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Remimazolam Versus Propopol Based Total Intravenous Anesthesia for Breast Surgery

Not Applicable
Withdrawn
Conditions
Hypotension
Interventions
Registration Number
NCT05375747
Lead Sponsor
Seoul National University Hospital
Brief Summary

Comparison of the incidence of hypotension under remimazolam and propofol-based anesthesia in patients undergoing breast surgery under general anesthesia

Detailed Description

The purpose of this study was to investigate whether remimazolam-based general anesthesia could reduce the incidence of hypotension in patients undergoing breast surgery under general anesthesia compared to propofol-based general anesthesia. The purpose of this study is to establish and test the hypothesis that the incidence of hypotension under general anesthesia based on remimazolam will be less than that of propofol based general anesthesia. In addition, this study compares the proportion of patients who require a vasopressor, the time taken for anesthesia induction, the time to recover from anesthesia, postoperative pain, the incidence of postoperative nausea and vomiting, the quality of postoperative recovery, and patient satisfaction.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Adult patients over the age of 19 undergoing elective breast cancer surgery under general anesthesia at Seoul National University Hospital
Exclusion Criteria
  • patients with acute narrow-angle glaucoma/ shock or coma/ acute alcohol poisoning/ sleep apnea/ alcohol or drug dependency/ severe or acute respiratory failure/ galactose intolerance/ Lapp lactase deficiency/ glucose galactose malabsorption/ severe hypersensitivity to dextran.
  • Patients with myasthenia gravis/ pulmonary heart disease/ chronic obstructive pulmonary disease/ bronchial asthma
  • Patients with cardiovascular diseases such as ischemic heart disease/ coronary artery disease/ angina pectoris/ myocardial infarction/ atherosclerosis/ arrhythmia/ cerebrovascular disease/ and stroke
  • Patients with chronic renal failure
  • Patients with severe hepatic impairment (Child Pugh class C)
  • Patients with American Society of Anesthesiology score III or higher
  • Patients with hypersensitivity to propofol and soy or peanuts
  • Epilepsy patients
  • Patient with fat metabolism abnormality
  • Patients with high intracranial pressure
  • Pregnant woman
  • Patients unable to use supraglottic airway due to poor dental condition
  • In cases that the researcher judges to be unsuitable for this clinical trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Propofol based total intravenous anesthesiaPropofolFor induction and maintenance of anesthesia, total intravenous anesthesia is performed using continuous intravenous infusion of propofol and remifentanil.
Remimazolam based total intravenous anesthesiaRemimazolamFor induction and maintenance of anesthesia, total intravenous anesthesia is performed using continuous intravenous infusion of remimazolam and remifentanil.
Primary Outcome Measures
NameTimeMethod
Hypotension incidencefrom induction of anesthesia to end of surgery

Incidence of hypotension (MAP \<65 mmHg) from induction of anesthesia to end of surgery

Secondary Outcome Measures
NameTimeMethod
Use of vasopressorfrom induction of anesthesia to end of surgery

Proportion of patients using vasopressors due to hypotension from induction of anesthesia to completion of surgery

Number of occurrences of hypotension during surgeryfrom induction of anesthesia to end of surgery

Number of occurrences of hypotension during surgery

Type of vasopressor usedfrom induction of anesthesia to end of surgery

Type of vasopressor used

Total dose of vasopressor usedfrom induction of anesthesia to end of surgery

Total dose of vasopressor used

Blood pressurefrom induction of anesthesia to end of surgery

Blood pressure during operation, noninvasive blood pressure is measured at lower leg

Heart ratefrom induction of anesthesia to end of surgery

Heart rate during operation

Saturation of percutaneous oxygen (SpO2)from induction of anesthesia to end of surgery

Saturation of percutaneous oxygen (SpO2) during operation

Patient State Index (PSi)from induction of anesthesia to end of surgery

Patient State Index (PSi) during operation

Incidence of bradycardiafrom induction of anesthesia to end of surgery

Incidence of bradycardia during operation, bradycardia is defined as heart rate less than 50

Severity of injection painAt the start of induction of general anesthesia

Severity of injection pain of sedative(propofol or remimazolam depending on group assignment) during induction of anethesia: none/ mild/ moderate/ severe

Incidence of intraoperative awarenessfrom induction of anesthesia to end of surgery

Incedence of intraoperative awareness during operation

Incidence of intraoperative body movementfrom induction of anesthesia to end of surgery

Incidence of intraoperative body movement during operation

Incidence of use of rescue sedative agentsfrom induction of anesthesia to end of surgery

Incidence of use of any kinds of rescue sedative agents

T ime from start of administration of sedative drug to loss of consciousnessfrom induction of anesthesia to loss of consciousness

T ime from start of administration of sedative drug to loss of consciousness

Time from the end of administration of sedative to eye openingfrom end of administration of sedative to eye opening

Time from the end of administration of sedative(propofol or remimazolam depending on group assignment) to eye opening

Time from the end of administration of sedative to response to verbal commandfrom end of administration of sedative to response to verbal command

Time from the end of administration of sedative(propofol or remimazolam depending on group assignment) to response to verbal command

Time from the end of administration of sedative to supraglottic airway removalfrom end of administration of sedative to supraglottic airway removal

Time from the end of administration of sedative(propofol or remimazolam depending on group assignment) to supraglottic airway removal

Numeric rating scale score in the recovery room immediately after surgeryImmediate after end of surgery

Numeric rating scale score in the recovery room immediately after surgery, Numeric rating scale: 0 points for no pain, 10 points for the worst pain imaginable / The higher the number, the more severe the pain

Subjective sleep quality on the day of surgeryDuring the day of surgery

Subjective sleep quality on the day of surgery, Score out of 10, the higher the number, the better the quality of sleep

Duration of post anesthesia care unit stayFrom entering post anesthesia care unit until leaving, post-operatively 1 hour average

Duration of post anesthesia care unit stay

Total analgesic consumption for 24 hours after surgeryFor 24 hours after the end of surgery

Total analgesic consumption for 24 hours after surgery

Incidence of nausea and vomiting within 24 hours after surgerywithin 24 hours after surgery

Incidence of nausea and vomiting within 24 hours after surgery

Severity of nausea and vomiting within 24 hours after surgerywithin 24 hours after surgery

Severity of nausea and vomiting within 24 hours after surgery: none,. mild, moderate, severe

Patient satisfaction with anesthesiaThe day of operation

Patient satisfaction with anesthesia, Score out of 10, the higher the number, the better the quality of sleep

Hospital length of stayFrom administration to discharge, average 4 days

Hospital length of stay

15 item Quality of Recovery24 hours after surgery

15 item Quality of Recovery: 15-item questionnaire about the degree of recovery after surgery, 10 points per question, total 150 points

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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