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Comparison of Remimazolam-based MAC With Inhalation General Anesthesia Under the Guidance of an ANI Monitor During TURB

Not Applicable
Not yet recruiting
Conditions
Patients Undergoing Transurethral Resection of Bladder
Interventions
Drug: general anesthesia with sevoflurane
Registration Number
NCT06217055
Lead Sponsor
Yonsei University
Brief Summary

In patients undergoing transurethral resection of bladder, the effect of remimazolam-based monitored anesthesia care (MAC) and inhalational general anesthesia will be compared under guidance by analgesia nociception index (ANI) monitoring. Anesthesia time, operation time, anesthesia time excluding operation time and total dose of opioid will be compared.

Detailed Description

In remimazolam-based MAC group, anesthesia will be induced with remimazolam and spontaneous breathing will be maintained. The dose of remimazolam and remifentanil will be adjusted according to the patient state index (PSI) and the analgesia nociception index(ANI).

In inhalation general anesthesia group, anesthesia will be induced with propofol and rocuronium and maintained with sevoflurane and remifentanil. Mechanical ventilation will be maintained by inserting laryngeal mask airway (LMA) or endotracheal tube. The doses of sevoflurane and remifentanil will be adjusted according to the patient state index (PSI) and the analgesia nociception index(ANI).

Surgery cost, anesthesia cost, patient and surgeon's satisfaction score, pain score, PONV score and the incidence of hypotension and hypoxemia will be compared.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
46
Inclusion Criteria

patients undergoing transurethral bladder resection

Exclusion Criteria
  • ASA class 4
  • emergency surgery
  • history of hypersensitivity to sevoflurane, propofol and remimazolam
  • galactose intolerance
  • patient refusal
  • patients in whom muscular relaxation are needed.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
inhalation general anesthesia groupgeneral anesthesia with sevofluranegeneral anesthesia with sevoflurane
remimazolam based MAC groupremimazolam based MACremimazolam based monitored anesthesia care
Primary Outcome Measures
NameTimeMethod
anesthesia time excluding operation time0-1 hour after the end of surgery (Time point at which patient exit the operating room)

anesthesia time excluding operation time

Secondary Outcome Measures
NameTimeMethod
incidence of hypotensionAt the end of surgery

hypotension: baseline BP reduction (20%)

surgeon's satisfaction scoreAt the end of surgery

surgeon's satisfaction score: very poor (1)/ poor (2)/ satisfactory (3)/ good (4)/excellent (5)

patient's satisfaction score0-2 hour after surgery (Time points at patient discharge from recovery room)

patient's satisfaction score: very poor (1)/ poor (2)/ satisfactory (3)/ good (4)/excellent (5)

surgery cost and anesthesia cost1 month after surgery

surgery cost and anesthesia cost: insured cost and non-insured cost

PONV score0-2 hour after surgery (Time points at patient discharge from recovery room), and 6 hour after surgery

PONV was defined as nausea or vomiting score.

pain score0-2 hour after surgery (Time points at patient discharge from recovery room), and 6 hour after surgery

pain score : NRS 0-10 The numerical rating scale requires the patient to rate their pain or nausea/vomiting on a defined scale. Numerical rating scale (NRS) is the simplest and most commonly used scale. The numerical scale is most commonly 0 to 10, with 0 being "no pain or no nausea/vomiting" and 10 being "the worst pain or nausea/vomiting imaginable.

incidence of hypoxemiaAt the end of surgery

hypoxemia : unresponsive to a jaw thrust maneuver and SPO2 \<92%

Trial Locations

Locations (1)

Yonsei university college of medicine

🇰🇷

Seoul, Korea, Republic of

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