Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia

“…Our study found that the incidence of peri-anesthesia hypotension caused by propofol was 67.9% during the 45 min to 1 h procedure. Previous trials mainly focused on the single-use of remimazolam on hypotension during induction ( 21 – 23 ). We continuously monitored the hypotension during the whole perioperative period and found that remimazolam decreased the hypotension by 50%, from 67.9% in propofol group to 32.1%.…”

Section: Discussionmentioning

confidence: 99%

The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: A randomized trial

Qiu

Zhao

et al. 2022

Front. Med.

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ObjectiveHypotension is common in propofol anesthesia. Whether remimazolam could reduce intraoperative hypotension remains unknown. We therefore tested the primary hypothesis that remimazolam reduces the incidence of intraoperative hypotension compared with propofol in adult patients undergoing endoscopic submucosal dissection (ESD) surgery.Materials and methodsWe conducted a prospective trial to compare patients who received either remimazolam or propofol bolus induction and thereafter intravenous infusion. The hemodynamic parameters were measured using CNAP® Monitor 500 system. Our primary analysis was to compare the incidence of hypotension defined as systolic blood pressure below 90 mmHg between remimazolam and propofol during the whole anesthesia period.ResultsThe incidence of hypotension decreased by 50%, from 67.9% in propofol group to 32.1% in remimazolam group (p < 0.01). Patients received less amount of intraoperative phenylephrine in the remimazolam group than the propofol group (0 [0–40] μg vs. 80 [0–200] μg, p < 0.01). Time-weighted average and cumulative time of hypotension was lower in remimazolam group compared with propofol group (p < 0.05). Cardiac output continuously measured by CNAP was preserved much better in remimazolam group compared with propofol group (p = 0.01), while systemic vascular resistance did not differ between the groups. The median time from discontinuation until full alertness was 4 [3–11.8] min in the remimazolam group compared with 15 [12.0–19.8] min in the propofol group (p < 0.01).ConclusionRemimazolam has better hemodynamic stability than propofol in adult patients undergoing ESD surgery. The benefits of remimazolam on hemodynamic stability and hypotension prevention may be partly contributed to its better preservation of cardiac output.Clinical Trial Registration[http://www.chictr.org.cn/com/25/showproj.aspx?proj=61104], identifier [ChiCTR2000037975].

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“…Dai et al [ 21 ] evaluated the safety and efficacy of remimazolam for anesthetic induction compared with propofol at 2 mg/kg in 190 patients with ASA PS I or II. A bolus dose of sufentanil (0.3 to 0.5 µg/kg) was administered 1 min before anesthetic induction.…”

Section: Remimazolammentioning

confidence: 99%

“…Successful induction rates were not significantly different between the R2, R3, and propofol groups. Dai et al [ 21 ] also compared the hypotension rate for the three induction doses of remimazolam (0.2 mg/kg, 0.3 mg/kg, and 0.4 mg/kg) to that for the induction dose of propofol (group P) at 2 mg/kg. Hypotension during induction, defined as a mean arterial blood pressure < 65 mmHg or a systolic blood pressure decrease to < 70% of baseline values, occurred in 13% of patients in group R1 and 24% of patients in group R2.…”

Section: Remimazolammentioning

confidence: 99%

Remimazolam – current knowledge on a new intravenous benzodiazepine anesthetic agent

Kim

Fechner

2022

Korean J Anesthesiol

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Intravenous anesthetic agents such as midazolam, propofol, and ketamine are routinely used to provide anesthesia and sedation. They have been shown to effectively induce and maintain amnesia, sedation, and hypnosis in various patient groups and clinical settings. However, all anesthetic agents have the potential to cause unwanted side effects such as hemodynamic instability, respiratory depression, or slow recovery due to prolonged post-procedural sedation. Remimazolam, a recently approved benzodiazepine for general anesthesia and procedural sedation in Korea, has been successfully used for these purposes. To date, inconclusive knowledge has been obtained regarding the use of remimazolam in different patient populations and under various surgical conditions. With respect to the specific pharmacokinetic and pharmacodynamic characteristics of remimazolam, the use of remimazolam is expected to increase providing safe general anesthesia and sedation. This review aims to provide an overview of the basic and clinical pharmacology of remimazolam and to compare it with midazolam and propofol.

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Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia

Cited by 107 publications

References 17 publications

Quality of Recovery After General Anesthesia with Remimazolam in Patients’ Undergoing Urologic Surgery: A Randomized Controlled Trial Comparing Remimazolam with Propofol

Quality of Recovery After General Anesthesia with Remimazolam in Patients’ Undergoing Urologic Surgery: A Randomized Controlled Trial Comparing Remimazolam with Propofol

The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: A randomized trial

Remimazolam – current knowledge on a new intravenous benzodiazepine anesthetic agent

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