Efficacy and Safety of Remimazolam Tosylate for Sedation in Gastroscopy

Gastric Cancer Clinical Trial

Official title:

A Multicenter, Randomized, Single-blind, Parallel Controlled Clinical Study on the Efficacy and Safety of Remimazolam Tosylate for Sedation in Gastroscopy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04727034
• Other study ID #: sudiansan1215
• Status: Recruiting
• Phase: N/A
• Start date: March 2, 2021
• Est. completion date: August 1, 2023

Study information

• Verified date: October 2022
• Source: RenJi Hospital
• Contact: Diansan Su, Dr.
• Phone: +862168383702
• Email: diansansu[@]yahoo.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Propofol is the most commonly used intravenous anesthetic for painless gastroscopy, but propofol significantly inhibits the respiratory and circulatory systems. Therefore, the incidence of intraoperative hypoxemia and hypotension is high. Remazolam tosylate is an ultra-short-acting benzodiazepine drug, which has a mild inhibitory effect on the respiratory and circulatory systems and has anterograde amnesia. These advantages make remazolam tosylate very likely to replace propofol in painless gastroscopic anesthesia.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 1800
• Est. completion date: August 1, 2023
• Est. primary completion date: July 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• 1)18=age=60 years old, no gender limit; 2) Patients receiving routine gastroscopy diagnosis and treatment; 3) ASA score is I or II; 4) 18 kg/m2<BMI<28kg/m2; 5) It is estimated that the operation time of gastroscope will not exceed 30 minutes; 6) Clearly understand, voluntarily participate in the research, and be signed and informed consent.

Exclusion Criteria:

1. Need to perform complicated endoscopic diagnosis and treatment techniques (such as cholangiopancreatography Surgery, endoscopic ultrasonography, endoscopic mucosal resection, endoscopic submucosa Stripping, oral endoscopic muscle dissection, etc.);

2. Patients who intend to undergo tracheal intubation;

3. It is judged to be difficult to manage the respiratory tract (modified Mallampati score is IV)patient;

4. Anemia or thrombocytopenia,( Hb<90g/L, PLT<80×109/L);

5. Diagnosed lung diseases (asthma, bronchitis, COPD, Pulmonary bullae,pulmonary embolism, pulmonary edema, lung cancer);

6. Liver and kidney disease;( AST and/or ALT=2.5×ULN,TBIL=1.5×ULN, blood creatinine is greater than the upper limit of normal);

7. There is a history of drug and/or alcohol abuse within 2 years before the beginning of the screening period.The average daily alcohol consumption exceeds 2 units of alcohol (1 unit = 360 mL beer Liquor or 45 mL liquor with 40% alcohol content or 150 mL grapes liqueur);

8. Hypertensive patients whose blood pressure has not been satisfactorily controlled by antihypertensive drugs(Sitting systolic blood pressure =160 mmHg during screening period, and/or diastolic pressure during screening period Pressure =100 mmHg);

9. Sitting systolic blood pressure =90 mmHg during the screening period;

10. Women who are pregnant or breastfeeding;

11. Benzodiazepines, opioids, propofol, lidoca Those who are allergic or contraindicated due to their drug components;

12. Participated in other drug clinical trials as subjects in the past 3 months;

13. The investigator believes that it is not appropriate to participate in this trial;

14. A well-diagnosed heart disease (heart failure, angina pectoris, myocardial infarction, heart rhythmabnormalities etc.).

Related Conditions & MeSH terms

• Gastric Cancer
• Hypoxia
• Propofol Adverse Reaction
• Sedation Complication

Intervention

Drug:
• Remimazolam tosylate
Remazolam tosylate is an ultra-short-acting benzodiazepine drug, which has a mild inhibitory effect on the respiratory and circulatory systems and has anterograde amnesia. These advantages make remazolam tosylate very likely to replace propofol in painless gastroscopic anesthesia.
• Propofol
Propofol is the most commonly used intravenous anesthetic for painless gastroscopy, but propofol significantly inhibits the respiratory and circulatory systems. Therefore, the incidence of intraoperative hypoxemia and hypotension is high.

Locations

Country	Name	City	State
China	Affiliated Hospital of Jiaxing University	Jiaxing
China	The Second Affifiliated Hospital of Jiaxing University	Jiaxing
China	The First Affiliated Hospital of Nanchang University	Nanchang
China	Renji Hospital	Shanghai	Shanghai, China
China	Shanghai East Hospital	Shanghai	Shanghai, China

Sponsors (5)

Lead Sponsor	Collaborator
RenJi Hospital	Affiliated Hospital of Jiaxing University, Shanghai East Hospital, The First Affiliated Hospital of Nanchang University, The Second Affifiliated Hospital of Jiaxing University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The success rate of remazolam tosylate for sedation in gastroscopy diagnosis and treatment	1) Complete the entire process of gastroscopy; 2) No sedative remedy is given; 3) After the initial dose of the test drug is administered, additional administration = 2 times within any 5-minute period; 4) The initial dose of propofol After the end, within any 5-minute period of additional administration = 2 times, it is recorded as propofol (control group) successfully sedated	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	Sedation induction time	induction time	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	Sedation recovery time	recovery time	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	Incidence of drug injection pain	drug injection pain	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	Doctor satisfaction and patient satisfaction	There is a scale from 1 to 10. Endoscopists and patients will score their satisfaction with the scale ,with 1-3 (dissatisfied),4-6 (satisfied) and 7-10 (very satisfied) after gastroscopy.	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	The time it takes for the patient to wake up and leave the hospital if the Sedation/Anaesthesia Discharge Rating Scale score exceeds 9 points;	Sedation/Anaesthesia Discharge Rating Scale	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	The incidence of hypoxia during sedation	(75% = SpO2 < 90% for <60 s);(SpO2 < 75% for any duration or 75% < SpO2 < 90% for >/=60 s)	Patients will be followed for the duration of hospital stay, an expected average of 2 hours
Secondary	Other adverse events assessed by the World SIVA adverse sedation event reporting tool	other adverse events recorded by tools proposed by the World Society of Intravenous Anesthesia International Sedation Task Force and HFNC supportive oxygen therapy-related adverse events.	Patients will be followed for the duration of hospital stay, an expected average of 2 hours