Clinical Trial Details
— Status: Recruiting
Administrative data
NCT number |
NCT06385002 |
Other study ID # |
2024-0158 |
Secondary ID |
|
Status |
Recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
June 5, 2024 |
Est. completion date |
May 31, 2025 |
Study information
Verified date |
June 2024 |
Source |
Pusan National University Yangsan Hospital |
Contact |
Hee Young Kim |
Phone |
82553602129 |
Email |
yuvi1981[@]naver.com |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Enhanced recovery after surgery (ERAS) protocols are being explored to improve patient
outcomes. The method of inducing anesthesia and maintenance using inhalation anesthetics is
common but may delay recovery. Remimazolam, a benzodiazepine-class drug, is noted for its
rapid metabolism and fewer hemodynamic changes. Research suggests combining sevoflurane and
propofol for anesthesia in adults enhances recovery, while studies in pediatric patients
indicate a reduction in emergence agitation with remimazolam. However, the impact of
combining sevoflurane and remimazolam on postoperative recovery in adult patients undergoing
gynecologic and laparoscopic surgery is not yet studied. The study aims to compare the time
to emergence from anesthesia and tracheal extubation between concurrent sevoflurane and
remimazolam administration versus sevoflurane alone.
Description:
- Laparoscopic oophorectomy or hysterectomy is a commonly performed gynecological surgery,
and rapid recovery, pain management, prevention of postoperative nausea and vomiting are
important factors determining early discharge and patient satisfaction. With the recent
emergence of enhanced recovery after surgery (ERAS), various clinical studies are being
conducted to improve the quality of patient recovery through decisions regarding
anesthesia methods and agents, fluid administration, prevention of nausea and vomiting,
and pain management during surgery.
- The method of inducing anesthesia with intravenous injection of anesthetic agents such
as propofol followed by maintenance of anesthesia using inhalation anesthetics is
generally performed as a method of general anesthesia. Inhalation anesthetics commonly
used for maintenance of anesthesia can be easily administered and removed via
ventilation, and they have the advantage of maintaining anesthesia depth relatively
easily by monitoring parameters such as bispectral Index (BIS) and end-tidal gas
concentration. However, it has the disadvantage of delaying recovery and increasing
hospital stay due to postoperative nausea and vomiting, and it decreases average
arterial pressure proportionally to the dose due to systemic vasodilation.
- Remimazolam (Byfavo Inj., Hana Pharm Col, Ltd., Seoul, Korea) is a benzodiazepine-class
drug used for induction and maintenance of general anesthesia and for sedation during
procedures. When remimazolam is used as a general anesthetic, it is rapidly metabolized
by enzymes in the liver compared to propofol, resulting in a short context-sensitive
half-life of 7.5 minutes and allowing for reversal with flumazenil. Additionally, it is
known to induce fewer hemodynamic changes.
- There is research indicating that combining sevoflurane and propofol (target plasma
concentration 1.2 mcg/mL) for general anesthesia in adult patients reduces arousal
excitement and provides rapid recovery. However, in general anesthesia using desflurane
or remimazolam, the time to tracheal extubation was longer in the remimazolam group.
Furthermore, there is research suggesting that combining remimazolam with inhalation
anesthesia during general anesthesia in pediatric patients can reduce the occurrence of
emergence agitation after surgery, but the time to emergence is longer. However, there
is currently no research on the effects of combining sevoflurane and remimazolam for
general anesthesia in adult patients on postoperative arousal and recovery.
The objective of this study is to investigate whether there is a difference in the time to
emergence from anesthesia and time to tracheal extubation in patients undergoing gynecologic
and laparoscopic surgery under general anesthesia, comparing the concurrent administration of
sevoflurane and remimazolam with the maintenance of anesthesia using sevoflurane alone.