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REVIEW Open access
Minerva Anestesiologica 2025 March;91(3):191-200
DOI: 10.23736/S0375-9393.24.18395-2
Copyright © 2024 THE AUTHORS
This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.
lingua: Inglese
Comparison of remimazolam and propofol on postoperative subjective quality of recovery in patients undergoing general anesthesia: a meta-analysis of randomized controlled trials
Ru-Ting XUE 1, Ran-Hong SUN 2, Min WANG 3, Hao GUO 2, Jie CHANG 2 ✉
1 Department of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; 2 Department of Anesthesiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China; 3 Department of Anesthesiology, the People’s Hospital of Shiyan Maojian, Shiyan, Hubei, China
Comment in: https://www.doi.org/10.23736/S0375-9393.24.18665-8.
INTRODUCTION: Remimazolam, a recently approved drug for surgical sedation and general anesthesia, has been compared with propofol in previous studies regarding its efficacy as a general anesthetic. However, the question of whether remimazolam demonstrates non-inferiority to propofol in postoperative subjective quality of recovery (QoR) among patients under general anesthesia has not been definitively answered.
EVIDENCE ACQUISITION: PubMed, Embase, and Cochrane Library databases were systematically searched for all published randomized controlled trials (RCTs) comparing the efficacy of remimazolam and propofol. The primary outcome assessed was the quality of recovery (QoR-15, QoR-40) on postoperative days (POD) 1-3. Secondary outcomes included the duration until consciousness recovery, extubation time, incidence of postoperative nausea and vomiting (PONV), and length of hospital stay.
EVIDENCE SYNTHESIS: The analysis involved 10 RCTs with a total of 1077 patients. Remimazolam showed comparable QoR scores to propofol on POD1 (nine trials, standardized mean difference [SMD]: 0.14, 95% confidence interval [CI]: -0.15 to 0.44, P=0.34), POD 2 (two trials, SMD: 0.09, 95% CI: -0.18 to 0.36, P=0.5), and POD 3 (four trials, SMD: 0.17, 95% CI: -0.51 to 0.85, P=0.62). Subgroup and sensitivity analyses confirmed the robustness of these findings. Furthermore, no significant differences were observed in recovery time for consciousness, extubation duration, incidence of PONV, or length of hospital stay between the remimazolam and propofol groups.
CONCLUSIONS: Remimazolam is similar to propofol in terms of postoperative subjective QoR for patients receiving general anesthesia.
KEY WORDS: Remimazolam; Propofol; Meta-analysis
