The Effects of Midazolam, Dexmedetomidine, and Esketamine on Bispectral Index and Raw Electroencephalogram in Patients Under Propofol-Remifentanil Baseline Anesthesia
This prospective, single-center, randomized interventional study aims to investigate the effects of commonly used adjunct anesthetic drugs on the Bispectral Index (BIS) and electroencephalographic (EEG) activity during total intravenous anesthesia.
BIS monitoring is widely used to estimate the depth of anesthesia. However, previous studies suggest that certain anesthetic drugs, particularly dexmedetomidine and esketamine, may alter BIS values independently of the patient's actual level of consciousness. As a result, BIS readings may not always accurately reflect anesthetic depth when multiple drugs are administered together.
Adult patients undergoing elective laparoscopic cholecystectomy under standardized propofol-remifentanil anesthesia will be randomly assigned to receive one of the following adjunct drugs: midazolam, dexmedetomidine, esketamine, or no additional study drug (control group). Continuous BIS values and raw EEG signals will be recorded throughout the study period.
The primary objective is to compare changes in BIS values among different adjunct anesthetic drugs under otherwise similar anesthetic conditions. The study will also explore corresponding EEG characteristics associated with these changes. The findings are expected to improve understanding of drug-related differences in processed EEG monitoring and provide data for future development of more accurate anesthesia depth assessment methods.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Li
- Telefonnummer: +86-15811578082
- E-Mail: lizhao2001@aliyun.com
Studienorte
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Beijing Municipality
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Beijing, Beijing Municipality, China, 100029
- China-Japan Friendship Hospital
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Kontakt:
- Li
- Telefonnummer: +86-15811578082
- E-Mail: lizhao2001@aliyun.com
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- ASA physical status I-II;
- BMI 18-28 kg/m²;
- Scheduled for elective laparoscopic cholecystectomy, with an expected surgical duration from skin incision to completion of wound closure of ≥45 min;
- Planned to receive propofol-remifentanil total intravenous anesthesia, with routine intraoperative BIS monitoring and simultaneous acquisition of raw EEG signals;
- Voluntarily agrees to participate in this study, has signed the informed consent form, and is able to cooperate with the intervention and assessment procedures.
Exclusion Criteria:
- A confirmed history of psychiatric or neurological disorders, or use of antipsychotics, antidepressants, benzodiazepines, or other sedative-hypnotic drugs within 4 weeks before surgery;
- Cognitive impairment identified by Mini-Cog screening;
- Poorly controlled or untreated hypertension, sinus bradycardia, or severe cardiac conduction block;
- Acute angle-closure glaucoma;
- Known allergy to any required anesthetic drug;
- Difficulty in electrode placement or any condition that may interfere with EEG monitoring.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Diagnose
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Aktiver Komparator: Control Group
Participants receive standardized propofol-remifentanil total intravenous anesthesia without administration of the study adjunct anesthetic drug.
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Propofol will be administered as part of standardized total intravenous anesthesia in all study groups.
Remifentanil will be administered as part of standardized total intravenous anesthesia in all study groups.
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Experimental: Midazolam Group
Participants receive standardized propofol-remifentanil total intravenous anesthesia plus midazolam according to the study protocol.
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Propofol will be administered as part of standardized total intravenous anesthesia in all study groups.
Remifentanil will be administered as part of standardized total intravenous anesthesia in all study groups.
Midazolam administered as an adjunct to standardized propofol-remifentanil total intravenous anesthesia according to the study protocol.
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Experimental: Dexmedetomidine Group
Participants receive standardized propofol-remifentanil total intravenous anesthesia plus dexmedetomidine according to the study protocol.
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Propofol will be administered as part of standardized total intravenous anesthesia in all study groups.
Remifentanil will be administered as part of standardized total intravenous anesthesia in all study groups.
Dexmedetomidine administered as an adjunct to standardized propofol-remifentanil total intravenous anesthesia according to the study protocol.
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Experimental: Esketamine Group
Participants receive standardized propofol-remifentanil total intravenous anesthesia plus esketamine according to the study protocol.
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Propofol will be administered as part of standardized total intravenous anesthesia in all study groups.
Remifentanil will be administered as part of standardized total intravenous anesthesia in all study groups.
