Efficacy of continuous intravenous remimazolam versus midazolam in the extraction of impacted wisdom teeth: protocol of a randomised controlled trial

Wang, Lejunzi; Quan, Jing; Pei, Lijian; Li, Mohan; Ruan, Xiuxiu; Chen, Shaohui; Zhang, Yuelun; Wan, Kuo; Huang, Yuguang

doi:10.1136/bmjopen-2022-067908

Cited by 1 publication

(1 citation statement)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results indicated that remimazolam had mild respiratory depression, minimal hemodynamic fluctuation, and no serious side effects, which were similar to the results of several previous clinical studies. [32][33][34] Our results confirmed that remimazolam, like other benzodiazepines, had an anterograde amnesia effect, [35][36][37] which was thought to be caused by the binding of remimazolam with the α1 of the GABAA receptor. 38 Although intubation comfort scores, cough scores, and post-intubation scores were not lower in group DS than that in groups R 1 S and R 2 S, patient satisfaction scores seemed to be higher in groups R 1 S and R 2 S than that in group DS due to the rates of amnesia for tracheal intubation being higher in groups R 1 S and R 2 S. A similar outcome was also seen in the study, 28 where the deeper, more consistent sedation and retrograde amnesia brought about by remimazolam resulted in median patient satisfaction scores that were higher in the remimazolam group than that in the dexmedetomidine group.…”

Section: Discussionsupporting

confidence: 74%

The Safety and Efficacy of Remimazolam Compared to Dexmedetomidine for Awake Tracheal Intubation by Flexible Bronchoscopy: A Randomized, Double-Blind, Controlled Trial

Chen,

Qin,

Zhang

et al. 2024

DDDT

View full text Add to dashboard Cite

Background Remimazolam is a novel ultra-short-acting benzodiazepine sedative that has the potential to be an alternative for procedural sedation due to its rapid sedation and recovery, no accumulation effect, stable hemodynamics, minimal respiratory depression, anterograde amnesia effect, and specific antagonist. Here, we aimed to compare the safety and efficacy of remimazolam with dexmedetomidine for awake tracheal intubation by flexible bronchoscopy (ATI-FB). Methods Ninety patients scheduled for ATI-FB were randomly divided into three groups, each consisting of 30 cases: dexmedetomidine 0.6 µg/kg + sufentanil (group DS), remimazolam 0.073 mg/kg + sufentanil (group R 1 S), or remimazolam 0.093 mg/kg + sufentanil (group R 2 S). The primary outcome was the success rate of sedation. Secondary outcomes were MOAA/S scores, hemodynamic and respiratory parameters, intubation conditions, intubation time, tracheal intubation amnesia, and adverse events. Results The success rates of sedation in groups R 2 S and DS were higher than that in group R 1 S (93.3%, 86.7%, respectively, vs 58.6%; P = 0.002), and intubation conditions were better than those in group R 1 S ( P < 0.05). Group R 2 S had shorter intubation times than groups R 1 S and DS ( P = 0.003), and a higher incidence of tracheal intubation amnesia than group DS ( P = 0.006). No patient in the three groups developed hypoxemia or hypotension, and there were no significant differences in oligopnea, PetCO 2 , or bradycardia ( P > 0.05). Conclusion In conclusion, both DS and R 2 S had higher success rates of sedation, better intubation conditions, and minor respiratory depression, but R 2 S, with its shorter intubation time, higher incidence of anterograde amnesia, and ability to be antagonized by specific antagonists, may be a good alternative sedation regimen for patients undergoing ATI-FB.

show abstract