. 妊娠週数37週以上の満期産 |
1. American Society Anesthesiologists physical status class I, or II
2. height between 140 and 180 cm
3. singleton pregnancy
4. gestational age of more 37 completed weeks |
除外基準/Key exclusion criteria |
1. 陣痛が始まっている場合
2. 前期破水
3. 既往帝王切開3回以上
4. 妊娠糖尿病
5. 妊娠高血圧
6. 子宮内発育遅延
7. 前置胎盤
8. BMI35以上 |
1. active labor
2. ruptured membranes
3. three or more previous Cesarean deliveries
4. gestational diabetes
5. pregnancy induced hypertension
6. intrauterine growth retardation
7. placenta previa
8. body mass index more than 35 |
目標参加者数/Target sample size |
70 |
結果/Result |
結果掲載URL/URL related to results and publications |
https://www.sciencedirect.com/science/article/pii/S0959289X16301820?via%3Dihub |
組み入れ参加者数/Number of participants that the trial has enrolled |
70 |
主な結果/Results |
帝王切開を脊髄くも膜下麻酔後単独で行うためには,0.5%ブピバカイン12mg程度必要である. |
The ED95 for success (main) was 12.6mg. The incidence of respiratory discomfort and maternal satisfaction scores did not differ significantly between dose groups. Phenylephrine dose and nausea/vomiting incidence increased with increasing doses of bupivacaine. |
主な結果入力日/Results date posted |
|
結果掲載遅延/Results Delayed |
|
結果遅延理由/Results Delay Reason |
|
|
最初の試験結果の出版日/Date of the first journal publication of results |
|
参加者背景/Baseline Characteristics |
選択的帝王切開を受ける妊婦.ASA2以下.20歳以上.身長140-180cm.37週以上.
多胎,BMI>35などは除く |
Healthy, term parturients who were scheduled for elective cesarean delivery were enrolled. |
参加者の流れ/Participant flow |
ランダムに高比重ブピバカイン6,7,8,9,10,11,12mg+フェンタニル15 μgおよび75 μgモルヒネも添加した7つの薬液グループに無作為に分けられ,帝王切開に臨む. |
Patients were randomized, according to a computer-generated randomization list using sealed opaque envelopes, into seven groups. The patient and assessing investigator were blinded to group allocation. On the day of surgery the envelope was handed to an anesthesiologist not involved in the study who prepared the study medications. The study medication was given to the blinded anesthesiologist having charge of perioperative anesthetic management before induction of anesthesia. |
有害事象/Adverse events |
なし |
none |
評価項目/Outcome measures |
帝王切開を脊髄くも膜下麻酔で行うために必要なブピバカインの量 |
Effective doses for 50% (ED50) and 95% (ED95) of subjects required for successmain during cesarean delivery. |
個別症例データ共有計画/Plan to share IPD |
|
|
個別症例データ共有計画の詳細/IPD sharing Plan description |
|
|