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Emergence AgitationPhase 4NCT05624424

Effect of Rematazolam Besylate, Propofol, and Sevoflurane Perioperative Sedation on Incidence of Emergence Agitation and Hemodynamics in Patients Undergoing Laparoscopic Abdominal Surgery

A Phase 4 study testing Rematazolam Besylate, Propofol and Sevoflurane in people with Emergence Agitation and Remimazolam Besylate, run by Second Affiliated Hospital of Nanchang University at 6 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Emergence agitation (EA) is a transient, self-limited, non-fluctuating state of psychomotor excitement, which closely revolves around the emergence of general anesthesia. Uncontrolled EA during the recovery period increases the potential risk of injury to patients and medical staff, resulting in varying degrees of… Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Rematazolam Besylate, Propofol and Sevoflurane
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,317 participants
Where
6 sitesChina
Study dates
15 Nov 2022to 31 Oct 2023
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1 Aged 18-65 years, sex was not limited;
  • 2 BMI 18-30kg/m2;
  • 3 Patients were scheduled for elective laparoscopic abdominal surgery under general anesthesia, the operation time 2h~4h;
  • 4 ASA Ⅰ-III;

Who cannot join

  • 1 Relative contraindications to general anesthesia: Patients with severe heart and lung disease, severe infection, uncontrolled hypertension, diabetes, and severe diabetic complications;
  • 2 Abnormal renal and liver function: AST or ALT≥2.5×ULN, TBIL≥1.5×ULN, Serum creatinine concentration (SCC)≥1.5×ULN;
  • 3 People with a history of mental illness or long-term use of psychotropic drugs (dementia, schizophrenia), chronic analgesic drug use, alcoholism, and cognitive impairment;
  • 4 Any cardiovascular or cerebrovascular accidents occurred within 3 months, such as myocardial infarction, stroke, transient ischemic attack;
  • 5 Female pregnant patients;
  • 6 Patients undergoing hepatobiliary surgery;
  • 7 Allergy to the experimental drug;
  • 8 Unable to cooperate to complete the test, the patient or family member rejected the participant;

Trial locations and contacts

6 sites in 1 country.

Fuzhou Hua, professor contact

+8615170238929

huafuzhou@126.com

6 sites in 1 country

China6 sites
  • People's Hospital of Ganzhou

    Ganzhou, Jiangxi

    Guiming Huang, professor, +8615907977699, liyouchun2007@163.com

  • the First Affiliated Hospital of Gannan Medical College, Gannan Medical College

    Ganzhou, Jiangxi

    Maolin Zhong, professor, +8613607978802, zml8802@163.com

  • The First People's Hospital of JiuJiang

    Jiujiang, Jiangxi

    Shenghong Zhong, professor, +8613607926616, jjmazui@163.com

  • the Second Affiliated Hospital of Nanchang University, Nanchang University

    Nanchang, Jiangxi

    Fuzhou Hua, professor, +8615170238929, huafuzhou@126.com

  • Tumor Hospital of Jiangxi Province

    Nanchang, Jiangxi

    Huaping Xiao, professor, +8613507082466, 463568985@qq.com

  • Shangrao People's Hospital

    Shangrao, Jiangxi

    Guoxiong Lin, professor, +8613707033801, lgxmaz@163.com

Other trials in China

About this study

Emergence agitation (EA) is a transient, self-limited, non-fluctuating state of psychomotor excitement, which closely revolves around the emergence of general anesthesia. Uncontrolled EA during the recovery period increases the potential risk of injury to patients and medical staff, resulting in varying degrees of adverse consequences, such as elevated blood pressure, incision rupture, bleeding, cardio-cerebrovascular accidents and so on, leading to a great waste of resources.

Accumulating scientific evidence indicates that the incidence of EA is related to the use of perioperative sedative drugs. As a novel ultra-short-acting benzodiazepines drugs, Remimazolam has been accepted for induction and maintenance of clinical anesthesia. Compared to traditional benzodiazepines drugs, Remimazolam combines the safety of midazolam with the effectiveness of propofol, and also has the advantages of acting quickly, short half-life, no injection pain, slight respiratory depression, independent of liver and kidney metabolism, long-term infusion without accumulation, and has a specific antagonist: flumazenil. This study aims to investigate whether perioperative sedation of Remimazolam besylate, propofol, and sevoflurane have different effects on the incidence of emergence agitation and hemodynamics in patients undergoing laparoscopic abdominal surgery.

Being tested
Rematazolam Besylate, Propofol, Sevoflurane, Sufentanil, Cisatracurium Besylate
Keywords
Emergence Agitation, Remimazolam Besylate, Propofol, Sevoflurane, Laparoscopic Abdominal Surgery, Perioperative Sedation, Anesthesia, General
Medical subject headings
Emergence Delirium

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rematazolam BesylateDrug

    Anesthesia was induced with Rematazolam Besylate 0.3~0.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS<60, followed by remimazolam 1-3 mg/kg/h until the end of surgery.

  • PropofolDrug

    Anesthesia was induced with Propofol 2~2.5 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS<60, followed by remimazolam 5~12 mg/kg/h until the end of surgery.

  • SevofluraneDrug

    Anesthesia was induced with etomidate 0.03 mg/kg (about 1 minute) by intravenous injection until the loss of consciousness (LoC) and BIS<60, followed by 2 %-3 % Sevoflorane until the end of surgery.

  • SufentanilDrug

    Anesthesia was induced with Sufentanil 0.3~0.5 ug/kg by intravenous injection after the LoC and BIS<60.

