Patient-controlled Remimazolam Sedation Under Spinal Anesthesia
Patient-controlled Remimazolam Sedation During Primary Hip Arthroplasty Under Spinal Anesthesia: an Open-Label Randomized Controlled Trial
The goal of this clinical trial is to compare the efficacy of patient-controlled sedation (PCS) versus clinician-controlled sedation (CCS) using remimazolam in adult patients undergoing primary hip arthroplasty under spinal anesthesia.
The main questions it aims to answer are:
- Does patient-controlled sedation significantly reduce the total consumption of remimazolam compared to clinician-controlled sedation?
- Are there differences in secondary outcomes, such as sedation depth , sedation-related adverse events, frequency of airway interventions, and patient/surgeon satisfaction?
Researchers will compare the PCS group to the CCS group to see if the patient-controlled method leads to a reduction in total remimazolam consumption while maintaining effective sedation.
Participants will:
- Be randomly assigned to either the PCS group or the CCS group.
- In the PCS group: Receive an initial 0.05 mg/kg remimazolam dose over 1 minute. If deeper sedation is desired, the patient can self-administer a 1 mg bolus of remimazolam via a button press, which has a 1-minute lockout interval.
- In the CCS group: Receive an initial 0.05 mg/kg remimazolam dose over 1 minute, followed by a continuous infusion starting at 0.3 mg/kg/h. The clinician will assess the MOAA/S score every 10 minutes and adjust the infusion rate to maintain a target MOAA/S score of 3.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Seokha Yoo, M.D., Ph.D.
- Telefonnummer: +82-2-2072-2467
- E-mail: muroki85@snu.ac.kr
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Patients aged 19 to 70 years with an ASA (American Society of Anesthesiologists) physical status of I or II who are undergoing primary hip arthroplasty under spinal anesthesia.
Exclusion Criteria:
- Refusal to participate in the study
- Patients with contraindications to spinal anesthesia
- Patients who do not consent to intraoperative sedation
- Patients with contraindications to remimazolam
- Patients with a history of allergy or hypersensitivity to remimazolam
- Patients with a baseline MOAA/S (Modified Observer's Assessment of Alertness/Sedation) score of 4 or lower
- Pregnant women
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Patient-controlled sedation
Patient-controlled remimazolam sedation
|
Patients will receive an initial 0.05 mg/kg remimazolam dose over 1 minute.
If deeper sedation is desired, the patient can self-administer a 1 mg bolus of remimazolam via a button press, which has a 1-minute lockout interval.
|
|
Aktiv komparator: Clinician-controlled sedation
Clinician-controlled remimazolam sedation
|
Patients will receive an initial 0.05 mg/kg remimazolam dose over 1 minute, followed by a continuous infusion starting at 0.3 mg/kg/h.
The clinician will assess the MOAA/S score every 10 minutes and adjust the infusion rate to maintain a target MOAA/S score of 3.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Total remimazolam consumption
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
Weight- and time-adjusted total remimazolam consumption (mg/kg/h)
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Preoperative Korean State-Trait Anxiety Inventory (K-STAI) X2 score
Tidsramme: Day before surgery
|
Range: 20-80 (lower values mean a higher anxious state)
|
Day before surgery
|
|
Preoperative mAPAIS
Tidsramme: Day before surgery
|
Day before surgery
|
|
|
Baseline quality of recovery (QOR-15-K) score
Tidsramme: Day before surgery
|
range:0-150 (a higher value means a better quality of recovery)
|
Day before surgery
|
|
Preoperative Korean State-Trait Anxiety Inventory (K-STAI) X1
Tidsramme: 30 minutes before admission to operation room
|
Range: 20-80 (lower values mean a higher anxious state)
|
30 minutes before admission to operation room
|
|
Intraoperative depth of sedation
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
|
Frequency of rescue sedative administration
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
|
|
Incidence of sedation-related adverse events
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS) criteria
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
|
Incidence of respiratory depression
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
Peripheral oxygen saturation < 95% or apnea > 30 s.
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
|
Frequency of airway interventions
Tidsramme: From start to end of anesthesia (the estimated period is up to 6 hours)
|
From start to end of anesthesia (the estimated period is up to 6 hours)
|
|
|
Length of stay in the post-anesthesia care unit (PACU)
Tidsramme: During the day of surgery, an average of 1 hour
|
Duration of the post-anesthetic care unit stay
|
During the day of surgery, an average of 1 hour
|
|
Patient satisfaction score with sedation
Tidsramme: Postoperative/during the post-anesthetic care unit stay (the estimated period is up to 3 hours)
|
How satisfied the patient was with sedation during surgery (10-point Likert scale, 10:the most satisfied, 0:the worst satisfied)
|
Postoperative/during the post-anesthetic care unit stay (the estimated period is up to 3 hours)
|
|
Surgeon satisfaction score
Tidsramme: Postoperative period/within 1 hour after surgery
|
How satisfied the surgeon was with the patient sedation during the surgery (10-point Likert scale, 10:the most satisfied, 0:the worst satisfied)
|
Postoperative period/within 1 hour after surgery
|
|
Quality of postoperative recovery (QOR-15K) score
Tidsramme: at postoperative 24 hours
|
range:0-150 (a higher value means a better quality of recovery)
|
at postoperative 24 hours
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2602-001-1716
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