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CataractPhase 3NCT07080229

Intranasal Dexmedetomidine on Blood Pressure in Elderly Hypertensive Patients Undergoing Cataract Surgery

A Phase 3 study testing Intranasal dexmedetomidine and Intranasal normal saline in people with Cataract and Hypertension, run by Suez Canal University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Cataract surgery in elderly patients with controlled hypertension carries a risk of hemodynamic instability, particularly fluctuations in mean arterial blood pressure (MAP). Dexmedetomidine, a selective α2-adrenergic agonist, offers hemodynamic stabilization and sedation when administered intranasally and provides a… Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Cataract, Hypertension
What is being tested?
Intranasal dexmedetomidine and Intranasal normal saline
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
126 participants
Where
1 siteEgypt
Study dates
16 Jul 2025to May 2026
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Patients aged ≥65 years.
  • Patients who will have stage 2 hypertension as per ACC/AHA guidelines (Systolic BP > 140 and Diastolic BP> 90 mmHg)
  • Elective cataract surgery under local anesthesia.
  • American Society of Anesthesiologists (ASA) physical status II or III.

Who cannot join

  • Allergy or contraindication to dexmedetomidine.
  • Significant baseline bradycardia (<50 bpm) or arrhythmias.
  • Use of sedative or anxiolytic medications.
  • History of severe hepatic, renal, or cerebrovascular diseases.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Abdelrhman M Alshawadfy, MD contact

+201091091620

abdelrhmanalshawadfy@gmail.com

Egypt1 site, 1 recruiting
  • Suez Canal University Hospitals

    Ismailia, Ismailia Governorate, 41522

    Mahammad E Salama, MD, 01016865861, mohammadelhossieny88@med.suez.edu.eg

    Recruiting

Other trials in Egypt

About this study

Official title: The Effect of Intranasal Dexmedetomidine Compared to Placebo on Blood Pressure in Elderly Hypertensive Patients Undergoing Cataract Surgery: A Double-Blind Randomized Controlled Trial

Cataract surgery in elderly patients with controlled hypertension carries a risk of hemodynamic instability, particularly fluctuations in mean arterial blood pressure (MAP). Dexmedetomidine, a selective α2-adrenergic agonist, offers hemodynamic stabilization and sedation when administered intranasally and provides a simple and non-invasive premedication option.

This study evaluates the effects of intranasal dexmedetomidine on perioperative mean arterial blood pressure in patients undergoing cataract surgeries.

Read more

Research Question:

Does intranasal dexmedetomidine premedication control blood pressure in elderly hypertensive patients undergoing cataract surgery?

Research Hypothesis:

Intranasal dexmedetomidine significantly reduces MAP and improves secondary outcomes compared to placebo.

Primary Objective: To evaluate the efficacy of intranasal Dexmedetomidine as a premedication to control hypertension in elderly patients scheduled for cataract surgery.

Secondary Objectives: 1. To assess surgery cancellation rates. 2. To evaluate satisfaction levels among patients, anesthesiologists, and surgeons using the Modified Observer's assessment of alertness/sedation scale (MOAA/S). 3- To evaluate the effect of intranasal dexmedetomidine on HR multiple readings starting from preoperative hold area till 2 hours postoperatively.

This randomized, double-blinded clinical trial will include 126 elderly hypertensive patients (≥65 years) undergoing cataract surgery under local anesthesia. Inclusion Criteria will consist of patients aged ≥65 years, ASA II or III, stage 2 hypertension as per ACC / AHA guidelines (SBP>140 and DBP> 90 mmHg), undergoing elective cataract surgery under local anesthesia. Exclusion Criteria will include allergy or contraindication to dexmedetomidine, significant baseline bradycardia (<50 bpm) or arrhythmia, use of sedative or anxiolytic medications, history of severe hepatic, renal, or cerebrovascular disease. Participants will be randomly assigned to receive either intranasal dexmedetomidine (1 mcg/kg ideal body weight) or a placebo (normal saline) 30 minutes before surgery. MAP, HR, and SpO₂ will be recorded at multiple perioperative intervals, and surgical cancellation rates, satisfaction levels will be noted, surgical duration, and hospital stay will be documented.