  • Cisatracurium BesylateDrug

    Anesthesia was induced with cisatracurium besilate 0.2-0.3 mg/kg by intravenous injection after the LoC and BIS<60, followed by 0.1 mg/kg/h Cisatracurium Besylate during the operation.

  • RemifentanilDrug

    After the LoC, remifentanil 0.1~0.3 ug/kg/min inject intravenously until the end of surgery.

Study groups in NCT05624424
Study groupRoleWhat they receive
Remimazolam BesylateExperimentalInduction of anesthesia Slowly inject Remimazolam Besylate 0.3~0.5 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS<60, if the degree of sedation is insufficient, additional Remimazolam Besylate (0.05 mg/kg each time) is allowed. After the LoC, sufentanil 0.3~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.
Receives: Drug: Rematazolam Besylate; Drug: Sufentanil; Drug: Cisatracurium Besylate; Drug: Remifentanil
PropofolActive comparatorInduction of anesthesia Slowly inject Propofol 2~2.5 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS<60, if the degree of sedation is insufficient, additional Propofol (0.5 mg/kg each time) is allowed. After the LoC, sufentanil 0.3~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.
Receives: Drug: Propofol; Drug: Sufentanil; Drug: Cisatracurium Besylate; Drug: Remifentanil
SevofluraneActive comparatorInduction of anesthesia Slowly inject Etomidate 0.03 mg/kg (about 1 minute) until loss of consciousness (LoC) and BIS<60, if the degree of sedation is insufficient, additional etomidate (0.03 mg/kg each time) is allowed. After the LoC, sufentanil 0.3~0.5 ug/kg and cisatracurium besilate 0.2-0.3 mg/kg are injected intravenously. After the muscles are sufficiently relaxed and blood circulation is stable, the tracheal tube is inserted under a glide scope.
Receives: Drug: Sevoflurane; Drug: Sufentanil; Drug: Cisatracurium Besylate; Drug: Remifentanil

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The incidence of emergence agitation

    The Riker Sedation-Agitation Scale (RSAS) score ≥ 5 points indicates the presence of emergence agitation.

    Measured: Duration from the time patients awakening to the time of departure from post-anesthesia care unit (PACU), average 1 hour.

  2. The incidence of emergence agitation

    The Richmond Agitation-Sedation Scale (RASS) ≥ +1 points indicates the presence of emergence agitation.

    Measured: Duration from the time patients awakening to the time of departure from PACU, average 1 hour.

Secondary outcomes (12)
  1. Systolic pressure

    Measured: "30 minutes before intubation", "immediately after intubation", "every 5 minutes after intubation until the patient leaves the post-anesthesia care unit, in about six hours", " mornings and afternoons on the 1st, 3rd and 7th day after operation".

  2. Diastolic pressure

    Measured: "30 minutes before intubation", "immediately after intubation", "every 5 minutes after intubation until the patient leaves the post-anesthesia care unit, in about six hours", " mornings and afternoons on the 1st, 3rd and 7th day after operation".

  3. Mean pressure

    Measured: "30 minutes before intubation", "immediately after intubation", "every 5 minutes after intubation until the patient leaves the post-anesthesia care unit, in about six hours", " mornings and afternoons on the 1st, 3rd and 7th day after operation".

  4. Heart rate

    Measured: "30 minutes before intubation", "immediately after intubation", "every 5 minutes after intubation until the patient leaves the post-anesthesia care unit, in about six hours", " mornings and afternoons on the 1st, 3rd and 7th day after operation".

  5. Recovery times

    Recovery times is defined as the period from discontinuation of anesthetic drugs to the recovery of the patient's self-consciousness and can respond correctly to external stimuli.

    Measured: Duration from the time patients awakening to the time of departure from PACU, average 1 hour.

  6. Delayed emergence

    Delayed emergence is defined as failure to shake hands and no significant response to nociceptive stimuli more than 30 minutes after surgery.

    Measured: Duration from the time patients awakening to the time of departure from PACU, average 1 hour.

  7. The incidence of postoperative delirium

    The incidence of postoperative delirium was assessed using CAM Scale.

    Measured: Record in the mornings on the 1st, 3rd and 7th day after operation.

  8. Postoperative Pain

    The Numericrating scale (NRS) is grouped from 0 to 10. The degree of pain increased directly with the score.

    Measured: Record in the mornings on the 1st, 3rd and 7th day after operation.

  9. Complication

    All the perioperative complications are recorded.

    Measured: During the perioperative period, up to 1 week.

  10. Hospitalization time

    The length of hospital stay is recorded.

    Measured: After the patient is discharged from the hospital, average 1 week.

  11. Hospital expenses

    Hospitalization costs include total hospitalization costs and anesthesia costs.

    Measured: After the patient is discharged from the hospital, average 1 week.

  12. 30-day all-cause mortality

    30-day all-cause mortality is recorded.

    Measured: 30 days after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Nov 2022
  2. Study start15 Nov 2022 (estimated)
  3. Primary completion31 Oct 2023 (estimated)
  4. Study completion31 Oct 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a RCTs.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
1,317 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05624424
Sponsor's protocol ID
2022-EA-2
Status last verified
Nov 2022
First submitted
7 Nov 2022
Last updated
22 Nov 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Rematazolam Besylate, Propofol and Sevoflurane in people with Emergence Agitation and Remimazolam Besylate, run by Second Affiliated Hospital of Nanchang University at 6 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 22 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Fuzhou Hua, professor (+8615170238929, huafuzhou@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The incidence of emergence agitation (time frame: Duration from the time patients awakening to the time of departure from post-anesthesia care unit (PACU), average 1 hour.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Nov 2022.

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