There is high incidence of hemodynamic instability in patients undergoing hepatectomy with low central venous pressure, especially in general anesthesia combined with epidural anesthesia. Remazolam, a new benzodiazepine, has no significant cardiovascular inhibitory effect. Investigators hypothesis that remazolam will provide better hemodynamic when compared with propofol in patients undergoing hepatectomy with general anesthesia combined with epidural anesthesia.
Investigators plan to adopt the following strategies in the clinical study of this project: (1) To compare remazolam and propofol during anesthetic induction and maintenance; (2) Remazolam group: remazolam is administered 0.3mg/kg intravenous for anesthesia induction. Propofol group: propofol is administered 2mg/kg intravenous for anesthesia induction; (3) Epidural analgesia is used during perioperative period, and remifentanil pump injection is used during the operation to assist the subjects to tolerate the tracheal catheter; (4) the haemodynamic instability score (Hemodynamic instability score) is used to comprehensively evaluate intraoperative hemodynamic status. (5) To evaluate the incidence of postoperative complications. Through the above strategies, investigators further determine the optimization effect of remazolam, a novel benzodiazepine drug, on intraoperative hemodynamics in patients undergoing low central venous pressure hepatectomy, and further lay an empirical foundation for the routine use of remazolam in clinical hepatectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
70
Remimazolam is used for sedation during anesthetic induction and maintenance.
propofol is used for sedation during anesthetic induction and maintenance.
Fudan University Shanghai Cancer Center
Shanghai, China
Hemodynamic instability score
The hemodynamic instability score is calculated as a weighted continuous measure ranging from 0 to 160 points, intended to reflect deviations of blood pressure and heart rate from predefined thresholds, and infusion rates of vasoactive agents and fluids.
Time frame: intraoperative
Cardiac index (CI)
The parameter of CI is measured by advanced hemodynamic monitoring device.
Time frame: intraoperative
Stroke volume variation (SVV)
The parameter of SVV is measured by advanced hemodynamic monitoring device.
Time frame: intraoperative
Systemic vascular resistance index (SVRI)
The parameter of SVRI is measured by advanced hemodynamic monitoring device.
Time frame: intraoperative
Complications in 1 week after surgery
Complications occured within 1 week after surgery
Time frame: 1 week after surgery
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