Esketamine administered as an adjunct to standardized propofol-remifentanil total intravenous anesthesia according to the study protocol.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in Bispectral Index (BIS) value from the pre-intervention baseline
Zeitfenster: Baseline and 5, 10, 15, 20, 25, 30 minutes after adjunct drug administration
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Change in Bispectral Index value from the stable pre-intervention baseline will be compared among the four study groups after administration of the assigned adjunct anesthetic drug under standardized propofol-remifentanil total intravenous anesthesia.
The pre-intervention baseline is defined as the stable BIS value immediately before administration of the assigned adjunct anesthetic drug.
The Bispectral Index is a dimensionless electroencephalography-derived index ranging from 0 to 100, with lower values indicating deeper hypnotic states.
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Baseline and 5, 10, 15, 20, 25, 30 minutes after adjunct drug administration
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in mean arterial pressure from pre-intervention baseline
Zeitfenster: Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Change in mean arterial pressure (MAP) from the stable pre-intervention baseline will be compared among the four study groups after administration of the assigned adjunct anesthetic drug under standardized propofol-remifentanil total intravenous anesthesia.
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Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Change in heart rate from pre-intervention baseline
Zeitfenster: Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Change in heart rate (HR) from the stable pre-intervention baseline will be compared among the four study groups after administration of the assigned adjunct anesthetic drug.
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Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Time from discontinuation of anesthetic drugs to airway device removal
Zeitfenster: From discontinuation of anesthetic drugs to airway device removal, up to 60 minutes.
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The time interval from discontinuation of anesthetic drugs to removal of the airway device will be recorded.
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From discontinuation of anesthetic drugs to airway device removal, up to 60 minutes.
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Time to Aldrete score of 10 in the post-anesthesia care unit
Zeitfenster: From admission to the post-anesthesia care unit to achievement of an Aldrete score of 10, up to 2 hours.
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The time from admission to the post-anesthesia care unit to achievement of an Aldrete score of 10 will be recorded.
The Aldrete score ranges from 0 to 10, with higher scores indicating better post-anesthesia recovery.
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From admission to the post-anesthesia care unit to achievement of an Aldrete score of 10, up to 2 hours.
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Brice questionnaire assessment
Zeitfenster: Before discharge from the post-anesthesia care unit, and at 24 and 48 hours after surgery.
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The Brice questionnaire will be used to assess postoperative recall and awareness-related events.
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Before discharge from the post-anesthesia care unit, and at 24 and 48 hours after surgery.
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Postoperative pain score
Zeitfenster: At admission to the post-anesthesia care unit, before discharge from the post-anesthesia care unit, and at 24 and 48 hours after surgery.
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Postoperative pain intensity will be assessed using the numeric rating scale (NRS).
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At admission to the post-anesthesia care unit, before discharge from the post-anesthesia care unit, and at 24 and 48 hours after surgery.
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Postoperative analgesic medication use
Zeitfenster: From admission to the post-anesthesia care unit to 48 hours after surgery.
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Use of postoperative analgesic medications, including opioid and non-opioid analgesics (e.g., NSAIDs), in the post-anesthesia care unit and hospital ward will be recorded and compared among study groups.
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From admission to the post-anesthesia care unit to 48 hours after surgery.
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Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in pre-specified electroencephalographic spectral features from baseline
Zeitfenster: Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Pre-specified electroencephalographic spectral features, including alpha-to-delta power ratio, frontal alpha power, alpha peak frequency, and burst suppression ratio, will be evaluated and compared among study groups at baseline and after administration of the assigned adjunct anesthetic drug.
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Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Change in electroencephalographic relative spectral power from baseline
Zeitfenster: Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Relative power spectral density of delta, theta, alpha, beta, and gamma frequency bands will be compared among study groups at baseline and after administration of the assigned adjunct anesthetic drug.
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Baseline and 5, 10, 15, 20, 25, and 30 minutes after adjunct drug administration.
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Organische Chemikalien
- Heterocyclische Verbindungen, 1-Ring
- Heterocyclische Verbindungen
- Heterocyclische Verbindungen, 2-Ring
- Heterocyclische Verbindungen, Fusionsring
- Azolen
- Kohlenwasserstoffe
- Kohlenwasserstoffe, zyklisch
- Säuren, acyclisch
- Carboxylsäuren
- Kohlenwasserstoffe, aromatisch
- Imidazoles
- Piperidine
- Phenole
- Benzolderivate
- Benzazepines
- Benzodiazepine
- Propionate
- Remifentanil
- Esketamin
- Midazolam
- Dexmedetomidin
- Propofol
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 2026-HX-40
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