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- Essai clinique NCT07661810
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.
Aperçu de l'étude
Statut
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Seokha Yoo, M.D., Ph.D.
- Numéro de téléphone: +82-2-2072-2467
- E-mail: muroki85@snu.ac.kr
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Autre
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: 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.
|
|
Comparateur actif: 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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Total remimazolam consumption
Délai: 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)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Preoperative Korean State-Trait Anxiety Inventory (K-STAI) X2 score
Délai: Day before surgery
|
Range: 20-80 (lower values mean a higher anxious state)
|
Day before surgery
|
|
Preoperative mAPAIS
Délai: Day before surgery
|
Day before surgery
|
|
|
Baseline quality of recovery (QOR-15-K) score
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
Délai: 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
Délai: 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
Délai: 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
Délai: at postoperative 24 hours
|
range:0-150 (a higher value means a better quality of recovery)
|
at postoperative 24 hours
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- 2602-001-1716
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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