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Minerva Anestesiologica 2021 Jul 14

DOI: 10.23736/S0375-9393.21.15517-8


language: English

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

Guangrong DAI 1, Lili PEI 2, Fenyu DUAN 1, Minhui LIAO 1, Yanke ZHANG 1, Mengxue ZHU 1, Zhibin ZHAO 1, Xiaobao ZHANG 1

1 Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China; 2 Department of Basic Medical Science, Kangda College of Nanjing Medical University, Lianyungang, China


BACKGROUND: Remimazolam is a new ultra-short acting benzodiazepine anesthetic which has predictable sedative duration and rapid recovery in gastrointestinal endoscopy. Propofol is a commonly used intravenous anesthetic in clinical work which also has rapid action, short action time and rapid recovery. To date, there have been relatively few articles comparing the two for general anesthesia induction. So we conducted a randomized trial to evaluate whether remimazolam is superior to propofol during anesthesia induction in terms of the efficacy and safety.
METHODS: One hundred and eighty nine ASA I or II patients scheduled for elective surgery were divided into four groups: remimazolam 0.2mg/kg (group R1), 0.3mg/kg(group R2), 0.4mg/kg(group R3), and propofol group(group P). All patients were anesthetized with single shot of experimental drugs during induction period. Efficacy was measured by completing the induction of anesthesia without rescue sedation and safety was defined as no severe adverse events.
RESULTS: Success induction rates in remimazolam groups were 89%(group R1), 94%(group R2) and 100%(group R3) while success induction rate in group P was 100%. Hypotension rates during induction were lower in R1 group (13%) and R2 group (24%) compared with group P (44%). Hypotension rate in R3 group (34%) was similar to propofol (44%). Injection site pain in group P was 27% while no pain was observed in remimazolam groups.
CONCLUSIONS: Remimazolam is a safe and effective sedative drug during induction with less adverse effects for general anesthesia in ASA I or II patients.

KEY WORDS: Remimazolam; Anesthesia; Induction; Propofol

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