Remimazolam is a novel benzodiazepine with ultra-short onset and offset of its effect. It can be used for general anesthesia. However, classical benzodiazepine such as midazolam was reported to increase the risk of postoperative delirium. Thus, the investigators aim to investigate the effect of remimazolam general anesthesia on postoperative delirium in elderly patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
262
continuous infusion
continuous infusion
Xijing hospital, Fourth military medical university
Xi'an, Shaanxi, China
incidence of delirium by 3 days after surgery
Time frame: from end of surgery to 3 days after surgery, in a total of 3 days
incidence of delirium by 30 minutes after extubation (emergence delirium)
Time frame: from extubation of tracheal tube to 30 minutes after extubation, in a total of 30 minutes
incidence of delirium by 1 day after surgery
Time frame: from end of surgery to 1 day after surgery, in a total of 1 day
time to eye opening
Time frame: from end of surgery to open eye response to verbal command, in an average of 10 minutes
time to orientation
Time frame: from end of surgery to being able to speak out name in an average of 10 minutes
incidence of hypotension during surgery
hypotension is defined as systolic blood pressure decreasing by more than 20% of baseline value
Time frame: from start of anesthesia induction to extubation, in an average of 2 hours
dosage of vasoactive drugs during surgery
vasoactive drugs refer to norepinephrine and epinephrine
Time frame: from start of anesthesia induction to extubation, in an average of 2 hours
Duration of sleep on the first night after surgery
sleep is monitored by a wrist acti-graphy
Time frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
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the visual analogue scale of sleep on the next day after surgery
0 is the worst quality of sleep, 10 is the best quality of sleep
Time frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
the Athens Insomnia scale (AIS) of sleep on the next day after surgery
The AIS is a self-reported questionnaire designed to quantify sleep difficulty based on ICD-10 diagnostic criteria. It consists of 8 items rated on a 4-point scale (0 = no problem, 3 = severe problem), yielding a total score ranging from 0 to 24. A cutoff score of 6 provides optimal sensitivity and specificity for screening insomnia.
Time frame: from end of surgery to 24 hours after surgery, in a total of 24 hours
the time to onset of delirium
Time frame: from end of surgery to onset of delirium, in an average of 1 days
the duration of delirium
the time between the first and last delirium-positive days
Time frame: from onset of delirium to the last day of delirium, in an average of 3 days