Comparison of Remimazolam Versus Propofol-based General Anesthesia on Postoperative Quality of Recovery in Patients Undergoing Ambulatory Upper Airway Surgery: a Randomized Controlled Trial
Overview
- Phase
- Phase 4
- Intervention
- Remimazolam
- Conditions
- Laryngeal Disease
- Sponsor
- Chung-Ang University Gwangmyeong Hospital
- Enrollment
- 116
- Locations
- 1
- Primary Endpoint
- Fit-for-discharge time
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The purpose of this study is to compare the effects of remimazolam and propofol on postoperative recovery time, complications, and safety in patients undergoing ambulatory upper airway surgery under general anesthesia.
Detailed Description
Patients scheduled for ambulatory upper airway (including nasal cavity, oral cavity, pharynx, larynx) surgery and who agree to participate in the study will be randomly assigned to the Remimazolam group and the Propofol group. In the Remimazolam group, general anesthesia is induced and maintained by continuous infusion of remimazolam and remifentanil. Once the surgery is completed, general anesthesia is recovered with flumazenil. In the Propofol group, general anesthesia is induced and maintained by continuous infusion of propofol and remifentanil using a target concentration controlled infusion method. In both groups, rocuronium is used for neuromuscular blokade, and sugammadex is used for reversal of neuromuscular blockade. When the surgery is completed, recovery time, occurrence of adverse events, and anesthesia recovery indicators are examined in 3 stages: in the operating room, while staying in the post-anesthesia care unit(PACU), and while staying in the day surgery center.
Investigators
Se-Hee Min
Assistant professor
Chung-Ang University Gwangmyeong Hospital
Eligibility Criteria
Inclusion Criteria
- •Adult patients (age 19 or older) undergoing ambulatory upper respiratory tract (nasal cavity, oral cavity, pharynx, larynx) surgery under general anesthesia
- •American Society of Anesthesiologists physical class classification I, II, and III
Exclusion Criteria
- •Patients who refused to participate in the study
- •Pregnant patients
- •Patients with a history of hypersensitivity to drugs or additives used during surgery
- •Patients with acute narrow-angle glaucoma
- •Alcohol or drug dependent patients
- •Patients with Child-Pugh class C liver dysfunction
Arms & Interventions
Remimazolam group
General anesthesia is induced by continuously injecting remimazolam (6 mg/kg/h) and remifentanil (2-6 ng/ml, target concentration controlled infusion) through an infusion pump. Afterwards, when the patient loses consciousness, rocuronium 0.6 mg/kg is injected for endotracheal intubation, and anesthesia is maintained with remimazolam (1-2 mg/kg/hr) and remifentanil after endotracheal intubation. When the surgery is completed, all anesthetic drugs being administered are stopped, and general anesthesia is terminated with flumazenil and sugammadex.
Intervention: Remimazolam
Propofol group
General anesthesia is induced by continuously injecting propofol (2-6 mg/ml, target concentration controlled injection) and remifentanil (2-6 ng/ml, target concentration controlled injection) using a TCI infusion pump. Afterwards, when the patient loses consciousness, rocuronium 0.6mg/kg is injected for endotracheal intubation, and anesthesia is maintained with propofol and remifentanil after endotracheal intubation. When the surgery is completed, all anesthetic drugs being administered are stopped, and general anesthesia is terminated through sugammadex.
Intervention: Propofol
Outcomes
Primary Outcomes
Fit-for-discharge time
Time Frame: 15 minutes after surgery
Evaluated on a scale of 0 to 10 through the Modified Post Anesthetic Discharge Scoring System (MPADSS); a score of 9 or higher meets the discharge criteria.
Secondary Outcomes
- postanesthetic care unit (PCAU) stay time, Day surgery center stay time(5 minutes)
- Incidence of adverse events(6 hours)
- Postoperative pain score(6 hours)
- Time to eye opening, time to extubate, time to postanesthetic care unit (PACU) transfer(1 minute)
- modified Observer's Alertness/Sedation Scale (MOAA/S) at PACU arrival(30 minutes)
- modified Aldrete score at PACU arrival(30 minutes)