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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.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Seokha Yoo, M.D., Ph.D.
- Telefoonnummer: +82-2-2072-2467
- E-mail: muroki85@snu.ac.kr
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
|
Actieve vergelijker: 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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Total remimazolam consumption
Tijdsspanne: 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)
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Preoperative Korean State-Trait Anxiety Inventory (K-STAI) X2 score
Tijdsspanne: Day before surgery
|
Range: 20-80 (lower values mean a higher anxious state)
|
Day before surgery
|
|
Preoperative mAPAIS
Tijdsspanne: Day before surgery
|
Day before surgery
|
|
|
Baseline quality of recovery (QOR-15-K) score
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: at postoperative 24 hours
|
range:0-150 (a higher value means a better quality of recovery)
|
at postoperative 24 hours
|
Medewerkers en onderzoekers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- 2602-001-1716
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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