UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000042318
Receipt number R000048304
Scientific Title Remimazolam during induction of anesthesia in patients with severe aortic stenosis
Date of disclosure of the study information 2020/11/04
Last modified on 2021/12/08 08:19:24

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Basic information

Public title

Remimazolam during induction of anesthesia in patients with severe aortic stenosis

Acronym

Remimazolam during induction of anesthesia in patients with severe aortic stenosis

Scientific Title

Remimazolam during induction of anesthesia in patients with severe aortic stenosis

Scientific Title:Acronym

Remimazolam during induction of anesthesia in patients with severe aortic stenosis

Region

Japan


Condition

Condition

Severe aortic stenosis

Classification by specialty

Anesthesiology

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

To observe the hemodynamic changes and time to loss of consciousness following the induction of general anesthesia with remimazolam in patients with severe aortic stenosis.
We will also collect data from patients who were used midazolam for induction of anesthesia retrospectively and compare them to remimazolam for hemodynamic and other changes.

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

Dosage of vasoconstrictor and inotropic agents during induction of anesthesia.

Key secondary outcomes

Hemodynamic change (blood pressure and heart rate).
Time to loss of consciousness, time from the start of anesthesia induction to the end of tracheal intubation, total remimazolam dose, change in BIS (bispectral index) level, change in TOI (tissue oxygenation index), postoperative nausea and vomiting, incidence of postoperative delirium, presence or absence of awareness at the time of induction of anesthesia, and postoperative flumazenil use and dose.


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

65 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

Patients with a diagnosis of severe aortic stenosis on a preoperative transthoracic echocardiogram.

Key exclusion criteria

(1) Patients undergoing emergency surgery
(2) Patients who are allergic to the study drugs (fentanyl, remifentanil, rocuronium, sugammadex, benzodiazepines, sevoflurane, desflurane)
(3) Patients for whom the use of remimazolam is contraindicated (patients with acute angle-closure glaucoma, myasthenia gravis, shock, coma, and acute alcoholism with suppressed vital signs)
(4) Patients with preoperative disturbance of consciousness
(5) Patients who have been sedated preoperatively
(6) Patients deemed inappropriate by the principal investigator/associators (excluded with reasons for exclusion)

Target sample size

20


Research contact person

Name of lead principal investigator

1st name Toshiyuki
Middle name
Last name Nakanishi

Organization

Nagoya City University Graduate School of Medical Sciences

Division name

Department of Anesthesiology and Intensive Care Medicine

Zip code

467-8601

Address

Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan

TEL

052-851-5511

Email

nakanishi.anest@gmail.com


Public contact

Name of contact person

1st name Toshiyuki
Middle name
Last name Nakanishi

Organization

Nagoya City University Graduate School of Medical Sciences

Division name

Department of Anesthesiology and Intensive Care Medicine

Zip code

467-8601

Address

Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan

TEL

052-851-5511

Homepage URL


Email

nakanishi.anest@gmail.com


Sponsor or person

Institute

Nagoya City University Graduate School of Medical Sciences, Department of Anesthesiology and Intensive Care Medicine

Institute

Department

Personal name



Funding Source

Organization

None.

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Nagoya City University Graduate School of Medical Sciences and Nagoya City University Hospital Institutional Review Board

Address

Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan

Tel

052-851-5511

Email

clinical_research@med.nagoya-cu.ac.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2020 Year 11 Month 04 Day


Related information

URL releasing protocol


Publication of results

Published


Result

URL related to results and publications

https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-021-01530-3

Number of participants that the trial has enrolled

20

Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2020 Year 10 Month 07 Day

Date of IRB

2020 Year 10 Month 14 Day

Anticipated trial start date

2020 Year 11 Month 05 Day

Last follow-up date

2022 Year 04 Month 30 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information

In this study, we will use remimazolam for induction of general anesthesia in patients with severe aortic stenosis and observe hemodynamic changes, time to loss of consciousness, and so on.

The other observations of the study were as follows.
Age, gender, height, weight, ASA PS, comorbidities, NYHA classification, and Hugh-Jones classification.
Transthoracic echocardiographic measurements (LVDd/Ds, LVEF, E/A/DcT, E/e', maximal flow velocity through the aortic valve, maximal pressure gradient, mean pressure gradient, aortic valve area, left ventricular outflow tract blood flow velocity/aortic valve blood flow velocity, other degrees of valvular disease, tricuspid valve regurgitation pressure gradient, etc.)
Twelve-lead ECG readings: heart rate, presence of arrhythmia, etc.
Chest x-ray: cardiothoracic ratio, presence of pleural effusion
Blood test: Hemoglobin, BUN, creatinine, NT-proBNP, HbA1c
Time from the start of anesthesia induction to the end of tracheal intubation, blood pressure (systolic, diastolic, mean blood pressure) according to arterial pressure waveforms, heart rate, BIS level, cerebral tissue oxygenation.
The amount of remimazolam used, the type and amount of circulating agonists used (e.g. ephedrine, phenylephrine, atropin, noradrenaline, adrenaline, dobutamine, dopamine, and nicardipine)
Flumazenil use and dosage, operative time, postoperative ventilatory time, CAM-ICU (Confusion assessment method for the ICU) assessment of delirium, awareness at the time of intubation, nausea and vomiting up to the second postoperative day, and number of days in the ICU.

We will collect 40 background-matched patients' data with severe aortic stenosis who were previously induced with midazolam retrospectively (1:2 matching) and compare the dosage of vasoconstrictor and inotropic drugs, hemodynamic changes, incidence of postoperative delirium, and so on.


Management information

Registered date

2020 Year 11 Month 02 Day

Last modified on

2021 Year 12 Month 08 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048304


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name