Efficacy and safety of remimazolam tosylate for sedation during upper gastrointestinal endoscopy: study protocol for a multicenter randomized controlled trial

Trials

Study Protocol

Caiyang Chen¹  Xiao Zhang¹  Zhongxue Su¹  Diansan Su¹  Xiaorong Huai¹  Huichen Zhu¹  Jie Zhou¹ 

[1]Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, 200127, Shanghai, China

关键词: Remimazolam tosylate;    Efficacy;    Safety;    Sedation;    Upper gastrointestinal endoscopy;   

DOI  :  10.1186/s13063-022-06935-0

 received in 2022-07-11, accepted in 2022-11-15,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundGastrointestinal endoscopy has been associated with difficult experiences and can leave patients with an unpleasant impression. Propofol and midazolam are the most commonly used intravenous anesthetics for sedation during gastrointestinal endoscopy. However, cardiac and pulmonary adverse events are the primary concerns associated with the use of these sedatives. Remimazolam tosylate is an ultra-short-acting benzodiazepine drug with a mild inhibitory effect on the respiratory and circulatory systems. These properties qualify remimazolam tosylate to be used as a replacement for propofol or midazolam as a sedative during gastrointestinal endoscopy. This study aims to describe the efficacy and safety of remimazolam tosylate as a sedative for upper gastrointestinal endoscopy.MethodsA multicenter, randomized, single-blind, parallel-controlled, noninferiority clinical study will be conducted to evaluate the efficacy and safety of remimazolam tosylate as a sedative during upper gastrointestinal endoscopy. Participants (n = 1800) will be randomized to receive remimazolam tosylate at 0.15 mg/kg (experimental group 1), remimazolam tosylate at 0.2 mg/kg (experimental group 2), or propofol at 1.5 mg/kg (control group). Procedure success will be assessed and defined as the completion of upper gastrointestinal endoscopy without the administration of a rescue sedative agent or more than two top-up doses of the trial drug in any 5-min period after initial administration. Sedation quality will be evaluated using the Modified Observer’s Assessment of Alertness/Sedation score. Adverse events will be recorded to evaluate safety.DiscussionThis study will determine the optimal dosage of remimazolam tosylate during upper gastrointestinal endoscopy and will describe its efficacy and safety. These findings may contribute to a more comfortable and safer experience for patients compared with that when the conventional sedative propofol is used.Trial registrationClinicalTrials.gov NCT04727034. Registered on February 18, 2021.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 2

13731_2022_257_Article_IEq12.gif