Remimazolam vs Dexmedetomidine for Sedation During Cesarean Delivery

AT
Overseen ByAlexander Tran
Age: 18+
Sex: Female
Trial Phase: Phase 4
Sponsor: Icahn School of Medicine at Mount Sinai
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two sedation drugs, remimazolam and dexmedetomidine, to determine which is more effective for women undergoing scheduled cesarean delivery. The goal is to identify which drug provides effective sedation with fewer side effects during spinal or epidural anesthesia. Women who are at least 37 weeks pregnant and scheduled for a cesarean delivery may be eligible to participate. As a Phase 4 trial, this research aims to understand how these FDA-approved drugs can benefit more patients, contributing to improved sedation options for future cesarean deliveries.

What is the safety track record for these treatments?

Previous studies have shown that remimazolam is safe for use in sedation. It generally has less impact on blood pressure and heart rate compared to other sedatives. Research also shows it effectively achieves the desired level of sedation, with fewer side effects like low blood pressure and slow heart rate.

Dexmedetomidine, another sedative, can sometimes affect heart rate and blood pressure. While effective, these possible effects should be considered.

Both treatments have been researched for their safety and effectiveness. Remimazolam is particularly noted for its quick onset and recovery times, which can benefit patients undergoing a cesarean delivery.12345

Why are researchers enthusiastic about this study treatment?

Remimazolam is unique because it offers a new approach to sedation during cesarean deliveries by providing rapid onset and quick recovery times, which can be especially beneficial in time-sensitive procedures. Unlike standard sedatives like midazolam and propofol, remimazolam is metabolized quickly by the body, reducing the risk of prolonged sedation and potential side effects. Researchers are excited because its fast action and predictable recovery profile could enhance patient comfort and safety during and after the procedure. Meanwhile, dexmedetomidine, known for its sedative properties with minimal respiratory depression, offers an alternative that may lead to a smoother sedation experience compared to other options.

What evidence suggests that this trial's treatments could be effective for sedation during cesarean delivery?

This trial will compare the effectiveness of remimazolam and dexmedetomidine for sedation during cesarean deliveries. Research has shown that remimazolam effectively keeps patients calm and comfortable during these procedures. It eases patient anxiety, reduces nausea and vomiting, and succeeds in over 98% of cases. Patients also wake up faster and feel clear-headed after using remimazolam.

Dexmedetomidine, which participants in this trial may receive, is another option known for its calming effects and is commonly used in medical procedures. It provides steady and calm sedation with little risk of breathing problems. Both treatments have shown promising results for safely calming patients during procedures like cesarean deliveries.35678

Who Is on the Research Team?

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Benjamin Hyers, MD

Principal Investigator

Icahn School of Medicine at Mount Sinai Department of Anesthesiology, Perioperative, and Pain Medicine

Are You a Good Fit for This Trial?

This trial is for pregnant women aged 18 or older, at least 37 weeks along, who are scheduled for a cesarean delivery and need spinal or epidural anesthesia. Those allergic to the study drugs, under 18, less than 37 weeks pregnant, or with chronic benzodiazepine use can't join.

Inclusion Criteria

Gestational age 37 weeks or greater
I am 18 years old or older.
I am pregnant and scheduled for a cesarean delivery.

Exclusion Criteria

Known hypersensitivity to benzodiazepines or dexmedetomidine
I am pregnant and less than 37 weeks along.
History of chronic benzodiazepine use or misuse
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive intravenous remimazolam or dexmedetomidine for procedural sedation during neuraxial anesthesia placement for cesarean delivery

Up to 4 hours
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including patient satisfaction and memory preservation

Up to 4 hours post-delivery
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Dexmedetomidine
  • Remimazolam

Trial Overview

The study compares two sedative medications—remimazolam and dexmedetomidine—given through an IV during spinal or epidural anesthesia placement in planned C-sections. Participants are randomly assigned to one of the two drugs.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: RemimazolamExperimental Treatment1 Intervention
Group II: DexmedetomidineActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Icahn School of Medicine at Mount Sinai

Lead Sponsor

Trials
933
Recruited
579,000+

Citations

Intraoperative remimazolam-nalbuphine infusion reduces ...

Remimazolam combined with nalbuphine significantly reduces VTR during cesarean delivery, providing effective sedation and analgesia while maintaining ...

Remimazolam in obstetric anaesthesia: a focused review

Remimazolam was associated with deeper sedation, improved maternal comfort, and a lower incidence of newly developed intraoperative nausea and vomiting

Comparison of remimazolam and midazolam ...

In conclusion, compared with midazolam, remimazolam significantly reduced the incidence and severity of newly developed IONV during sedation ...

Effectiveness of Remimazolam on Preventing Adverse ...

Remimazolam significantly reduces nausea and vomiting in cesarean sections, enhancing patient satisfaction (P < 0.05).

Perioperative clinical outcomes of remimazolam in regional ...

Qiao et al. also reported a high overall sedation success rate (98.93%) with remimazolam [19]. These data suggest that remimazolam may provide ...

Remimazolam as a Novel Option for Procedural Sedation - PMC

Clinical studies have demonstrated that remimazolam not only provides faster induction and recovery times but also achieves higher sedation ...

Review of clinical advances in the procedural sedation ...

Results demonstrated a 100% sedation success rate for remimazolam, along with predictable duration of action and high sedation safety. This study suggests that ...

Remimazolam and Its Place in the Current Landscape of ...

remimazolam was seen to have a quicker onset of sedation, stronger safety profile and shorter neuropsychiatric recovery period