Remimazolam versus propofol for sedation in gastrointestinal endoscopy and colonoscopy within elderly patients: a meta-analysis of randomized controlled trials

Ahmer, Wania; Imtiaz, Sahar; Alam, Daniyal Muhammad; Ahmed, Khadija; Sajid, Barka; Yousuf, Juvairia; Asnani, Sunny; Fahim, Muhammad Ahmed Ali; Ali, Rahmeen; Mansoor, Marium; Safdar, Muhammad Talha; Anjum, Muhammad Umair; Hasanain, Muhammad; Larik, Muhammad Omar

doi:10.1007/s00228-024-03624-6

Eur J Clin Pharmacol

2024

DOI: 10.1007/s00228-024-03624-6

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Remimazolam versus propofol for sedation in gastrointestinal endoscopy and colonoscopy within elderly patients: a meta-analysis of randomized controlled trials

Wania Ahmer,

Sahar Imtiaz,

Daniyal Muhammad Alam

et al.

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Cited by 6 publications

References 34 publications

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Response to “Randomized controlled trial of remimazolam compared with placebo in Japanese patients undergoing upper gastrointestinal endoscopy: Phase III investigator‐initiated clinical trial”

Park

2024

Digestive Endoscopy

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Response to “Randomized controlled trial of remimazolam compared with placebo in Japanese patients undergoing upper gastrointestinal endoscopy: Phase III investigator‐initiated clinical trial”

Park

2024

Digestive Endoscopy

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Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study

Lee,

Jung,

Lee

et al. 2024

Digestive Endoscopy

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ObjectivesPropofol is commonly used for endoscopic sedation. However, it can induce adverse hemodynamic effects. Remimazolam is known to have a fast onset and short duration comparable to that of propofol, but with fewer effects on hemodynamics. We assessed the Oxygen Reserve Index to verify whether a sedative dose of remimazolam would better preserve oxygenation in the mild hyperoxic range than propofol in sedated patients undergoing diagnostic upper gastrointestinal endoscopy.MethodsPatients scheduled for diagnostic upper gastrointestinal endoscopy were enrolled. Patients were randomly assigned to either the remimazolam or propofol groups and received 0.1 mg/kg remimazolam or 0.5 mg/kg propofol, respectively. Bolus injections of either 0.05 mg/kg remimazolam or 0.25 mg/kg propofol were added if required. The primary outcome was the prevalence of oxygen reserve depletion, defined as the Oxygen Reserve Index decreasing to 0.00, and hypoxia defined as peripheral oxygen saturation falling to <94%.ResultsAmong 69 patients, the incidence of oxygen reserve depletion was significantly higher in the propofol group (65.7% vs. 38.2%, P = 0.022). Hypoxia was frequently observed in the propofol group, whereas none was observed in the remimazolam group (11.4% vs. 0%, P = 0.042). Additional sedative injections were frequently required to complete endoscopy in the propofol group. None of the patients in the remimazolam group required airway interventions. Nausea was frequent in the propofol group in the recovery room.ConclusionOur results indicate that remimazolam is a safe and useful sedative for upper gastrointestinal endoscopy.

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Efficacy and safety of remimazolam besylate and ciprofol in painless gastrointestinal endoscopy in the elderly

Zhu

2024

Acta Cir. Bras.

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Purpose: This study aimed to ascertain the efficacy and safety of remimazolam besylate and ciprofol in elderly patients undergoing painless gastrointestinal endoscopy. Methods: Patients in the control group (n = 31) were anesthetized with ciprofol, and those in the observation group (n = 31) were anesthetized with remimazolam besylate. The anesthetic effect, analgesic effect, hemodynamics, cognitive function, and adverse reactions between the two groups were compared. Results: The observation group had shorter anesthesia onset time, recovery time, as well as anesthesia recovery room stay time and a higher effective rate of analgesia. At T 1 , T 2 , and T 3 , the mean arterial pressure and heart rate of the observation group were higher versus the control group; at T 1 and T 2 , SpO 2 in the observation group was higher versus the control group. The simple mental state scale score of the observation group was higher than that of the control group (all p 0.05). The total incidence of adverse reactions exhibited no difference between the two groups ( p > 0.05). Conclusion: Versus ciprofol, remimazolam besylate has better anesthetic and analgesic effects, more stable hemodynamics, less impact on patients’ cognitive function, and good safety in elderly patients undergoing painless gastrointestinal endoscopy.

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Remimazolam versus propofol for sedation in gastrointestinal endoscopy and colonoscopy within elderly patients: a meta-analysis of randomized controlled trials

Cited by 6 publications

References 34 publications

Response to “Randomized controlled trial of remimazolam compared with placebo in Japanese patients undergoing upper gastrointestinal endoscopy: Phase III investigator‐initiated clinical trial”

Response to “Randomized controlled trial of remimazolam compared with placebo in Japanese patients undergoing upper gastrointestinal endoscopy: Phase III investigator‐initiated clinical trial”

Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study

Efficacy and safety of remimazolam besylate and ciprofol in painless gastrointestinal endoscopy in the elderly

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