Effect of Rematazolam Besylate, Propofol, and Sevoflurane Perioperative Sedation on Incidence of Emergence Agitation and Hemodynamics in Patients Undergoing Laparoscopic Abdominal Surgery

NCT ID: NCT05624424

Last Updated: 2022-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

1317 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-15

Study Completion Date

2023-10-31

Brief Summary

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Emergence agitation (EA) is a transient, self-limited, non-fluctuating state of psychomotor excitement, which closely revolves around the emergence of general anesthesia. Uncontrolled EA during the recovery period increases the potential risk of injury to patients and medical staff, resulting in varying degrees of adverse consequences, such as elevated blood pressure, incision rupture, bleeding, cardio-cerebrovascular accidents and so on, leading to a great waste of resources.

Accumulating scientific evidence indicates that the incidence of EA is related to the use of perioperative sedative drugs. As a novel ultra-short-acting benzodiazepines drugs, Remimazolam has been accepted for induction and maintenance of clinical anesthesia. Compared to traditional benzodiazepines drugs, Remimazolam combines the safety of midazolam with the effectiveness of propofol, and also has the advantages of acting quickly, short half-life, no injection pain, slight respiratory depression, independent of liver and kidney metabolism, long-term infusion without accumulation, and has a specific antagonist: flumazenil. This study aims to investigate whether perioperative sedation of Remimazolam besylate, propofol, and sevoflurane have different effects on the incidence of emergence agitation and hemodynamics in patients undergoing laparoscopic abdominal surgery.

Detailed Description

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Conditions

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Emergence Agitation Remimazolam Besylate Perioperative Sedation Laparoscopic Abdominal Surgery Anesthesia, General

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a RCTs.
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Care provider and investigator (anesthesiologist) cannot be blinded for different appearance of remimazolam, propofol and sevoflurane.

Study Groups

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Remimazolam Besylate

Induction of anesthesia Slowly inject Remimazolam Besylate 0.3\~0.5 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS\<60, if the degree of sedation is insufficient, additional Remimazolam Besylate (0.05 mg/kg each time) is allowed. After the LoC, sufentanil 0.3\~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.

Group Type EXPERIMENTAL

Rematazolam Besylate

Intervention Type DRUG

Anesthesia was induced with Rematazolam Besylate 0.3\~0.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by remimazolam 1-3 mg/kg/h until the end of surgery.

Sufentanil

Intervention Type DRUG

Anesthesia was induced with Sufentanil 0.3\~0.5 ug/kg by intravenous injection after the LoC and BIS\<60.

Cisatracurium Besylate

Intervention Type DRUG

Anesthesia was induced with cisatracurium besilate 0.2-0.3 mg/kg by intravenous injection after the LoC and BIS\<60, followed by 0.1 mg/kg/h Cisatracurium Besylate during the operation.

Remifentanil

Intervention Type DRUG

After the LoC, remifentanil 0.1\~0.3 ug/kg/min inject intravenously until the end of surgery.

Propofol

Induction of anesthesia Slowly inject Propofol 2\~2.5 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS\<60, if the degree of sedation is insufficient, additional Propofol (0.5 mg/kg each time) is allowed. After the LoC, sufentanil 0.3\~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Anesthesia was induced with Propofol 2\~2.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by remimazolam 5\~12 mg/kg/h until the end of surgery.

Sufentanil

Intervention Type DRUG

Anesthesia was induced with Sufentanil 0.3\~0.5 ug/kg by intravenous injection after the LoC and BIS\<60.

Cisatracurium Besylate

Intervention Type DRUG

Anesthesia was induced with cisatracurium besilate 0.2-0.3 mg/kg by intravenous injection after the LoC and BIS\<60, followed by 0.1 mg/kg/h Cisatracurium Besylate during the operation.

Remifentanil

Intervention Type DRUG

After the LoC, remifentanil 0.1\~0.3 ug/kg/min inject intravenously until the end of surgery.

Sevoflurane

Induction of anesthesia Slowly inject Etomidate 0.03 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS\<60, if the degree of sedation is insufficient, additional etomidate (0.03 mg/kg each time) is allowed. After the LoC, sufentanil 0.3\~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.

Group Type ACTIVE_COMPARATOR

Sevoflurane

Intervention Type DRUG

Anesthesia was induced with etomidate 0.03 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by 2 %-3 % Sevoflorane until the end of surgery.

