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Peritoneal NeoplasmsREPAIRNCT07785557

Remimazolam Versus Propofol for Early Recovery After Cytoreductive Surgery

A study testing Remimazolam and Propofol in people with Peritoneal Neoplasms and Postoperative Recovery, run by Beijing Tsinghua Chang Gung Hospital at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The REPAIR Trial is a single-center, prospective, randomized, parallel-group superiority trial enrolling 320 adults scheduled for elective cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Peritoneal Neoplasms, Postoperative Recovery
What is being tested?
Remimazolam and Propofol
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
320 participants
Where
1 siteChina
Study dates
Aug 2026to May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1.Age 18 to 75 years. 2.American Society of Anesthesiologists physical status class II or III. 3.Pathologically confirmed primary peritoneal surface malignancy or peritoneal metastasis from colorectal, gastric, ovarian, or appendiceal malignancy.
  • 4.Scheduled for elective cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy under general anesthesia.
  • 5.Expected surgical duration of at least 2 hours and planned postoperative admission to the intensive care unit.
  • 6.Able to understand and independently complete the Chinese Quality of Recovery-15 questionnaire.
  • 7.Willing to participate and able to provide written informed consent. Exclusion Criteria
  • Emergency surgery.
Show all 15Show fewer
  • Uncontrolled bacterial, fungal, or viral infection requiring systemic anti-infective treatment within 14 days before surgery, or temperature of 38.0 °C or higher at post-consent eligibility confirmation with corresponding clinical, imaging, microbiological, or laboratory evidence. Perioperative antimicrobial prophylaxis is not an exclusion.
  • Child-Pugh class C, total bilirubin greater than 3 times the upper limit of normal, or alanine or aspartate aminotransferase greater than 5 times the upper limit of normal.
  • Estimated glomerular filtration rate below 30 mL/min/1.73 m² or maintenance renal replacement therapy.
  • Known allergy to remimazolam, benzodiazepines, propofol, or their excipients, or a contraindication to either study drug.
  • Continuous or near-daily opioid use for at least 90 days before surgery, or benzodiazepine or Z-drug use on at least 5 days per week for at least 4 weeks.
  • Severe cognitive, psychiatric, hearing, speech, or language impairment that prevents understanding and independent completion of the QoR-15 after standardized explanation.
  • Pregnancy or breastfeeding.
  • A preoperative plan for continuous epidural analgesia or another continuous regional analgesic technique that is incompatible with the study's standardized intravenous analgesia pathway.
  • A specific clinical condition that, in the investigator's judgment, would make participation pose an unacceptable risk.

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site
  • Beijing Tsinghua Changgung Hospital

    Beijing, Beijing Municipality, 102218

    Yi Duan, MD, +86-13810385311, dya01610@btch.edu.cn

    dya01610@btch.edu.cn

Other trials in China

About this study

Official title: Effect of Remimazolam Versus Propofol on Early Postoperative Quality of Recovery in Patients Undergoing Cytoreductive Surgery for Peritoneal Surface Malignancies: A Randomized Controlled Trial

The REPAIR Trial is a single-center, prospective, randomized, parallel-group superiority trial enrolling 320 adults scheduled for elective cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Participants will be assigned 1:1 to bispectral index-guided remimazolam- or propofol-based general anesthesia under standardized perioperative care. The primary objective is to determine whether remimazolam improves patient-reported recovery 48 ± 4 hours after surgery, measured by the Chinese 15-item Quality of Recovery score (QoR-15; range, 0 to 150; higher scores indicate better recovery). The investigators hypothesize that remimazolam will produce a higher 48-hour QoR-15 score than propofol. Secondary outcomes will characterize recovery at 24 and 72 hours, intraoperative hypotension burden and vasopressor use, acute kidney injury, infection, delirium, respiratory complications, other safety events, and 30-day mortality.

Read the detailed description

Cytoreductive surgery for peritoneal surface malignancies often involves extensive peritoneal stripping, multivisceral resection, major fluid shifts, and prolonged anesthesia. Some patients also receive HIPEC. Propofol may cause vasodilation and cardiovascular depression, whereas remimazolam may provide greater hemodynamic stability. Whether this difference translates into clinically meaningful improvement in overall postoperative recovery remains uncertain.

After written informed consent and completion of baseline assessments, eligible participants will be randomized 1:1 using variable block sizes of 4, 6, or 8, stratified by whether HIPEC is planned. Allocation will be obtained from a permission-controlled electronic randomization system after eligibility is reconfirmed in the operating room and immediately before the first assigned study hypnotic. Participants, postoperative QoR-15 assessors, complication adjudicators, and the primary statistician will remain masked. Anesthesia clinicians cannot be masked because they must titrate the assigned drug.

Both groups will receive bispectral index-guided total intravenous anesthesia with a target BIS of 40 to 60 and standardized principles for analgesia, hemodynamic rescue, temperature management, neuromuscular monitoring, extubation, and intensive care. Surgery end is defined as completion of skin closure, and all postoperative assessment windows are anchored to that time.

