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Response Surface Modeling of Remimazolam and Sevoflurane

27. maj 2026 opdateret af: Kim Hee Young, Pusan National University Yangsan Hospital

Response Surface Model Between Remimazolam and Sevoflurane; Comparison of the Minto and the Greco Model

This prospective randomized open-label study aims to investigate the pharmacodynamic interaction between remimazolam and sevoflurane during general anesthesia using response surface modeling. Although remimazolam has favorable hemodynamic stability compared with propofol, its hypnotic effect may be less predictable and poorly correlated with conventional sedation monitoring indices such as the bispectral index (BIS). In clinical practice, remimazolam and sevoflurane are often combined during induction and maintenance of anesthesia; however, the optimal interaction between these agents remains unclear.

This study will evaluate whether the interaction between remimazolam and sevoflurane is synergistic, additive, or infra-additive using two representative response surface interaction models: the Minto model and the Greco model. BIS values and predicted effect-site concentrations will be analyzed using NONMEM software.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Remimazolam is a recently developed ultra-short-acting benzodiazepine anesthetic with favorable pharmacokinetic characteristics, including a short context-sensitive decrement time and relatively stable hemodynamics. Despite these advantages, remimazolam may exhibit weaker hypnotic potency and inconsistent correlations with conventional anesthetic depth monitors such as BIS.

In current clinical practice, anesthesiologists frequently combine remimazolam with volatile anesthetics such as sevoflurane during induction or maintenance of anesthesia. However, the pharmacodynamic interaction between remimazolam and sevoflurane has not been fully elucidated.

The present study will investigate the interaction between remimazolam and sevoflurane using response surface modeling. The study will enroll adult patients undergoing elective laparoscopic surgery under general anesthesia. Various combinations of remimazolam infusion rates and end-tidal sevoflurane concentrations will be administered during anesthetic induction. BIS values and predicted effect-site concentrations will be collected and analyzed.

Pharmacodynamic interaction analyses will be performed using NONMEM nonlinear mixed-effects modeling software. Both the Minto interaction model and the Greco interaction model will be applied to determine whether the interaction between remimazolam and sevoflurane is synergistic, additive, or infra-additive.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

80

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Hee Young Kim, MD, PhD
  • Telefonnummer: 82-55-360-2129
  • E-mail: anekhy@gmail.com

Studiesteder

  • Sydkorea
      • Yangsan, Sydkorea, 50612
        • Rekruttering
        • Pusan National University Yangsan Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Ingen

Beskrivelse

Inclusion Criteria:

  • Adults aged 20 to 80 years
  • Scheduled for elective surgery under general anesthesia at Pusan National University Yangsan Hospital
  • American Society of Anesthesiologists (ASA) physical status I or II
  • Able to provide written informed consent

Exclusion Criteria:

  • Known allergy to remimazolam or sevoflurane
  • Renal, hepatic, neuromuscular, or neurological disease
  • Use of medications affecting the central nervous system
  • Chronic psychoactive drug use
  • Ischemic heart disease
  • Pregnant women

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Remimazolam and Sevoflurane Combination During Anesthetic Induction
Participants undergoing elective surgery under general anesthesia will receive varying combinations of remimazolam and sevoflurane during anesthetic induction to evaluate pharmacodynamic interactions using response surface modeling.
Medicin: Remimazolam (Byfavo)
Remimazolam will be administered at infusion rates ranging from 0 to 6 mg/kg/h using an infusion pump with pharmacokinetic simulation software.
Medicin: Sevoflurane (Volatile Anesthetic)
Sevoflurane will be administered by inhalation with targeted end-tidal concentrations between 0 and 2 vol%.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Interaction coefficient (α) between remimazolam and sevoflurane derived from the Minto response surface model
Tidsramme: During anesthetic induction
The interaction coefficient (α) describing the pharmacodynamic interaction between remimazolam effect-site concentration and end-tidal sevoflurane concentration will be estimated using the Minto response surface model based on BIS values collected during anesthetic induction.
During anesthetic induction
Interaction parameter between remimazolam and sevoflurane derived from the Greco response surface model
Tidsramme: During anesthetic induction
The pharmacodynamic interaction parameter describing the interaction between remimazolam effect-site concentration and end-tidal sevoflurane concentration will be estimated using the Greco response surface model based on BIS values collected during anesthetic induction.
During anesthetic induction

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
BIS response according to hypnotic combinations
Tidsramme: During anesthetic induction
Bispectral Index (BIS) values will be continuously recorded during anesthetic induction according to predefined combinations of remimazolam effect-site concentration and end-tidal sevoflurane concentration. The BIS is a processed electroencephalographic monitoring scale ranging from 0 to 100, where lower values indicate deeper levels of hypnosis and higher values indicate lighter levels of sedation or consciousness.
During anesthetic induction
Loss of consciousness (LOC)
Tidsramme: During anesthetic induction
Time to loss of consciousness during induction
During anesthetic induction
Recovery of consciousness (ROC)
Tidsramme: During emergence from anesthesia
Time to recovery of consciousness
During emergence from anesthesia
Heart rate
Tidsramme: Intraoperative period
Heart rate (beats per minute) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Systolic blood pressure
Tidsramme: Intraoperative period
Systolic blood pressure (mmHg) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Mean blood pressure
Tidsramme: Intraoperative period
Mean blood pressure (mmHg) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Cardiac output
Tidsramme: Intraoperative period
Cardiac output (L/min) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Cardiac index
Tidsramme: Intraoperative period
Cardiac index (L/min/m²) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Stroke volume variation
Tidsramme: Intraoperative period
Stroke volume variation (%) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Pulse pressure variation
Tidsramme: Intraoperative period
Pulse pressure variation (%) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period
Peripheral oxygen saturation
Tidsramme: Intraoperative period
Peripheral oxygen saturation (%) will be recorded at 5-minute intervals during the intraoperative period.
Intraoperative period

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Pusan National University Yangsan Hospital

Efterforskere

  • Ledende efterforsker: Hee Young Kim, MD, PhD, Pusan National University Yangsan Hospital, Yangsan, South Korea

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

15. maj 2026

Primær færdiggørelse (Anslået)

1. april 2027

Studieafslutning (Anslået)

31. december 2027

Datoer for studieregistrering

Først indsendt

14. maj 2026

Først indsendt, der opfyldte QC-kriterier

27. maj 2026

Først opslået (Faktiske)

2. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 05-2023-090

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Kliniske forsøg med Laparoskopisk kirurgi

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