Background: The clinical efficacy of effect-site targeted patient-maintained propofol sedation (PMPS) compared to anaesthetist-controlled propofol sedation (ACPS) for patients undergoing awake joint replacement surgery is currently unknown. There is no commercially available medical device capable of delivering PMPS so we have designed and built such a device. We plan a clinical trial to compare PMPS to ACPS and to collect data relating to the safety of our prototype device in delivering sedation.
Methods: The trial is an open-label, randomised, controlled superiority trial recruiting adults who are undergoing elective primary lower-limb arthroplasty with sedation by propofol infusion by effect-site targeting into two equal-sized parallel arms: PMPS and ACPS. The primary research objective is to compare the body-weight-normalised rate of propofol consumption when sedation for surgery on adults undergoing elective primary lower-limb arthroplasty under spinal anaesthesia is patient-maintained versus when it is anaesthetist-controlled. The study primary null hypothesis is that there is no difference in the rate of propofol consumption when sedation is patient-maintained versus anaesthetist-controlled.
Discussion: This is the first trial to test the superiority of effect-site-targeted patient-maintained propofol sedation versus anaesthetist-controlled propofol sedation in terms of total propofol consumption during the sedation period. The results of this trial will help inform clinicians and device manufacturers of the clinical efficacy and safety of patient-maintained propofol sedation applied to a common operative setting.
Trial Registration: International Standard Randomised Controlled Trial Number Registry, ISRCTN29129799 . Prospectively registered on 12 June 2018.
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http://dx.doi.org/10.1186/s13063-019-3228-4 | DOI Listing |
Ann Intensive Care
January 2025
Department of Intensive Care Unit, Yanbian University Hospital, No. 1327, Juzi Street, Xinxing Street, Yanji, 136200, Jilin, China.
Background: Invasive procedures and environmental factors in the intensive care unit (ICU) may cause anxiety and discomfort in patients, who often require sedation therapy. The aim of this study was to assess the safety of remimazolam tosilate for procedural sedation in ICU patients receiving mechanical ventilation following endotracheal intubation. Eighty patients from a single centre were randomly assigned to either the propofol group or the remimazolam group.
View Article and Find Full Text PDFClin Endosc
January 2025
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
Eur Arch Otorhinolaryngol
January 2025
Sleep Disorders Center, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
Objective: In this study, we aimed to evaluate the localization and configuration of vibration and obstruction in drug-induced sleep endoscopy(DISE) in obstructive sleep apnea patients and to investigate the optimal sedation depth.
Materials And Methods: The study was conducted prospectively with 42 patients. After achieving sedation with intravenous anesthetic agents, simultaneous monitoring of the patient's bispectrometry (BIS), DISE and sleep testing with a type 2 polysomnography device were performed.
Pak J Pharm Sci
January 2025
Department of Anesthesiology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Jiangsu, China.
Traditional sedatives like Propofol can lead to adverse effects. This study compares the safety and efficacy of Ciprofol monotherapy versus combined Propofol for painless gastroscopy. Patients underwent painless gastroscopy at our hospital from January 2023 to December 2023 were studied.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, Beijing, Xicheng District, 100050, China.
Background: As a popularly used analgesic adjuvant, intravenous (IV) lidocaine could reduce the consumption of propofol in painless gastrointestinal (GI) endoscopy. However, whether IV lidocaine could affect the incidence of oxygen-desaturation episodes (ODE) during painless GI endoscopy is still unknown. Therefore, we tested the hypothesis that IV lidocaine could decrease the incidence of propofol-induced ODE and involuntary movements in patients during GI endoscopy.
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