A total of 120 patients (American Society of Anesthesiologist Physical Status 1-3) who signed a consent form among patients aged 19-80 years who are scheduled to undergo brachial plexus block and upper extremity surgery under monitored anesthetic care at our hospital were enrolled. Recruited patients are divided into three groups through computer-generated randomization by using the patient identification number assigned during patient recruitment. (40 people in each group) Standard monitoring is performed when the patient arrives at the operating room. Patients receive oxygen at 5-6 L/min using a simple facial mask, and receive a brachial plexus block under ultrasound guidance. After confirming the success of brachial plexus block, administration of propofol, remimazolam, or dexmedetomidine is started according to the assigned group. Assess the patient's level of consciousness through the MOAA/S (modified observer's assessment of alertness/sedation scale) scale. The drug injection ends when the skin suture is started after the main procedure. The time from the end of injection of each drug until MOAA/S becomes 5 points is measured. After the patient is transferred to the recovery room, the Aldrete score is assessed. The recovery profile, perioperative hemodynamic change, desaturation event, block duration, patient movement during surgery, patient satisfaction, and surgeon's satisfaction were investigated and analyzed for comparison.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
The patient receives continuous infusion of remimazolam at a rate of 0.3-1.0 mg/kg/hr.
Patients are administered propofol at an effective site concentration of 1.0-2.5 mcg/ml through target-controlled infusion.
The patient is administered a dose of dexmedetomidine at 1 mcg/kg for 10 minutes, followed by continuous infusion at a rate of 0.2-1.0 mcg/kg/hr.
Asan Medical Center
Seoul, South Korea
Recovery profile
Time taken for MOAA/S score to reach 5 (MOAA/S: Modified Observer's Alertness/Sedation scale) Awake (5) - Unresponsive (0)
Time frame: up to 1 hour after post-anesthesia case unit entry
Length of stay in post-anesthesia care unit
Length of stay from entering PACU to leaving
Time frame: up to 3 hours after post-anesthesia case unit entry
Intraoperative hypotension
mean blood pressure less than 60mmHg
Time frame: up to 1hour from the initiation of sedative administration
Occurrence of desaturation during surgery
Oxygen saturation less than 92%
Time frame: From the start of sedative injection to the end of surgery or assessed up to 3 hours
Duration of nerve block
Time frame: From end of surgery until 24 hours after end of surgery
patient satisfaction
7 point Likert scale
Time frame: From end of surgery until 24 hours after end of surgery
Surgeon's satisfaction
7 point Likert scale
Time frame: From end of surgery until 24 hours after end of surgery
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