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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Remimazolam group | Experimental |
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| Propofol group | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Remimazolam | Drug | The experimental group was sedated with remimazolam. |
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| Measure | Description | Time Frame |
|---|---|---|
| Differences in dynamic cerebral blood flow autoregulation | 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. | From the time the patient enters the operating room to the time they leave the operating room, one and a half hours on average. |
| Measure | Description | Time Frame |
|---|---|---|
| systolic pressure | Indicators related to perioperative hemodynamics | Up to 5 hours including preoperative, intraoperative, and postoperative periods |
| diastolic pressure | Indicators related to perioperative hemodynamics |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fuzhou Hua, professor | Contact | +8615170238929 | huafuzhou@126.com | |
| Xing Liu, Dr. | Contact | +8618379804346 | liuxingmed@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| the Second Affiliated Hospital of Nanchang University, Nanchang University | Recruiting | Nanchang | Jiangxi | China |
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| Propofol | Drug | The control group was sedated with propofol. |
|
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| Up to 5 hours including preoperative, intraoperative, and postoperative periods |
| mean pressure | Indicators related to perioperative hemodynamics | Up to 5 hours including preoperative, intraoperative, and postoperative periods |
| heart rate | Indicators related to perioperative hemodynamics | Up to 5 hours including preoperative, intraoperative, and postoperative periods |
| pulse | Indicators related to perioperative hemodynamics | Up to 5 hours including preoperative, intraoperative, and postoperative periods |
| Recovery times | 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. | Up to 30 minutes after operation |
| Complication | All the perioperative complications are recorded. | During the perioperative period |
| ID | Term |
|---|---|
| C522201 | remimazolam |
| D017409 | Sufentanil |
| C101584 | cisatracurium |
| D015742 | Propofol |
| ID | Term |
|---|---|
| D005283 | Fentanyl |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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