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Comparison of Recovery Profiles Among Propofol, Remimazolam, and Dexmedetomidine After Intraoperative Sedation

Phase 4
Completed
Conditions
Brachial Plexus Block
Propofol
Dexmedetomidine
Remimazolam
Orthopedic Procedures
Sedatives
Interventions
Registration Number
NCT05688345
Lead Sponsor
Asan Medical Center
Brief Summary

A total of 120 patients (American Society of Anesthesiologist Physical Status 1-3) who signed a consent form among patients aged 19-80 years who are scheduled to undergo brachial plexus block and upper extremity surgery under monitored anesthetic care at our hospital were enrolled.

Recruited patients are divided into three groups through computer-generated randomization by using the patient identification number assigned during patient recruitment. (40 people in each group) Standard monitoring is performed when the patient arrives at the operating room. Patients receive oxygen at 5-6 L/min using a simple facial mask, and receive a brachial plexus block under ultrasound guidance. After confirming the success of brachial plexus block, administration of propofol, remimazolam, or dexmedetomidine is started according to the assigned group. Assess the patient's level of consciousness through the MOAA/S (modified observer's assessment of alertness/sedation scale) scale. The drug injection ends when the skin suture is started after the main procedure. The time from the end of injection of each drug until MOAA/S becomes 5 points is measured. After the patient is transferred to the recovery room, the Aldrete score is assessed.

The recovery profile, perioperative hemodynamic change, desaturation event, block duration, patient movement during surgery, patient satisfaction, and surgeon's satisfaction were investigated and analyzed for comparison.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • ASA PS 1-3
  • Patients scheduled for upper extremity surgery under brachial plexus block and monitored anesthetic care
Exclusion Criteria
  • Patients who refuse to participate in this study
  • Patients with poorly controlled hypertension, hyperthyroidism, or moderate to severe heart disease
  • Patients with severe hepatic or renal disease
  • Patients who are chronically using antidepressants, anticonvulsants, or psychoactive drugs
  • Patients who abuse drugs or alcohol
  • Patients with severe sleep apnea
  • Patients with cognitive impairment who have severe difficulties in communication
  • Patients with allergy to propofol, dexmedetomidine, or remimazolam
  • Patients judged to be inappropriate for this study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RemimazolamRemimazolamMaintenance doses of remimazolam is administered for sedation
PropofolPropofolPropofol is administered for sedation through target-controlled infusion
DexmedetomidineDexmedetomidineLoading and maintenance doses of dexmedetomidine are administered for sedation
Primary Outcome Measures
NameTimeMethod
Recovery profileup to 1 hour after post-anesthesia case unit entry

Time taken for MOAA/S score to reach 5 (MOAA/S: Modified Observer's Alertness/Sedation scale) Awake (5) - Unresponsive (0)

Secondary Outcome Measures
NameTimeMethod
Surgeon's satisfactionFrom end of surgery until 24 hours after end of surgery

7 point Likert scale

Length of stay in post-anesthesia care unitup to 3 hours after post-anesthesia case unit entry

Length of stay from entering PACU to leaving

Occurrence of desaturation during surgeryFrom the start of sedative injection to the end of surgery or assessed up to 3 hours

Oxygen saturation less than 92%

patient satisfactionFrom end of surgery until 24 hours after end of surgery

7 point Likert scale

Intraoperative hypotensionup to 1hour from the initiation of sedative administration

mean blood pressure less than 60mmHg

Duration of nerve blockFrom end of surgery until 24 hours after end of surgery

Trial Locations

Locations (1)

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

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