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The 90% Effective Dose of Remimazolam for Duodenoscopy Insertion During ERCP With Alfentanil 10µg/kg

Not Applicable
Conditions
Anesthesia
Interventions
Registration Number
NCT05053763
Lead Sponsor
Jianbo Yu
Brief Summary

Remimazolam has shown promising results for sedation in colonoscopy . Alfentanil is widely used in the analgesia of ERCP . The purpose of the study was to determine the 90% Effective Dose of Remimazolam for Duodenoscopy Insertion During ERCP With Alfentanil 10µg/kg

Detailed Description

1. Title:The 90% Effective Dose of Remimazolam for Duodenoscopy Insertion During ERCP With Alfentanil 10µg/kg 2. Research center: Single center. 3. The population of the study: Age is between 18 and 85 years; ASA I-III levels; Patients undergone elective ERCP surgery, non-intubation patients; 4. Sample size:The sample size was decided based on that of prior Literature.The study was carried out using a biased coin design up-and-down sequential method, where the dose of remimazolam administered to each patient depended on the response of the previous one with success/failure duodenoscopy insertion during ERCP are required for reliable estimates. The first patient recruited received a dose of 0.2mg/kg, based on our past experience.Subsequently, if a patient had a failure duodenoscopy insertion, the dose of remimazolam was increased by 0.025mg/kg in the next subject. If a patient had a successful duodenoscopy insertion the next subject was randomised to receive either a lower dose (with a decrement of 0.025mg/kg), with a probability of b = 0.11, or the same dose, with a probability of 1-b = 0.89.

We defined duodenoscopy insertion a failure was as gross purposeful muscular movement, coughing or vomiting occurring during or within 2 minutes of insertion of duodenoscopy. If BIS\>75 and MOAA/S \> 1 when 3 min after the intravenous injection of remimazolam, it was considered a failure, and the patient received rescue sedation. Success was depicted when the reactions mentioned earlier were absent.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Age is between 18 and 85 years
  • ASA I-III levels;
  • Patients undergone elective ERCP surgery, non-intubation patients;
Exclusion Criteria
  • Chronic pain with long-term use of analgesics, psychotropic substances (including opioids, NSAIDs, sedatives, antidepressants), alcohol abusers, with known drug allergy;
  • BMI<18 or BMI>30;
  • Previous abnormal surgical anesthesia recovery history;
  • Hypertension or systolic blood pressure greater than 160 mmHg or diastolic blood pressure greater than 95 mmHg when the patient admission to the operating room
  • Suffering from esophageal reflux; • Sedatives, analgesics and antipruritic drugs were used 24 hours before operation;
  • Expected difficult intubation ;
  • Opioids allergy history;
  • Take monoamine oxidase inhibitor or antidepressant within 15 days;
  • Pregnant or parturient women;
  • Involved in other drug trials within three months;
  • Patients who can not communicate well with the researcher

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental: age<65 groupRemimazolamThe 90% effective dose of remimazolam for duodenoscopy insertion with alfentanil 10µg/kg
Active Comparator:age ≥65 groupRemimazolamThe 90% effective dose of remimazolam for duodenoscopy insertion with alfentanil 10µg/kg
Primary Outcome Measures
NameTimeMethod
The number of success duodenoscopy insertion1 day

success duodenoscopy insertion is defined by no body movement

Secondary Outcome Measures
NameTimeMethod
The number of the occurrence of bradycardia1 day

bradycardia is defined lower than 50 beats / min

The number of the occurrence of hypotension1 day

hypotension is defined MAP decrease by 20%

The number of the occurrence of injection pain1 day

injection pain is defined the patient complained of vascular pain

Trial Locations

Locations (1)

Tianjin Nankai Hospital

🇨🇳

Tianjin, Tianjin, China

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