- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04919174
A Randomized Single-blind Clinical Trial of the Efficacy and Safety of Remimazolam in Painless Bronchoscopy
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
All patients undergoing bronchoscopy under general anesthesia will be recruited and should complete relevant preoperative examinations. The patient fasted for 6-8 hours before the operation, and an indwelling trocar was placed in the vein. After entering the room, the patient will be monitored with electrocardiogram(ECG), pulse oximetry, non-invasive blood pressure, and underwent oxygen inhalation (5L/min) through a nasal cannula. All patients used 2% lidocaine glue to moisten the nasal cavity for local anesthesia before the operation, the bronchoscope was inserted through the nose. The subjects take a supine position. When the bronchoscope passes through the vocal cords and carina, 5 ml of 2% lidocaine is delivered through the channel to suppress the cough reflex. Then the patients were randomly divided into two groups:
- one group use dexmedetomidine-remifentanil for anesthesia: the initial dose of dexmedetomidine is 0.1ml/kg, infused for 5 minutes, and then adjusted to 0.1-0.5ml/kg/h; the initial dose of remifentanil is 0.05ml/kg, infused for 5 minutes, and then adjusted to 0.1- 0.5 ml/kg/h.
- the other group use remimazolam-remifentanil for anesthesia: the initial dose of remimazolam is 0.1ml/kg, infused for 5 minutes, and then adjusted to 0.1-0.5ml/kg/h; the initial dose of remifentanil is 0.05ml/kg, infused for 5 minutes, and then adjusted to 0.1- 0.5 ml/kg/h.
All patients started bronchoscopy when they reached TE sedation (modified observer's assessment of sedation,MOAA/S score 3 points). If the assessment of sedation after administration suggests that the sedation is insufficient, propofol 0.4-0.6 mg/kg is repeatedly administered every 5 minutes, with the maximum dose not exceeding 200 mg to maintain sedation. In the maintenance phase of sedation, appropriate sedation is pre-defined as a MOAA/S score of 4 or less. The drug was continuously infused until the end of the bronchoscopy, and all patients were transferred to the post-anaesthesia care unit (PACU) for further observation.
Data from the DoCare Clinic electronic anesthesia recording system was used in this experiment. Bronchoscopy was performed by the same bronchologist with more than 10 years of experience.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Zhejiang
-
Hangzhou, Zhejiang, China, 310000
- Recruiting
- The Second Affiliated Hospital of Zhejiang University Medical College
-
Contact:
- Min Yan, MD
- Phone Number: 15888210247
- Email: zryanmin@zju.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18 to 70 years old.
- Need for bronchoscopy (for example, unexplained cough, hemoptysis, localized wheezing and hoarseness, chest X-ray and/or CT scans suggest abnormalities, examination and evaluation of lungs before surgery, chest trauma, lungs Or bronchial infectious disease).
- ASA classification I-III level.
- BMI≤30kg/m2.
- Women of childbearing age have a negative pregnancy test.
- Before the study, the patients voluntarily signed and dated the informed consent form approved by the institutional review board.
Exclusion Criteria:
- Patients with known allergies to benzodiazepines, flumazenil, opioids, naloxone or certain drugs.
- Patients with long-term use of benzodiazepines or opioids.
- Patients with a history of drug abuse or alcohol abuse in the past two years.
- Bradycardia (baseline HR <60bpm) or hypotension (baseline SAP<100mmHg).
- Asthma or chronic obstructive pulmonary disease(COPD) or FEV1<1.0L.
- SpO2 <90% before bronchoscopy.
- Patients who received any study drug within 30 days before screening or less than 7 half-lives of the drug.
- Any patient with cognitive impairment or inability to provide informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Control group
Patients receive dexmedetomidine for sedation
|
Sedation with dexmedetomidine
Other Names:
|
Experimental: Test group
Patients receive remimazolam for sedation
|
Sedation with remimazolam
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of Decreased Oxygen Saturation [ Safety]
Time Frame: Within 1 hour after the operation
|
Oxygen Saturation<90%, more than 30s
|
Within 1 hour after the operation
|
Interruption Rate of Bronchoscopy [effectiveness]
Time Frame: Within 1 hour after the operation
|
the occurrence of body movement or coughing makes the operating physician have to suspend the operation for physical restraint or adding drugs
|
Within 1 hour after the operation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood Pressure
Time Frame: Within 1 hour after the operation
|
Hemodynamic variable
|
Within 1 hour after the operation
|
Heart Rate
Time Frame: Within 1 hour after the operation
|
Hemodynamic variable
|
Within 1 hour after the operation
|
Hemodynamic variable
Time Frame: Within 1 hour after the operation
|
SpO2
|
Within 1 hour after the operation
|
Respiratory Rate
Time Frame: Within 1 hour after the operation
|
Hemodynamic variable
|
Within 1 hour after the operation
|
Anesthesia onset time
Time Frame: Within 1 hour after the operation
|
onset time (min)
|
Within 1 hour after the operation
|
Remedial drug demand dose of the two groups of patients
Time Frame: Within 1 hour after the operation
|
Remedial drug demand dose
|
Within 1 hour after the operation
|
Satisfaction Scores of The Operating Physicians
Time Frame: Within 1 hour after the operation
|
Satisfaction Scores (0-5,higher scores mean a better outcome.)
|
Within 1 hour after the operation
|
Incidence of adverse reactions
Time Frame: Within 1 hour after the operation
|
Within 1 hour after the operation
|
|
Incidence of operation-related complications
Time Frame: Within 1 hour after the operation
|
Within 1 hour after the operation
|
|
Anesthesia resuscitation time
Time Frame: Within 1 hour after the operation
|
resuscitation time (min)
|
Within 1 hour after the operation
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Analgesics, Opioid
- Narcotics
- Hypnotics and Sedatives
- Remifentanil
- Dexmedetomidine
Other Study ID Numbers
- 2021-0058
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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