Read the detailed description

Intranasal Administration Technique:

  1. Intranasal dexmedetomidine (1 mcg/kg ideal body weight) will be diluted to a total volume of 1 ml.
  2. A mucosal atomization device (MAD) will be used for administration.
  3. The dose will be divided evenly, with 0.5 mL sprayed into each nostril while the patient is in a semi-recumbent position.
  4. The control group will receive an equivalent volume of 0.9% saline using the same method.

Local Anesthesia A peribulbar block will be administered with a mixture of lidocaine 2% and bupivacaine 0.5% (total volume: 5 mL).

The block will be performed under aseptic conditions by an experienced anesthesiologist.

Being tested
Intranasal dexmedetomidine, Intranasal normal saline
Keywords
Cataract, Hypertension, Intranasal Dexmedetomidine, Elderly
Medical subject headings
Cataract, Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intranasal dexmedetomidineDrug

    Intranasal dexmedetomidine (1 mcg/kg ideal body weight) will be diluted to a total volume of 1 ml and will be administered via a mucosal atomization device (MAD) 30 minutes before surgery. The dose will be divided evenly, with 0.5 mL sprayed into each nostril while the patient is in a semi-recumbent position.

  • Intranasal normal salineDrug

    Intranasal normal saline (1 ml) will be administered via mucosal atomization device (MAD) 30 minutes before surgery. The dose will be divided evenly, with 0.5 mL sprayed into each nostril while the patient is in a semi-recumbent position.

Study groups in NCT07080229
Study groupRoleWhat they receive
Dexmedetomidine group (Study group)Active comparatorIn this group, Dexmedetomidine (1 mcg/kg ideal body weight) will be administered intranasally 30 minutes before surgery.
Receives: Drug: Intranasal dexmedetomidine
Placebo group (Control group)Placebo comparatorIn this group, Normal Saline will be administered intranasally 30 minutes before surgery.
Receives: Drug: Intranasal normal saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean arterial blood pressure (MAP)

    Mean arterial blood pressure (MAP), measured in mmHg, will be recorded in both groups at the following time points:

    • Preoperative baseline
    • Every 5 minutes after intranasal drug administration
    • Intraoperative baseline
    • Immediately after peribulbar block
    • Every 5 minutes after the block until the end of the surgery
    • Every 15 minutes postoperatively until discharge

    Measured: From preoperative baseline until 2 hours postoperatively

Secondary outcomes (6)
  1. Surgical cancellation rate

    The number and percentage of cases in each group in which cataract surgery will be cancelled due to uncontrolled blood pressure, inadequate sedation, patient anxiety, or any other reason

    Measured: From the preoperative period until completion or cancellation of the surgery

  2. Sedation score using the Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S).

    Sedation will be evaluated using the MOAA/S scale at predefined time points:

    • Every 5 minutes after intranasal drug administration
    • Intraoperative baseline
    • Immediately after peribulbar block
    • Every 5 minutes after the block until the end of the surgery
    • Every 15 minutes postoperatively until discharge

    The MOAA/S is a scale from 0 to 5 assessing a subject's responsiveness to verbal and physical stimuli as follows:

    0: No response after painful stimuli

    1. Responds only after painful trapezius squeeze
    2. Responds only after mild prodding or shaking
    3. Responds only after name is called loudly and/or repeatedly
    4. Lethargic response to name spoken in normal tone
    5. Responds readily to name spoken in normal tone

    Measured: From preoperative drug administration until 2 hours postoperatively

  3. Heart rate (HR)

    Heart rate (HR) will be recorded in both groups at the following time points:

    • Preoperative baseline
    • Every 5 minutes after intranasal drug administration
    • Intraoperative baseline
    • Immediately after peribulbar block
    • Every 5 minutes after the block until the end of the surgery
    • Every 15 minutes postoperatively until discharge

    Measured: From preoperative baseline until 2 hours postoperatively

  4. Patient Satisfaction

    Patient satisfaction with anesthesia care was measured using the Iowa Satisfaction with Anesthesia Scale (ISAS), a validated instrument specifically designed for monitored anesthesia care and sedation. The ISAS consists of 11 items rated on a 6-point Likert scale, with both positively and negatively worded statements. The total score was calculated as the mean of all items after appropriate reverse coding, with higher scores indicating greater satisfaction.