The primary outcome is the Chinese QoR-15 total score 48 ± 4 hours after surgery. The primary analysis will use analysis of covariance or an equivalent general linear model with treatment group, baseline QoR-15 score, and planned HIPEC stratum as covariates. The adjusted between-group mean difference, 95% confidence interval, and two-sided P value will be reported. The sample size of 320 provides 90% power to detect a 6-point difference assuming a common standard deviation of 15 and allowing 15% for an unavailable primary outcome or loss to follow-up.

Being tested
Remimazolam, Propofol
Keywords
Cytoreductive surgery, Hyperthermic intraperitoneal chemotherapy, Remimazolam, Propofol, Quality of Recovery-15, Postoperative quality of recovery, Intraoperative hypotension, Total intravenous anesthesia, Peritoneal surface malignancy
Medical subject headings
Peritoneal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RemimazolamDrug

    Remimazolam is infused intravenously at 6 mg/kg/hour for induction. If a Modified Observer's Assessment of Alertness/Sedation score of 1 or lower is not reached after 3 minutes, the rate is increased to 12 mg/kg/hour. After loss of consciousness, maintenance starts at 1.0 mg/kg/hour and is adjusted in steps of 0.2 mg/kg/hour at intervals of at least 5 minutes within an allowed range of 0.5 to 2.0 mg/kg/hour to maintain BIS 40 to 60. Infusion stops at completion of skin closure. Dosing weight is actual body weight for BMI below 30 kg/m² and adjusted body weight for BMI of 30 kg/m² or higher. Flumazenil is not used routinely and is reserved for clinically indicated rescue.

  • PropofolDrug

    Propofol 1.5 to 2.5 mg/kg is administered intravenously over 60 to 90 seconds for induction. After loss of consciousness, maintenance starts at 6 mg/kg/hour and is adjusted in steps of 1 mg/kg/hour at intervals of at least 5 minutes. The usual range is 4 to 10 mg/kg/hour and the allowed range is 3 to 12 mg/kg/hour to maintain BIS 40 to 60. Infusion stops at completion of skin closure. Dosing weight is actual body weight for BMI below 30 kg/m² and adjusted body weight for BMI of 30 kg/m² or higher.

Study groups in NCT07785557
Study groupRoleWhat they receive
RemimazolamExperimentalParticipants receive remimazolam for induction and maintenance of general anesthesia. Drug dosing is titrated using a common BIS target of 40 to 60 and the same prespecified perioperative management principles used in the comparator arm.
Receives: Drug: Remimazolam
PropofolActive comparatorParticipants receive propofol for induction and maintenance of general anesthesia. Drug dosing is titrated using a common BIS target of 40 to 60 and the same prespecified perioperative management principles used in the experimental arm.
Receives: Drug: Propofol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quality of Recovery-15 total score at 48 hours

    The validated Chinese QoR-15 contains 15 items scored from 0 to 10. The total score ranges from 0 to 150, with higher scores indicating better recovery. The first valid assessment within the prespecified window is used. If any item cannot be completed, the total score is missing rather than prorated. Participants who die before the assessment window are not assigned a score of zero; mortality is reported separately and addressed in prespecified sensitivity analyses.

    Measured: 48 ± 4 hours after the end of surgery, defined as completion of skin closure (allowable window, 44 to 52 hours)

Secondary outcomes (24)
  1. Quality of Recovery-15 total score at 24 hours

    Chinese QoR-15 total score, ranging from 0 to 150, with higher scores indicating better recovery. The first valid assessment in the prespecified window is used.

    Measured: 24 ± 2 hours after completion of skin closure (allowable window, 22 to 26 hours)

  2. Cumulative duration of mean arterial pressure below 65 mmHg

    Total number of valid monitored minutes with mean arterial pressure below 65 mmHg.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery

  3. Time-weighted average of mean arterial pressure below 65 mmHg

    TWA-MAP65 is calculated as the area under the threshold of 65 mmHg divided by valid arterial-pressure monitoring time. It reflects both depth and duration of hypotension and is reported in mmHg. Invasive arterial pressure data are summarized as one-minute medians after prespecified artifact handling.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery

  4. Quality of Recovery-15 total score at 72 hours

    Chinese QoR-15 total score, ranging from 0 to 150, with higher scores indicating better recovery. Participants discharged before the visit may complete the assessment by a masked telephone interview.

    Measured: 72 ± 6 hours after completion of skin closure (allowable window, 66 to 78 hours)

  5. Proportion of valid monitoring time with mean arterial pressure below 65 mmHg

    Percentage of valid invasive arterial-pressure monitoring time during which mean arterial pressure is below 65 mmHg.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery

  6. Lowest intraoperative mean arterial pressure

    Lowest valid one-minute median mean arterial pressure, reported in mmHg, after application of prespecified artifact rules.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery.

  7. Time to first vasopressor administration

    Elapsed time from initiation of the assigned study hypnotic to the first vasopressor dose, reported in minutes. Participants who do not receive a vasopressor are described separately.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery.

