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Efficacy and Safety of Remimazolam Tosylate for Sedation in Gastroscopy

Not Applicable
Recruiting
Conditions
Sedation Complication
Hypoxia
Propofol Adverse Reaction
Gastric Cancer
Interventions
Registration Number
NCT04727034
Lead Sponsor
RenJi Hospital
Brief Summary

Propofol is the most commonly used intravenous anesthetic for painless gastroscopy, but propofol significantly inhibits the respiratory and circulatory systems. Therefore, the incidence of intraoperative hypoxemia and hypotension is high. Remazolam tosylate is an ultra-short-acting benzodiazepine drug, which has a mild inhibitory effect on the respiratory and circulatory systems and has anterograde amnesia. These advantages make remazolam tosylate very likely to replace propofol in painless gastroscopic anesthesia.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1800
Inclusion Criteria
  • 1)18≤age≤60 years old, no gender limit; 2) Patients receiving routine gastroscopy diagnosis and treatment; 3) ASA score is I or II; 4) 18 kg/m2<BMI<28kg/m2; 5) It is estimated that the operation time of gastroscope will not exceed 30 minutes; 6) Clearly understand, voluntarily participate in the research, and be signed and informed consent.
Exclusion Criteria
  1. Need to perform complicated endoscopic diagnosis and treatment techniques (such as cholangiopancreatography Surgery, endoscopic ultrasonography, endoscopic mucosal resection, endoscopic submucosa Stripping, oral endoscopic muscle dissection, etc.);
  2. Patients who intend to undergo tracheal intubation;
  3. It is judged to be difficult to manage the respiratory tract (modified Mallampati score is IV)patient;
  4. Anemia or thrombocytopenia,( Hb<90g/L, PLT<80×109/L);
  5. Diagnosed lung diseases (asthma, bronchitis, COPD, Pulmonary bullae,pulmonary embolism, pulmonary edema, lung cancer);
  6. Liver and kidney disease;( AST and/or ALT≥2.5×ULN,TBIL≥1.5×ULN, blood creatinine is greater than the upper limit of normal);
  7. There is a history of drug and/or alcohol abuse within 2 years before the beginning of the screening period.The average daily alcohol consumption exceeds 2 units of alcohol (1 unit = 360 mL beer Liquor or 45 mL liquor with 40% alcohol content or 150 mL grapes liqueur);
  8. Hypertensive patients whose blood pressure has not been satisfactorily controlled by antihypertensive drugs(Sitting systolic blood pressure ≥160 mmHg during screening period, and/or diastolic pressure during screening period Pressure ≥100 mmHg);
  9. Sitting systolic blood pressure ≤90 mmHg during the screening period;
  10. Women who are pregnant or breastfeeding;
  11. Benzodiazepines, opioids, propofol, lidoca Those who are allergic or contraindicated due to their drug components;
  12. Participated in other drug clinical trials as subjects in the past 3 months;
  13. The investigator believes that it is not appropriate to participate in this trial;
  14. A well-diagnosed heart disease (heart failure, angina pectoris, myocardial infarction, heart rhythmabnormalities etc.).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Test group 2(Remimazolam tosylate 0.2mg/kg)Remimazolam tosylateRemimazolam tosylate 0.2mg/kg
Test group 1(Remimazolam tosylate 0.15mg/kg)Remimazolam tosylateRemimazolam tosylate 0.15mg/kg
Control groupPropofolPropofol(1.5mg/kg)
Primary Outcome Measures
NameTimeMethod
The success rate of remazolam tosylate for sedation in gastroscopy diagnosis and treatmentPatients will be followed for the duration of hospital stay, an expected average of 2 hours

1) Complete the entire process of gastroscopy; 2) No sedative remedy is given; 3) After the initial dose of the test drug is administered, additional administration ≤ 2 times within any 5-minute period; 4) The initial dose of propofol After the end, within any 5-minute period of additional administration ≤ 2 times, it is recorded as propofol (control group) successfully sedated

Secondary Outcome Measures
NameTimeMethod
Sedation induction timePatients will be followed for the duration of hospital stay, an expected average of 2 hours

induction time

Doctor satisfaction and patient satisfactionPatients will be followed for the duration of hospital stay, an expected average of 2 hours

There is a scale from 1 to 10. Endoscopists and patients will score their satisfaction with the scale ,with 1-3 (dissatisfied),4-6 (satisfied) and 7-10 (very satisfied) after gastroscopy.

Incidence of drug injection painPatients will be followed for the duration of hospital stay, an expected average of 2 hours

drug injection pain

The time it takes for the patient to wake up and leave the hospital if the Sedation/Anaesthesia Discharge Rating Scale score exceeds 9 points;Patients will be followed for the duration of hospital stay, an expected average of 2 hours

Sedation/Anaesthesia Discharge Rating Scale

The incidence of hypoxia during sedationPatients will be followed for the duration of hospital stay, an expected average of 2 hours

(75% ≤ SpO2 \< 90% for \<60 s);(SpO2 \< 75% for any duration or 75% \< SpO2 \< 90% for \>/=60 s)

Other adverse events assessed by the World SIVA adverse sedation event reporting toolPatients will be followed for the duration of hospital stay, an expected average of 2 hours

other adverse events recorded by tools proposed by the World Society of Intravenous Anesthesia International Sedation Task Force and HFNC supportive oxygen therapy-related adverse events.

Sedation recovery timePatients will be followed for the duration of hospital stay, an expected average of 2 hours

recovery time

Trial Locations

Locations (5)

Shanghai East Hospital

🇨🇳

Shanghai, Shanghai, China, China

Renji Hospital

🇨🇳

Shanghai, Shanghai, China, China

Affiliated Hospital of Jiaxing University

🇨🇳

Jiaxing, China

The Second Affifiliated Hospital of Jiaxing University

🇨🇳

Jiaxing, China

The First Affiliated Hospital of Nanchang University

🇨🇳

Nanchang, China

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