Remimazolam Tosylate Combined with Low-Dose Propofol Improves Sedation and Safety in Hysteroscopy

Abstract

Background Propofol is widely used for sedation of hysteroscopy. It can cause injection pain, respiratory depression, and hypotension. Remimazolam is a novel ultra-short-acting benzodiazepine. Clinical practice has found that the use of remimazolam alone often leads to body movement during hysteroscopy, which decreases the safety and comfort. Here this study is to investigate whether remimazolam combined with low-dose propofol can improve the sedation effect and safety of hysteroscopy. Patients and Methods In this prospective, randomized, parallel-controlled trial, women (18 to 60 years) undergoing hysteroscopy were randomly assigned to receive propofol (Group P), remimazolam tosylate (Group R), or remimazolam tosylate plus propofol (Group RP). Intraoperative sedation depth was kept at the bispectral index (BIS) value of 40–60. 6 μg/kg alfentanil was used for analgesic before sedation. Intraoperative low pulse oxygen saturation (SpO 2 ), body movement, injection pain, mean arterial pressure (MAP), heart rate (HR), and postoperative recovery time, dizziness, nausea and vomiting were recorded and compared. Results From February to July 2022, 193 patients were recruited and randomly assigned to group P (n=64), group R (n=64), or group RP (n=65). There was no significant inter-group difference of the intraoperative BIS values. The incidence of low SpO 2 , injection pain, hypotension, and postoperative dizziness in group RP were less than that in group P, and had no significant difference from group R. The incidence of body movement in group RP was less than that in group R, and had no significant difference from group P. Postoperative recovery time of group RP was shorter than that of the other two groups. No significant inter-group difference in bradycardia, nausea and vomiting was observed. Conclusion Remimazolam tosylate combined with low dose of propofol improved sedation and safety in hysteroscopy, and may be a more ideal sedative method for hysteroscopy.

The study of different dosages of remazolam combined with sufentanil and propofol on painless gastroscopy: A randomized controlled trial

“…Among the patients in this trial, the dosage of propofol and the additional frequency in R3 group was more than that in R6 group, indicating that the dosage of propofol in painless gastroscopy will decrease as the dosage of remidazolam increases. This is consistent with the findings of Zhang et al [ 30 ] that the use of remazolam before induction can significantly reduce the dose of propofol during anesthesia induction. The results of this study suggest that we can reduce the recommended dose when using narcotic drugs in combination.…”

The Study Of Remazolam Combined With Sufentanil And Propofol On Painless Gastroscopy: A Randomized Controlled Trial.

“…Among the patients in this trial, the dosage of propofol and the additional frequency in Con group was more than that in Rem group, indicating that the dosage of propofol in painless gastroscopy could be signi cantly reduced by the use of remazolam besylate. This is consistent with the ndings of Zhang et al that the use of remazolam before induction can signi cantly reduce the dose of propofol during anesthesia induction [31] . The results of this study suggest that we can reduce the recommended dose when using narcotic drugs in combination.…”

Application of remimazolam-0.6% sevoflurane anesthesia for flash visual evoked potential monitoring during pituitary adenoma resection: a non-inferiority randomized controlled trial

“…During surgery, it is important to minimize body movement responses when using remimazolam anesthesia [32], as well as to reduce the inhibitory effect of sevoflurane on FVEP. Although previous studies have verified the depth of remimazolam-based total intravenous anesthesia for patients, prolonged high-dose remimazolam infusion would lead to a delay recovery of consciousness [33,34]. Taking both drug aftereffects and FVEP signals into account, we applied a 0.6% sevoflurane combined with remimazolam anesthesia protocol.…”