    Measured: Assessed once the patient is in the post-anesthesia care unit (PACU) prior to discharge

  5. Anesthesiologist Satisfaction

    Anesthesiologist Satisfaction will be evaluated using structured 5 point Likert scale (1 = very dissatisfied, 5 = very satisfied). The assessment includes adequacy of sedation, ease of patient management, hemodynamic stability, airway safety, and overall satisfaction. A composite score will be calculated as the mean of all items, with higher scores indicating greater satisfaction.

    Measured: Assessed immediately after completion of the procedure

  6. Surgeon Satisfaction

    Surgeon satisfaction was assessed using a structured 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied). The assessment included surgical field conditions, patient cooperation, ocular stability, ease of performing the procedure, and overall satisfaction. A composite score will be calculated as the mean of all items, with higher scores indicating greater satisfaction.

    Measured: Assessed immediately after completion of the procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jul 2025
  2. Study start16 Jul 2025
  3. Primary completionApr 2026 (estimated)
  4. Study completionMay 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
126 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07080229
Sponsor's protocol ID
5989#
Status last verified
Aug 2025
First submitted
14 Jul 2025
Last updated
7 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Wang K, Wu M, Xu J, Wu C, Zhang B, Wang G, Ma D. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis. Br J Anaesth. 2019 Dec;123(6):777-794. doi: 10.1016/j.bja.2019.07.027. Epub 2019 Oct 24.

    PubMed 31668347
  • Liu S, Wang Y, Zhu Y, Yu T, Zhao H. Safety and sedative effect of intranasal dexmedetomidine in mandibular third molar surgery: a systematic review and meta-analysis. Drug Des Devel Ther. 2019 Apr 23;13:1301-1310. doi: 10.2147/DDDT.S194894. eCollection 2019.

    PubMed 31114165
  • Xu X, Cao Y, Wu Y, Ding M. Intranasal Dexmedetomidine in Elderly Patients (Aged > 65 Years) During Maxillofacial Surgery: Sedative Properties and Safety Analysis. J Oral Maxillofac Surg. 2022 Mar;80(3):443-455. doi: 10.1016/j.joms.2021.10.013. Epub 2021 Oct 30.

    PubMed 34838503
  • Li A, Yuen VM, Goulay-Dufay S, Sheng Y, Standing JF, Kwok PCL, Leung MKM, Leung AS, Wong ICK, Irwin MG. Pharmacokinetic and pharmacodynamic study of intranasal and intravenous dexmedetomidine. Br J Anaesth. 2018 May;120(5):960-968. doi: 10.1016/j.bja.2017.11.100. Epub 2018 Feb 2.

    PubMed 29661413
  • Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Dec 9;130(24):2215-45. doi: 10.1161/CIR.0000000000000105. Epub 2014 Aug 1. No abstract available.

    PubMed 25085962
  • Fang R, Yu YF, Li EJ, Lv NX, Liu ZC, Zhou HG, Song XD. Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019. BMC Public Health. 2022 Nov 12;22(1):2068. doi: 10.1186/s12889-022-14491-0.

    PubMed 36369026

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Intranasal dexmedetomidine and Intranasal normal saline in people with Cataract and Hypertension, run by Suez Canal University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 7 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mohammad E Salama, MD (+201016865861, MohammadElhossieny88@med.suez.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean arterial blood pressure (MAP) (time frame: From preoperative baseline until 2 hours postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07080229, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Apr 2026.

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