Sufentanil

Intervention Type DRUG

Anesthesia was induced with Sufentanil 0.3\~0.5 ug/kg by intravenous injection after the LoC and BIS\<60.

Cisatracurium Besylate

Intervention Type DRUG

Anesthesia was induced with cisatracurium besilate 0.2-0.3 mg/kg by intravenous injection after the LoC and BIS\<60, followed by 0.1 mg/kg/h Cisatracurium Besylate during the operation.

Remifentanil

Intervention Type DRUG

After the LoC, remifentanil 0.1\~0.3 ug/kg/min inject intravenously until the end of surgery.

Interventions

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Rematazolam Besylate

Anesthesia was induced with Rematazolam Besylate 0.3\~0.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by remimazolam 1-3 mg/kg/h until the end of surgery.

Intervention Type DRUG

Propofol

Anesthesia was induced with Propofol 2\~2.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by remimazolam 5\~12 mg/kg/h until the end of surgery.

Intervention Type DRUG

Sevoflurane

Anesthesia was induced with etomidate 0.03 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS\<60, followed by 2 %-3 % Sevoflorane until the end of surgery.

Intervention Type DRUG

Sufentanil

Anesthesia was induced with Sufentanil 0.3\~0.5 ug/kg by intravenous injection after the LoC and BIS\<60.

Intervention Type DRUG

Cisatracurium Besylate

Anesthesia was induced with cisatracurium besilate 0.2-0.3 mg/kg by intravenous injection after the LoC and BIS\<60, followed by 0.1 mg/kg/h Cisatracurium Besylate during the operation.

Intervention Type DRUG

Remifentanil

After the LoC, remifentanil 0.1\~0.3 ug/kg/min inject intravenously until the end of surgery.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 1 Aged 18-65 years, sex was not limited;
* 2 BMI 18-30kg/m2;
* 3 Patients were scheduled for elective laparoscopic abdominal surgery under general anesthesia, the operation time 2h\~4h;
* 4 ASA Ⅰ-III;

Exclusion Criteria

* 1 Relative contraindications to general anesthesia: Patients with severe heart and lung disease, severe infection, uncontrolled hypertension, diabetes, and severe diabetic complications;
* 2 Abnormal renal and liver function: AST or ALT≥2.5×ULN, TBIL≥1.5×ULN, Serum creatinine concentration (SCC)≥1.5×ULN;
* 3 People with a history of mental illness or long-term use of psychotropic drugs (dementia, schizophrenia), chronic analgesic drug use, alcoholism, and cognitive impairment;
* 4 Any cardiovascular or cerebrovascular accidents occurred within 3 months, such as myocardial infarction, stroke, transient ischemic attack;
* 5 Female pregnant patients;
* 6 Patients undergoing hepatobiliary surgery;
* 7 Allergy to the experimental drug;
* 8 Unable to cooperate to complete the test, the patient or family member rejected the participant;
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yichang Humanwell Pharmaceutical Co., Ltd., China

INDUSTRY

Sponsor Role collaborator

Second Affiliated Hospital of Nanchang University

OTHER

Sponsor Role lead

Responsible Party

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Fuzhou Hua

Chief Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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People's Hospital of Ganzhou

Ganzhou, Jiangxi, China

Site Status

the First Affiliated Hospital of Gannan Medical College, Gannan Medical College

Ganzhou, Jiangxi, China

Site Status

The First People's Hospital of JiuJiang

Jiujiang, Jiangxi, China

Site Status

the Second Affiliated Hospital of Nanchang University, Nanchang University

Nanchang, Jiangxi, China

Site Status

Tumor Hospital of Jiangxi Province

Nanchang, Jiangxi, China

Site Status

Shangrao People's Hospital

Shangrao, Jiangxi, China

Site Status

Countries

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China

Central Contacts

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Fuzhou Hua, professor

Role: CONTACT

+8615170238929

Yang Fang

Role: CONTACT

+8618370985324

Facility Contacts

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Guiming Huang, professor

Role: primary

+8615907977699

Maolin Zhong, professor

Role: primary

+8613607978802

Shenghong Zhong, professor

Role: primary

+8613607926616

Fuzhou Hua, professor

Role: primary

+8615170238929

Huaping Xiao, professor

Role: primary

+8613507082466

Guoxiong Lin, professor

Role: primary

+8613707033801

Other Identifiers

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2022-EA-2

Identifier Type: -

Identifier Source: org_study_id

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