Title:Clinical Trial Comparing Remimazolam with Propofol During Intravenous
Anesthesia: A Prospective Randomised Clinical Trial
Volume: 27
Issue: 10
Author(s): Lu Yang, Jin Zhang, Nengke Xiao, Junjie Chen, Hengjuan Liu, Xuan He*, Xingpeng Xiao*Fan Zhang*
Affiliation:
- Department of Anesthesiology,
Renmin Hospital of Wuhan University, Wuhan, China
- Department of Anesthesiology,
Renmin Hospital of Wuhan University, Wuhan, China
- Department of Anesthesiology,
Renmin Hospital of Wuhan University, Wuhan, China
Keywords:
Remimazolam, propofol, intravenous anesthesia, general anesthesia, effectiveness, safety.
Abstract:
Background and Objective: Remimazolam is a water-soluble sedative-anesthetic with
short-acting properties and less hemodynamic effects. Currently, it is primarily used for gastroenteroscopy
sedation.
Aim: The aim of this study is to investigate the effectiveness and safety of Remimazolam as an alternative
intravenous anesthetic agent in surgical patients, in order to expand clinical options beyond Propofol.
Methods: Eighty patients aged 20-69 and classified as an American Society of Anesthesiologists
physical status I-II were randomly assigned to either the Remimazolam group (RM group) or the
Propofol group (PR group) for anesthesia induction and maintenance. Hemodynamics and
Bispectral Index (BIS) were recorded before and after anesthesia, along with other relevant indices
such as the time, to loss of consciousness (LoC), operation time, anesthesia time, awakening
time, the number of cases of injection site pain. Additionally, the Ramsay sedation score,
intraoperative awareness, dreaming, and postoperative adverse events were also assessed.
Results: After anesthesia, both groups experienced a significant decrease in blood pressure compared
to baseline values, however, the reduction in blood pressure was less significant in the RM
group than in the PR group (P<0.05). The heart rate of patients in the RM group remained relatively
stable at all time points. There were significantly more cases of injection site pain and use
of pressor or atropine during operation observed in the PR group compared to the RM group
(P<0.05). There were no significant differences between the two groups in terms of time to loss
of consciousness, anesthesia time, operation time, awakening time, and intraoperative awareness
(P>0.05). However, at 5 and 30 minutes after awakening, the Ramsay sedation score was significantly
better in the RM group compared to the PR group (P<0.05).
Conclusion: When remimazolam is used for intravenous anesthesia induction and maintenance,
it can achieve a favorable anesthetic effect while maintaining a relatively stable blood pressure
and heart rate. Patients experience shorter awakening times (8.3±3.7 min), better awakening
quality (5 min Ramsay sedation score is 2 points), and no intraoperative awareness.
