NCT05304559

Brief Summary

Elderly patients with hip fracture are older and have a high incidence of perioperative complications. the postoperative recovery of elderly patients with hip fracture is affected by hemodynamic instability and pain caused by fracture. S-ketamine is the S-isomer of ketamine. Compared with traditional ketamine, S-ketamine has stronger analgesic effect and fewer adverse reactions of nervous system. The parasympathetic effect of S-ketamine can antagonize the circulatory inhibition of propofol and make the hemodynamics more stable in elderly patients with hip fracture.Iliac fascial space block (fasciailiacacompartmentblock,FICB) mainly depends on local anesthetics spreading to the femoral nerve, lateral femoral cutaneous nerve and obturator nerve in the iliofascial space to achieve analgesia in its dominant area. Ultrasound-guided iliac fascial space block can effectively reduce the amount of anesthetics and has shorter puncture time and fewer complications. It can more effectively reduce the perioperative pain of elderly patients with hip fracture.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
108

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Mar 2022

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 1, 2022

Completed
25 days until next milestone

Study Start

First participant enrolled

March 26, 2022

Completed
5 days until next milestone

First Posted

Study publicly available on registry

March 31, 2022

Completed
26 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 26, 2022

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

January 31, 2023

Completed
Last Updated

March 31, 2022

Status Verified

March 1, 2022

Enrollment Period

1 month

First QC Date

March 1, 2022

Last Update Submit

March 27, 2022

Conditions

Keywords

cognitive dysfunctions-ketaminenerve block

Outcome Measures

Primary Outcomes (1)

  • incidence of peioperative neurocognitive impairment

    incidence of peioperative neurocognitive impairment

    Perioperative period

Study Arms (3)

Drug group

EXPERIMENTAL

S-ketamine 0.1mg/kg was injected intravenously during anesthesia induction and esmolamine 0.1mg/ (kg.h) was injected intravenously during anesthesia maintenance.S-Ketamine was put into the analgesia pump as an adjuvant for continuous analgesia until 2 days after operation.

Drug: S-Ketamine

Device group

EXPERIMENTAL

The hip fracture was diagnosed clinically on admission and ultrasound-guided iliofascial space block was performed after evaluation, and the analgesia lasted until 2 days after operation.

Device: Continuous iliac fascia space block

Normal saline group

PLACEBO COMPARATOR

normal saline 0.1ml/kg was injected intravenously during anesthesia induction and normal saline 0.1ml/ (kg.h) was injected intravenously during anesthesia maintenance.normal saline was put into the analgesia pump as an adjuvant for continuous analgesia until 2 days after operation.

Drug: Normal saline

Interventions

S-Ketamine0.1mg/kg was injected intravenously during anesthesia induction and S-Ketamine0.1mg/ (kg.h) was injected intravenously during anesthesia maintenance.S-Ketamine was put into the analgesia pump as an adjuvant for continuous analgesia until 2 days after operation.

Also known as: control group
Drug group

After admission, the iliac fascia space block and catheterization were performed under the guidance of ultrasound, and the analgesia was continued until two days after operation.

Also known as: control group
Device group

Normal saline0.1ml/kg was injected intravenously during anesthesia induction and Normal saline0.1ml/ (kg.h) was injected intravenously during anesthesia maintenance.Normal saline was put into the analgesia pump as an adjuvant for continuous analgesia until 2 days after operation.

Normal saline group

Eligibility Criteria

Age65 Years - 85 Years
Sexall
Healthy VolunteersYes
Age GroupsOlder Adult (65+)

You may qualify if:

  • Clinical diagnosis of hip fracture
  • Aged 65 or above
  • ASA Ⅰ-Ⅲ
  • No mental and nervous system diseases
  • No pathological fractures, such as bone tumor, bone tuberculosis, osteomyelitis, etc
  • No puncture site infection
  • No hospital stay for more than 48 hours after operation

You may not qualify if:

  • Patients with severe cardiac, hepatic and renal dysfunction before operation
  • Long-term use of analgesics, sedatives and alcoholism
  • Patients with respiratory tract management difficulties (modified Ma's score is IV)
  • Previous neuropsychiatric diseases such as severe cerebrovascular, Alzheimer's disease, epilepsy and Parkinson's disease
  • Previous history of intracranial surgery or craniocerebral injury
  • Severe vision, hearing, language impairment or other reasons unable to communicate
  • Allergic or contraindicated to ropivacaine or non-steroidal anti-inflammatory drugs (NSAID)
  • Emergency surgery or trauma patients.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Affiliated Hospital of Yangzhou University

Yangzhou, China

RECRUITING

MeSH Terms

Conditions

Hip FracturesCognitive Dysfunction

Interventions

EsketamineControl GroupsSaline Solution

Condition Hierarchy (Ancestors)

Femoral FracturesFractures, BoneWounds and InjuriesHip InjuriesLeg InjuriesCognition DisordersNeurocognitive DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Epidemiologic Research DesignEpidemiologic MethodsInvestigative TechniquesResearch DesignMethodsCrystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical Preparations

Study Officials

  • jJianhong Sun, master

    Yangzhou University

    STUDY CHAIR

Central Study Contacts

Tianshuang Yang, bachelor

CONTACT

Maohua Wang, master

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: A total of 108 patients were enrolled in this trial (the control group was shared by the two schemes). Research drug (esmolamine) test group: control group was designed at 1:1, 36 cases in each group. Research technique (continuous iliac fascia space block) test group: control group was designed at 1:1, 36 cases in each group.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Resident physician

Study Record Dates

First Submitted

March 1, 2022

First Posted

March 31, 2022

Study Start

March 26, 2022

Primary Completion

April 26, 2022

Study Completion

January 31, 2023

Last Updated

March 31, 2022

Record last verified: 2022-03

Locations