Comparison of remimazolam–remifentanil and propofol–remifentanil during laparoscopic cholecystectomy

Abstract

Background: Remimazolam is a novel benzodiazepine with fast onset and short half-life. We compared the effects of remimazolam and propofol on recovery profiles for general anesthesia in patients undergoing laparoscopic cholecystectomy. Methods: We randomly assigned 108 patients to either a remimazolam (n=54) or propofol (n=54) group. Remimazolam and propofol were used for induction and maintanance of anesthesia. Following anesthesia, we recorded the time until an Aldrete score of 9 was achieved. The time to reach a Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score of 2 and the time from the end of anesthesia to eye opening time, recovery time of orientation, time to spontaneous breathing, extubation time, and the time required for analgesics were measured. Heart rate, blood pressure, and bispectral index were assessed before, during, and after pneumoperitoneum. Results: We included 101 patients in the analysis. In the remimazolam group, it took longer to reach an Aldrete score of 9 after the drug infusion ended (P = 0.031). There was no difference in the time to reach MOAA/S 2 between the two groups. The time to eye opening, recovery time of orientation, and time required for analgesics were longer and heart rate was higher in the remimazolam group. Neither blood pressure, nor extubation time differed between groups.Conclusions: Remimazolam and propofol provided safe induction and maintenance of anesthesia in patients undergoing laparoscopic cholecystectomy. The recovery time from anesthesia with remimazolam is longer than that with propofol. Fewer hemodynamic changes were observed with remimazolam, but further studies are needed.

Comparison of Hemodynamic Parameters Based on the Administration of Remimazolam or Sevoflurane in Patients under General Anesthesia in the Beach Chair Position: A Single-Blinded Randomized Controlled Trial

“…Previous studies on remimazolam have reported that when flumazenil is administered postoperatively, the emergence time is shorter than that with traditional anesthetic drugs [41][42][43]. In the absence of flumazenil, the emergence time was not different or longer [44,45]. The results of the present study can also be attributed to the administration of flumazenil during the emergence phase.…”

Bolus administration of remimazolam was superior to midazolam for deep sedation in elderly patients undergoing diagnostic bronchoscopy: A randomized, double-blind, controlled trial

“…[ 4 , 5 ] Fortunately, several emerging agents are being considered as acceptable alternatives, such as remimazolam, a new benzodiazepine for intravenous use in procedural sedation, has the rapid onset–offset properties comparable to propofol but with minor respiratory/circulatory depression. [ 6 , 7 ] Some studies have confirmed that remimazolam could be safely and effectively used for bronchoscopy and had a faster onset of action and faster recovery of neuropsychiatric functions compared to midazolam. [ 8 , 9 ] However, whether remimazolam may be the preferred pharmacological agents for bronchoscopy sedation in elderly patients has not been reported in the literature.…”

Quality of Postoperative Recovery in Total Intravenous Anesthesia between Remimazolam and Propofol for Intraoperative Neurophysiological Monitoring: A Prospective Double-Blind Randomized Controlled Trial

“…Consequently, remimazolam has emerged as a safe option for continuous intravenous infusion and has been increasingly used as an anesthetic for sedation and general anesthesia. A few studies have compared postoperative recovery between remimazolam and propofol in general anesthesia, but these surgeries were relatively minor, and the results were inconsistent [6,7].…”