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CompletedNCT07076628Updated Jul 22, 2025

Respiratory Depression of Remimazolam vs. Propofol for Monitored Anesthesia Care

A Phase 4 interventional study of Propofol and Remimazolam in Propofol, Remimazolam and Hysteroscopic Surgery, sponsored by DongGuk University. Completed at 1 site in South Korea. Open to female participants aged 19 Years to 60 Years. Per ClinicalTrials.gov, last updated 2025-07-22.

Sponsored by DongGuk University · Phase 4, Interventional, and Supportive care

Phase
Phase 4
Study type
Interventional
Enrollment
76
Allocation
Randomized
Ages
19 Years to 60 Years
Sex
Female
01

Study summary

The comparison of incidence of respiratory depression between remimazolam and propofol under monitored anesthesia care for hysteroscopic surgery

Read the detailed description
  • Non-invasive blood pressure, electrocardiogram, and oxygen saturation sensors are attached.

    • Wear an oxygen mask (5L per minute), and place the sampling line for end-tidal carbon dioxide partial pressure measurement inside the nose.

      • Check the randomization table to determine the drug to be administered, and prepare propofol or remimazolam accordingly.

        • Record the baseline values (0 min).

          • Start administration of Remifentanil.

            ⑥ Administer anesthesia to adjust the maintenance dose to reach a sedation level of 2 or less on the MOAA/S scale.

            ⑦ Adjust the remifentanil dose according to the patient's response

            ⑧ When the target sedation level is reached, the surgical preparation process and surgery begin, and the study variables are observed and recorded at 5-minute intervals.

            ⑨ Stop drug administration upon end of surgery.

            ⑩ After confirming proper recovery of consciousness and spontaneous breathing, leave the recovery room.

            ⑪ Before leaving the recovery room, check the complete recovery and investigate the patient's satisfaction with anesthesia.

02

Conditions studied

  • Propofol
  • Remimazolam
  • Hysteroscopic Surgery
  • Respiratory Insufficiency
  • Hemodynamics Instability
03

Who can participate

Ages eligible
19 Years to 60 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • ASA PS 1-2
  • Elective hysteroscopic surgery under monitored anesthesia care
  • No drug abuse history

Exclusion criteria

Exclusion Criteria:

  • BMI > 30 kg/m2
  • Hepatic or renal insufficiency
  • Alcohol abuse
  • Respiratory, hemodynamic compromise, or diseases
  • History of general/regional anesthesia during the last month
  • A patient who is taking sedatives or analgesics
  • Under the investigator's judgment
04

Study design

Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
76 participants (actual)

Study arms

  • Active comparator
    Propofol group

    Propofol infusion with remifentanil for hysteroscopic surgery

    Drug: Propofol

  • Active comparator
    Remimazolam group

    Remimazolam infusion with remifentanil for hysteroscopic surgery

    Drug: Remimazolam

Interventions

  • DrugPropofol

    Propofol infusion with remifentanil

  • DrugRemimazolam

    Remimazolam infusion with remifentanil

05

What researchers measure

Primary outcomes

  1. Respiratory insufficiency before surgery

    Respiratory rate \< 9/min, Apnea \> 29 s, ETCO2 \> 54 mmHg, SpO2 \< 96%

    Time frame: From the beginning of drug infusion until the moment of starting surgery (assessed up to 30 minutes)

  2. Respiratory insufficiency during surgery

    Respiratory rate \< 9/min, Apnea \> 29 s, ETCO2 \> 54 mmHg, SpO2 \< 96%

    Time frame: From the beginning of the surgery until the end of the drug infusion (assessed up to 60 minutes)

Secondary outcomes

  1. Pain on injection

    Patients will answer just after drug infusion begins (Yes or No)

    Time frame: Just after the beginning of drug infusion

  2. Hypertension

    \> 140 mmHg during Monitored Anesthetic Care (MAC)

    Time frame: Through the Monitored Anesthetic Care (From the beginning of drug infusion until the end of the drug infusion) up to 60 minutes

  3. Hypotension

    \< 90 mmHg during the Monitored Anesthetic Care

    Time frame: Through the Monitored Anesthetic Care (From the beginning of drug infusion until the end of the drug infusion) up to 60 minutes

  4. Bradycardia

    Heart rate \< 50/min during the Monitored Anesthetic Care

    Time frame: Through the Monitored Anesthetic Care (From the beginning of drug infusion until the end of the drug infusion) up to 60 minutes

  5. Tachycardia

    Heart rate \> 100/min during the Monitored Anesthetic Care

    Time frame: Through the Monitored Anesthetic Care (From the beginning of drug infusion until the end of the drug infusion) up to 60 minutes

  6. Maximum ETCO2

    ETCO2 will be measured every single respiration in the nasal cavity

    Time frame: Through the Monitored Anesthetic Care (From the beginning of drug infusion until the end of the drug infusion) up to 60 minutes

  7. Patient satisfaction with Monitored Anesthetic Care

    4-point rating scale on the Satisfaction with MAC (4: Fully satisfied, 3: Partially satisfied, 2: Partially unsatisfied, 1: Totally unsatisfied)

    Time frame: Just before leaving the recovery room

  8. Postoperative Nausea/Vomiting (PONV)

    Patients are asked to answer yes/no on PONV, just before leaving the recovery room.

    Time frame: During staying at the recovery room (up to 60 minutes)

06

Study locations

1 site
  • Dept. of anesthesiology and pain medicine, Dongguk University Ilsan Hospital
    Goyang, Gyeonggido 10326, South Korea
07

References and documents

Publications

  • Zhang X, Li S, Liu J. Correction to: Efficacy and safety of remimazolam besylate versus propofol during hysteroscopy: single-centre randomized controlled trial. BMC Anesthesiol. 2021 Jun 18;21(1):173. doi: 10.1186/s12871-021-01390-x. No abstract available. PubMed 34144683 ↗
  • Antonik LJ, Goldwater DR, Kilpatrick GJ, Tilbrook GS, Borkett KM. A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part I. Safety, efficacy, and basic pharmacokinetics. Anesth Analg. 2012 Aug;115(2):274-83. doi: 10.1213/ANE.0b013e31823f0c28. Epub 2011 Dec 20. PubMed 22190555 ↗
  • Wiltshire HR, Kilpatrick GJ, Tilbrook GS, Borkett KM. A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part II. Population pharmacokinetic and pharmacodynamic modeling and simulation. Anesth Analg. 2012 Aug;115(2):284-96. doi: 10.1213/ANE.0b013e318241f68a. Epub 2012 Jan 16. PubMed 22253270 ↗
  • Sneyd JR, Rigby-Jones AE. Remimazolam for anaesthesia or sedation. Curr Opin Anaesthesiol. 2020 Aug;33(4):506-511. doi: 10.1097/ACO.0000000000000877. PubMed 32530890 ↗
  • Doi M, Morita K, Takeda J, Sakamoto A, Yamakage M, Suzuki T. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial. J Anesth. 2020 Aug;34(4):543-553. doi: 10.1007/s00540-020-02788-6. Epub 2020 May 16. PubMed 32417976 ↗
08

Registry details

Key details

Study ID
NCT07076628
Lead sponsor
DongGuk University
Responsible party
Junyong In, MD, PhD (Professor, DongGuk University) — Principal investigator
First posted
Jul 22, 2025
Start date
Aug 24, 2023
Primary completion
May 30, 2025
Completion
May 30, 2025
Last update
Jul 22, 2025

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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