  8. Cumulative dose of vasopressors

    Cumulative dose of each vasopressor is reported using the original drug units. A norepinephrine-equivalent dose may also be reported using a conversion rule finalized in the data dictionary before enrollment begins.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery.

  9. Maximum vasopressor infusion rate

    Maximum recorded continuous infusion rate for each vasopressor, using drug-specific units.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery.

  10. Number of hypotension rescue episodes

    Count of prespecified hypotension rescue episodes triggered by mean arterial pressure below 65 mmHg for at least 1 minute or any mean arterial pressure below 55 mmHg, after verification of the arterial waveform and clinical context.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery.

  11. Number of study-hypnotic dose reductions due to hypotension

    Count of dose reductions of the assigned study hypnotic documented as being prompted by hypotension.

    Measured: From initiation of the assigned study hypnotic until completion of skin closure during the index surgery

  12. Incidence of acute kidney injury

    Acute kidney injury is defined by any KDIGO criterion: serum creatinine increase of at least 0.3 mg/dL (26.5 µmol/L) within 48 hours, increase to at least 1.5 times baseline within the observation window, or urine output below 0.5 mL/kg/hour for 6 hours. KDIGO stage is also recorded.

    Measured: From completion of skin closure through postoperative day 7 or hospital discharge, whichever occurs first.

  13. Incidence of postoperative infection

    Occurrence of surgical-site, intra-abdominal, pulmonary, urinary-tract, catheter-related, or bloodstream infection adjudicated by masked assessors using applicable CDC/NHSN definitions and clinical, imaging, microbiological, and treatment data.

    Measured: Within 30 days after completion of skin closure

  14. Incidence of postoperative delirium

    Delirium is assessed twice daily. CAM-ICU is administered when the Richmond Agitation-Sedation Scale score is -3 or higher. Any positive CAM-ICU assessment counts as delirium for that day; reasons for inability to assess are recorded.

    Measured: Postoperative days 1 to 3 or until transfer out of the ICU, whichever occurs first.

  15. Incidence of postoperative hypoxemia

    Oxygen saturation below 90% or arterial oxygen tension below 60 mmHg lasting at least 10 minutes and requiring escalation of oxygen therapy.

    Measured: Within 7 days after completion of skin closure

  16. Use of noninvasive ventilation

    Any postoperative use of noninvasive positive-pressure ventilation for a clinical indication.

    Measured: Within 7 days after completion of skin closure.

  17. Use of high-flow nasal cannula oxygen

    Any postoperative use of high-flow nasal cannula oxygen for a clinical indication.

    Measured: Within 7 days after completion of skin closure

  18. Incidence of respiratory failure

    Postoperative respiratory failure adjudicated according to the prespecified perioperative respiratory outcome definitions.

    Measured: Within 7 days after completion of skin closure

  19. Incidence of reintubation

    Reinsertion of an endotracheal tube for a clinical indication after the first planned extubation.

    Measured: Within 7 days after the first planned extubation

  20. Incidence of pneumonia

    Postoperative pneumonia adjudicated using the prespecified clinical, imaging, microbiological, and treatment criteria. Pneumonia may also satisfy the postoperative infection definition and will be reported in both relevant outcome domains without summing event counts into a new composite outcome.

    Measured: Within 7 days after completion of skin closure

  21. Incidence of bradycardia

    Heart rate below 45 beats per minute for at least 1 minute or bradycardia requiring pharmacologic treatment.

    Measured: From the first dose of assigned study hypnotic through postoperative day 30

  22. Incidence of study-drug allergic reactions

    Any clinically diagnosed allergic or hypersensitivity reaction attributed as possibly, probably, or definitely related to a study hypnotic.

    Measured: From the first dose of assigned study hypnotic through postoperative day 30

  23. Incidence of serious adverse events

    Number and proportion of participants with at least one serious adverse event, classified and reported according to the approved protocol and ethics requirements.

    Measured: From the first dose of assigned study hypnotic through postoperative day 30

  24. All-cause mortality

    Death from any cause.

    Measured: Within 30 days after completion of skin closure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Aug 2026
  2. Study startAug 2026 (estimated)
  3. Primary completionMar 2028 (estimated)
  4. Study completionMay 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
320 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07785557
Sponsor's protocol ID
27032-0-01
Acronym
REPAIR
Status last verified
Aug 2026
First submitted
21 Aug 2026
Last updated
25 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: The final individual participant data sharing plan has not yet been determined. Any future sharing of de-identified participant-level data and supporting materials will require applicable institutional and ethics approvals and must remain within the scope of the informed consent.

Questions about this trial

What is this clinical trial studying?

A study testing Remimazolam and Propofol in people with Peritoneal Neoplasms and Postoperative Recovery, run by Beijing Tsinghua Chang Gung Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 25 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yi Duan, MD (+86-13810385311, dya01610@btch.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality of Recovery-15 total score at 48 hours (time frame: 48 ± 4 hours after the end of surgery, defined as completion of skin closure (allowable window, 44 to 52 hours)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Aug 2026.

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