Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial

Qiongchuan Wang; Jiangui Gong; Li Zhao; Jing Peng; Mei Duan

doi:10.47297/wspbdsWSP2752-630501.20240401

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Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial

Volume 4, Issue 1

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Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial
Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial
1.Department of Anesthesiology,the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
2.Emergency Department (Outpatient Chemotherapy Center),the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
Vol. 4, Issue 1, Pages: 5-15(2024)
Published： 30 June 2024 ，
DOI：10.47297/wspbdsWSP2752-630501.20240401
Accepted：

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Wang Qiongchuan,Gong Jiangui,Zhao Li,et al.Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial[J].Biomedical Data Science,2024,04(01):5-15.
DOI：

Wang Qiongchuan,Gong Jiangui,Zhao Li,et al.Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial[J].Biomedical Data Science,2024,04(01):5-15. DOI： 10.47297/wspbdsWSP2752-630501.20240401.

摘要

Abstract

Background

—Remimazolam (HR7056

RT) is a new type of ultra-short-acting sedative drug. At present

there are few studies on its use in gastroenteroscopy procedural sedation

and it is not clear whether threr is a good correlation between RT and Bispectral Index (BIS). Therefore

the purpose of this study was to investigate the efficacy and safety of RT for procedural sedation during painless gastroenteroscopy.

Methods

—A total of 100 patients who underwent gastrointestinal endoscopy in Yunnan Luliang Peifang Hospital from January 1

2022 to June 30

2022 were included. T

hey met the following criteria: age 18~75 years old

gender was not limited

American Society of Anesthesiologists(ASA) I-II class

body mass index (BMI) is 18.0~28.0kg/m

. Patients were randomly divided into AR group and AP group. AR group was given RT0.2mg/kg

supplemented with 0.05mg/kg as needed; AP group was given propofol 2mg/kg

supplemented with 0.5mg/kg. Give sedation supplements and evaluate the sedation effect based on the modified observational alertness/sedation assessment (MOAA/S) score

the time of loss of consciousness (LOC)

successful sedation in one dose

the supplementary dose and recovery time of consciousness were recorded. Adverse reactions related to sedative drugs were recorded

including the incidence of injection pain

hemodynamic events

and respiratory depression. Postoperative nausea and vomiting

visual analog scale (VAS) scores at rest

dizziness and headache

and patient and physician satisfaction were also compared between the two groups.

Results

—The data of 97 patients were analyzed finally. The effective rate of sedation in both groups was 100%. The LOC time of the AR group was longer than that of the AP group(47±23s vs. 20±10s

P<0.001). The success rate of one-dose sedation in AR group was lower than that in AP group (P<0.05). The supplementary dose of sedation in AR group was more than that in AP group (P<0.05). Compared with the AP group

the incidence of intraoperative hemodynamic events (6% vs 23%

P<0.05) and respiratory depression (14% vs 33%

P<0.05) in the AR group were significantly reduced

and the incidence of injection pain The rate was also significantly lower than that of the AP group (P<0.001). The intraoperative BIS value in the AR group was significantly higher than that in the AP group (P<0.05)

while there was no difference in the MOAA/S score between the two groups (P > 0.05).

Conclusion

—Remimazolam is an effective and safe sedative drug

which can be used in painless gastrointestinal endoscopy. Compared with propofol

it has the advantages of less intraoperative adverse reactions and no injection pain

especially RT sedation can achieve the similar sedative effect as propofol

but does not require a deeper depth of anesthesia. It should be noted that the time to induce sedation is slightly longer when RT is used

and the intraoperative supplementary dose is slightly increased.

关键词

Keywords

RemimazolamPropofolGastrointestinal endoscopyDeep sedationEffectivenessSafety

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