Dynamic Cerebral Autoregulation, General Anesthesia, Laparoscopic Cholecystectomy, Propofol, Remimazolam
Conditions
Keywords
General Anesthesia, Laparoscopic Cholecystectomy, Remimazolam, Propofol, dynamic cerebral autoregulation
Brief summary
Cerebral autoregulation (CA) is the property of the cerebral vascular bed to maintain cerebral perfusion in the presence of changes in blood pressure. In the case of anesthesia, altered cerebral autoregulation, including altered carbon dioxide and hemodilution, can impair physiological changes in the body and lead to poor postoperative prognosis. As a novel ultra-short-acting benzodiazepines drugs, remimazolam has been accepted for induction and maintenance of clinical anesthesia. Compared to the 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. Our study aimed to investigate the different effects of remimazolam and propofol on dynamic cerebral blood flow autoregulation function during general anesthesia.
Interventions
DRUGRemimazolam
The experimental group was sedated with remimazolam.
DRUGPropofol
The control group was sedated with propofol.
Sponsors
Second Affiliated Hospital of Nanchang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18-60 years, gender not limited 2. Patients proposed to undergo elective laparoscopic cholecystectomy under general anesthesia, with an expected operative length of approximately 1h\ 2h 3. Good penetration of the temporal window. 4. ASA anesthesia classification grade I to II. 5. can communicate effectively with the physician. 6. Patients were aware of and voluntarily signed the informed consent form.
Exclusion criteria
1. Relative contraindications to general anesthesia: patients with severe heart and lung function diseases. 2. History of syncope, and dizziness. 3. Patients with a history of psychiatric disorders, neurological disorders, drug abuse, or drug addiction 4. Patients with cerebrovascular or carotid artery lesions; 5. Those who are unable to cooperate in completing the test 6. Persons who have taken benzodiazepines intermittently in the last three months. 7. Those with known allergies or allergies to the test drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Differences in dynamic cerebral blood flow autoregulation | From the time the patient enters the operating room to the time they leave the operating room, one and a half hours on average. | Comparison of the consistency, gain and phase of the transfer function parameters in the frequency range of 0.02-0.07 Hz, 0.07-0.2 Hz and 0.2-0.5 Hz for the propofol and rimazolam groups, respectively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| diastolic pressure | Up to 5 hours including preoperative, intraoperative, and postoperative periods | Indicators related to perioperative hemodynamics |
| mean pressure | Up to 5 hours including preoperative, intraoperative, and postoperative periods | Indicators related to perioperative hemodynamics |
| heart rate | Up to 5 hours including preoperative, intraoperative, and postoperative periods | Indicators related to perioperative hemodynamics |
| systolic pressure | Up to 5 hours including preoperative, intraoperative, and postoperative periods | Indicators related to perioperative hemodynamics |
| Recovery times | Up to 30 minutes after operation | The period from discontinuation of anesthetic drugs to the recovery of the patient's self-consciousness and can respond correctly to external stimuli. All the patients can be allowed to leave the post-anesthesia care unit after Aldrete ≥ 9. Delayed awakening is defined as failure to achieve Aldrete ≥ 9 more than 30 minutes after surgery. |
| Complication | During the perioperative period | All the perioperative complications are recorded. |
| pulse | Up to 5 hours including preoperative, intraoperative, and postoperative periods | Indicators related to perioperative hemodynamics |
Countries
China
Contacts
Primary ContactFuzhou Hua, professor
Backup ContactXing Liu, Dr.
Outcome results
None listed