Effect of Remimazolam on Postoperative Delirium (RED)
Effect of General Anesthesia With Remimazolam Versus Propofol on Postoperative Delirium in Elderly Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Zhihong Lu
- Phone Number: +8613891975018
- Email: deerlu23@163.com
Study Locations
-
-
Shaanxi
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Xi'an, Shaanxi, China, 710032
- Xijing hospital, Fourth military medical university
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥60 years
- patients scheduled for elective surgery under general anesthesia
Exclusion Criteria:
- American Society of Anesthesiologists status ≥Ⅳ
- history of neurologic or psychiatric diseases
- difficulty in communication
- abuse of drug or alcohol
- suspected allergy to propofol or benzodiazepines
- significant cardiac, pulmonary, hepatic, or renal dysfunction
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: remimazolam
Remimazolam (0.15 mg/kg) is used for anesthesia induction.
Remimazolam continuous infusion is used for general anesthesia maintenance; dosage:0.7-1.5mg/kg/h;
duration: from start of anesthesia induction to end of surgery
|
continuous infusion
|
|
Active Comparator: propofol
Propofol (1.5 mg/kg) is used for anesthesia induction.
Propofol continuous infusion is used for general anesthesia maintenance; dosage:4-8mg/kg/h; duration: from start of anesthesia induction to end of surgery
|
continuous infusion
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
incidence of delirium by 3 days after surgery
Time Frame: from end of surgery to 3 days after surgery, in a total of 3 days
|
from end of surgery to 3 days after surgery, in a total of 3 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
incidence of delirium by 1 day after surgery
Time Frame: from end of surgery to 1 day after surgery, in a total of 1 day
|
from end of surgery to 1 day after surgery, in a total of 1 day
|
|
|
incidence of hypotension during surgery
Time Frame: from start of anesthesia induction to extubation, in an average of 2 hours
|
hypotension is defined as systolic blood pressure decreasing by more than 20% of baseline value
|
from start of anesthesia induction to extubation, in an average of 2 hours
|
|
Duration of sleep on the first night after surgery
Time Frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
|
sleep is monitored by a wrist acti-graphy
|
from end of surgery to 24 hours after surgery, in a total of 24 hours
|
|
incidence of delirium by 30 minutes after extubation (emergence delirium)
Time Frame: from extubation of tracheal tube to 30 minutes after extubation, in a total of 30 minutes
|
from extubation of tracheal tube to 30 minutes after extubation, in a total of 30 minutes
|
|
|
time to eye opening
Time Frame: from end of surgery to open eye response to verbal command, in an average of 10 minutes
|
from end of surgery to open eye response to verbal command, in an average of 10 minutes
|
|
|
time to orientation
Time Frame: from end of surgery to being able to speak out name in an average of 10 minutes
|
from end of surgery to being able to speak out name in an average of 10 minutes
|
|
|
dosage of vasoactive drugs during surgery
Time Frame: from start of anesthesia induction to extubation, in an average of 2 hours
|
vasoactive drugs refer to norepinephrine and epinephrine
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from start of anesthesia induction to extubation, in an average of 2 hours
|
|
the visual analogue scale of sleep on the next day after surgery
Time Frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
|
0 is the worst quality of sleep, 10 is the best quality of sleep
|
from end of surgery to 24 hours after surgery, in a total of 24 hours
|
|
the Athens Insomnia scale (AIS) of sleep on the next day after surgery
Time Frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
|
The AIS is a self-reported questionnaire designed to quantify sleep difficulty based on ICD-10 diagnostic criteria.
It consists of 8 items rated on a 4-point scale (0 = no problem, 3 = severe problem), yielding a total score ranging from 0 to 24.
A cutoff score of 6 provides optimal sensitivity and specificity for screening insomnia.
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from end of surgery to 24 hours after surgery, in a total of 24 hours
|
|
the time to onset of delirium
Time Frame: from end of surgery to onset of delirium, in an average of 1 days
|
from end of surgery to onset of delirium, in an average of 1 days
|
|
|
the duration of delirium
Time Frame: from onset of delirium to the last day of delirium, in an average of 3 days
|
the time between the first and last delirium-positive days
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from onset of delirium to the last day of delirium, in an average of 3 days
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Tang F, Yi JM, Gong HY, Lu ZY, Chen J, Fang B, Chen C, Liu ZY. Remimazolam benzenesulfonate anesthesia effectiveness in cardiac surgery patients under general anesthesia. World J Clin Cases. 2021 Dec 6;9(34):10595-10603. doi: 10.12998/wjcc.v9.i34.10595.
- Liu T, Lai T, Chen J, Lu Y, He F, Chen Y, Xie Y. Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double-blind, controlled trial. Pharmacol Res Perspect. 2021 Oct;9(5):e00851. doi: 10.1002/prp2.851.
- Kilpatrick GJ. Remimazolam: Non-Clinical and Clinical Profile of a New Sedative/Anesthetic Agent. Front Pharmacol. 2021 Jul 20;12:690875. doi: 10.3389/fphar.2021.690875. eCollection 2021.
- Doi M, Morita K, Takeda J, Sakamoto A, Yamakage M, Suzuki T. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial. J Anesth. 2020 Aug;34(4):543-553. doi: 10.1007/s00540-020-02788-6. Epub 2020 May 16.
- Oka S, Satomi H, Sekino R, Taguchi K, Kajiwara M, Oi Y, Kobayashi R. Sedation outcomes for remimazolam, a new benzodiazepine. J Oral Sci. 2021 Jun 29;63(3):209-211. doi: 10.2334/josnusd.21-0051. Epub 2021 Jun 7.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Pathologic Processes
- Nervous System Diseases
- Postoperative Complications
- Neurologic Manifestations
- Confusion
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Delirium
- Emergence Delirium
- Drug-Related Side Effects and Adverse Reactions
- Organic Chemicals
- Hydrocarbons
- Hydrocarbons, Cyclic
- Hydrocarbons, Aromatic
- Phenols
- Benzene Derivatives
- Propofol
- remimazolam
Other Study ID Numbers
Other Study ID Numbers
- XJH-A-20220628
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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