Remimazolam is a novel short-acting benzodiazepine drug that acts on the benzodiazepine binding site of gamma-aminobutryic acid (GABA) A receptor, is metabolized by esterase, and has a context-sensitive half-time of about 6-7 minutes. Looking at some previous studies using Remimazolam, the safety and efficacy as a general anesthetic have been sufficiently proven. In particular, compared to intravenous anesthetic agents such as propofol, the action time of anesthetics is relatively longer, but the frequency of hypotension is low. However, most studies have been conducted on patients of American Society Anesthesiologist (ASA) class I-II, and studies on patients with high severity have not yet been sufficiently secured. Therefore, this study aims to compare the efficacy and safety of Remimazolam as an anesthetic with Sevoflurane in terms of hemodynamics in patients with high severity undergoing OPCAB surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
94
Induction dose: 6 mg/kg/h with sufentanil Maintenance dose: 1\~2 mg/kg/h with sufentanil If arousal occurs during surgery, rapidly increase the infusion rate of remimazolam to 12 mg/kg/h and infuse for 1 minute. If the patient's arousal persists after these measures, stop remimazolam infusion and replace with another drug.
Induction dose: 2\~3 mg midazolam with sufentanil Maintenance: Adjust the concentration to be BIS 35-65 based on 0.5 mac If arousal occurs during surgery, raise the concentration of sevoflurane to 1.5 MAC (increase the total gas flow rate to 8 l/min) and if arousal persists after 1 minute, administer midazolam 2-3 mg.
Ajou University Hospital
Suwon, Gyeonggido, South Korea
cardiac index (T4)
The cardiac index (CI) at that time was measured and compared between the two groups.
Time frame: 5 minutes before operation
cardiac index (T5)
The cardiac index (CI) at that time was measured and compared between the two groups.
Time frame: 10 minutes after starting left internal mammary artery dissection
cardiac index (T6)
The cardiac index (CI) at that time was measured and compared between the two groups.
Time frame: 10 minutes after starting left anterior descending coronary artery anastomosis
cardiac index (T7)
The cardiac index (CI) at that time was measured and compared between the two groups.
Time frame: 10 minutes after starting Y-graft anastomosis of graft vessels
NE dose
total amount of norepinephrine during OPCAB
Time frame: During surgery(from induction of anesthesia to end of surgery)
Incidence of hypotension
The incidence of hypotension during OPCAB are counted by number which based on the anesthetic record.
Time frame: During surgery(from induction of anesthesia to end of surgery)
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