Efficacy and Safety of Eleveld PK/PD Model-based Dosing During General Anesthesia
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Eleveld model-guided dosing, Standard weight-based label dosing.
- Кому может быть актуально
- Состояния в реестре: Remimazolam, Pharmacokinetics and Pharmacodynamics. Базовые параметры: 19 лет — 79 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- South Korea
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Comparison of Efficacy and Safety Between Eleveld PK/PD Model-based Dosing and Standard Dosing During General Anesthesia
Обзор
The goal of this randomized, controlled clinical trial is to evaluate the efficacy, safety, and recovery profile of an individualized, Eleveld pharmacokinetic/pharmacodynamic model-guided dosing strategy for remimazolam in adult patients undergoing elective non-cardiac surgery under general anesthesia. The main questions it aims to answer are: Does Eleveld model-guided customized dosing significantly reduce the eye-opening time at the end of surgery compared to standard weight-based dosing? Can the Eleveld model-guided approach prevent relative drug accumulation and delayed emergence while maintaining an adequate depth of anesthesia and comparable hemodynamic stability? Researchers will compare the Experimental Group (Eleveld model-guided dosing) to the Control Group (Standard weight-based label dosing) to see if preemptive dose optimization based on individual patient covariates effectively reduces the total drug consumption, frequency of rescue flumazenil administration, and emergence time. Participants will: * Be randomly assigned to receive remimazolam for the induction and maintenance of general anesthesia according to either the Eleveld model-guided customized regimen or the standard weight-based regimen. * Have their depth of anesthesia continuously monitored using a Bispectral Index (BIS) sensor. * Be assessed for the primary outcome (time to eye-opening upon verbal command after discontinuation of anesthetics) and secondary outcomes, including total drug consumption, hemodynamic stability, and postoperative complications (e.g., re-sedation, delirium, PONV).
Вмешательства
- Препарат Eleveld model-guided dosing
Eleveld model-guided dosing via a validated web-based calculator - Препарат Standard weight-based label dosing
Induction at 9 mg/kg/h and maintenance at 1-2 mg/kg/h
Первичные конечные точки
- Eye-Opening Time, EOT [Срок оценки: Time from the discontinuation of remimazolam to eye-opening upon verbal command (min), up to 1h]
Вторичные конечные точки (12)
- Time to loss of consciousness (LOC) [Срок оценки: Time from the start of remimazolam administration to loss of consciousness (min), up to 1h]
- Intraoperative Bispectral Index (BIS) values [Срок оценки: Perioperative/Periprocedural]
- Incidence of intraoperative bradycardia (heart rate < 45 bpm) [Срок оценки: Perioperative/Periprocedural]
- Incidence of intraoperative tachycardia (heart rate > 110) [Срок оценки: Perioperative/Periprocedural]
- Incidence of intraoperative hypotension (mean blood pressure < 65 mmHg) [Срок оценки: Perioperative/Periprocedural]
- Incidence of intraoperative hypertension (SBP > 140 mmHg) [Срок оценки: Perioperative/Periprocedural]
- Total dose of intraoperative remimazolam (mg) [Срок оценки: Perioperative/Periprocedural]
- Total dose of intraoperative remifentanil (㎍) [Срок оценки: Perioperative/Periprocedural]
- Total dose(s) of intraoperative vasopressor(s) [Срок оценки: Perioperative/Periprocedural]
- Extubation time (min) [Срок оценки: Time from the discontinuation of remimazolam to the removal of the endotracheal tube, up to 1h]
- Incidence of flumazenil administration [Срок оценки: From discontinuation of remimazolam to patient discharge from the operating room, up to 1h]
- Incidence of rescue sevoflurane use [Срок оценки: Perioperative/Periprocedural]
Критерии участия
Критерии включения
- Patients aged 19 to 79 years undergoing elective non-cardiac surgery expected to last 60 minutes or longer under general anesthesia with endotracheal intubation
Критерии исключения
- Emergency surgery
- Surgery requiring evoked potential (EP) monitoring
- Chronic benzodiazepine users
- Body Mass Index (BMI) ≥ 35 kg/㎡
- Chronic kidney disease
- Hepatic dysfunction or chronic liver disease
- Contraindication or history of hypersensitivity to remimazolam
- American Society of Anesthesiologists (ASA) physical status ≥ IV
- Pregnant women
- Contraindication or history of hypersensitivity to flumazenil
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Двойное слепое
- Основная цель
- Другое
Центры проведения
South Korea · 1 центр
- Seoul National University Hospital — Seoul
Идентификаторы
NCT: NCT07675850 · 2602-094-1720