Acute Cholecystitis
Conditions
Brief summary
This study is conducted to determine whether the occurrence of hypotension is reduced by the combined use of remimazolam and remifentanil compared to the conventional combination use of propofol and remifentanil. Patients enrolled in the study are infused continuously with either propofol or remimazolam from the start of anesthesia to the end of surgery.
Interventions
DRUGpropofol group
During induction, the propofol group starts the effect site concentration at 4.0 ng/ml with TCI and adjusts it to around 3.0 \ 4.0 ng/ml after intubation to maintain an appropriate EEG-based depth of anesthesia.
In the remimazolam group, start remimazolam at 6 mg/kg/hr and adjust it to 1 mg/kg/hr after loss of consciousness to maintain an appropriate EEG-based depth of anesthesia.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
1. patients 19 years of age or older 2. the American Society of Anesthesiologists classification 1-3 3. patients undergoing laparoscopic cholecystectomy at Severance Hospital
Exclusion criteria
1. Emergency surgery, 2. patients with heart disease or arrhythmias, 3. patients undergoing concurrent surgery other than laparoscopic cholecystectomy, 4. obesity (BMI\>30), 5. patients who were admitted on the surgery day, 6. foreigners, 7. illiteracy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Percent of patients with hypotension event | from start of drugs to end of anesthesia on the surgery 1 day |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time-weighted average of hypotension | from start of drugs to end of anesthesia on the surgery 1 day | time-weighted average of hypotension is calculated as the depth of hypotension below a MAP of 65 mm Hg (in millimeters of mercury) × time spent below a MAP of 65 mm Hg (in minutes) divided by total duration of operation (in minutes). |
| dose of Norepinephrine or nicardipine | from start of drugs to end of anesthesia on the surgery 1 day | — |
| difference of QOR-40 score | Baseline (preoperative period) and Postoperative day 1 | QoR-40 was developed by Myles et al and is a questionnaire that can examine the quality of recovery and health status of patients in the early postoperative period. Patients will also fill out a questionnaire before surgery for comparison with postoperative scores. |
| Heart rate variability | from start of drugs to end of anesthesia on the surgery 1 day | Heart rate variability is a relatively easy and non-invasive measurement method that reflects the level of balance between the sympathetic and parasympathetic nerves at every moment using EKG records. |
| Sedline(Psi) | from start of drugs to end of anesthesia on the surgery 1 day | — |
Countries
South Korea
Outcome results
None listed