Effect of remimazolam vs propofol on emergence from general anesthesia in patients undergoing cerebral endovascular procedures : A randomized controlled, non-inferiority trial
Copyright © 2023 Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: This study aimed to compare the time to emergence from general anesthesia with remimazolam versus propofol in patients undergoing cerebral endovascular procedures.
DESIGN: A prospective, double-blind, randomized controlled, non-inferiority trial.
SETTING: An academic hospital.
PATIENTS: Adult patients scheduled for cerebral endovascular procedures.
INTERVENTIONS: Patients were randomized at a 1:1 ratio to undergo surgery under general anesthesia with remimazolam (0.1 mg kg-1 for induction and 0.3-0.7 mg kg-1 h-1 for maintenance) or propofol (1-1.5 mg kg-1 for induction and 4-10 mg kg-1 h-1 for maintenance).
MEASUREMENTS: The primary outcome was the time to emergence from anesthesia. The non-inferiority margin was -2.55 min in group difference. Major secondary outcomes included hypotension during induction, incidence of postoperative delirium and Modified Rankin Scale (mRs) at 30 days and 90 days after surgery.
MAIN RESULTS: Of the 142 randomized patients, 129 completed the trial. In the modified intention-to-treat analysis, the mean time to emergence from anesthesia was 16.1 [10.4] min in the remimazolam group vs. 19.0 [11.2] min in the propofol group. The group difference was -2.9 min [95% CI -6.5, 0.7] (P = 0.003 for non-inferiority). The remimazolam group had lower rate of hypotension during induction (11.3% vs 25.4%, P = 0.03) and use of vasopressors during surgery (29.6% vs 62.0%, P < 0.001). The two groups did not differ in postoperative delirium and mRs at 30 and 90 days after surgery.
CONCLUSIONS: In patients undergoing cerebral endovascular procedures, remimazolam did not increase the time from anesthesia vs propofol.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:93 |
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| Enthalten in: |
Journal of clinical anesthesia - 93(2024) vom: 06. März, Seite 111356 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhang, Junbao [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 15.01.2024 Date Revised 12.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jclinane.2023.111356 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365469599 |
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| 100 | 1 | |a Zhang, Junbao |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effect of remimazolam vs propofol on emergence from general anesthesia in patients undergoing cerebral endovascular procedures |b A randomized controlled, non-inferiority trial |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 15.01.2024 | ||
| 500 | |a Date Revised 12.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: This study aimed to compare the time to emergence from general anesthesia with remimazolam versus propofol in patients undergoing cerebral endovascular procedures | ||
| 520 | |a DESIGN: A prospective, double-blind, randomized controlled, non-inferiority trial | ||
| 520 | |a SETTING: An academic hospital | ||
| 520 | |a PATIENTS: Adult patients scheduled for cerebral endovascular procedures | ||
| 520 | |a INTERVENTIONS: Patients were randomized at a 1:1 ratio to undergo surgery under general anesthesia with remimazolam (0.1 mg kg-1 for induction and 0.3-0.7 mg kg-1 h-1 for maintenance) or propofol (1-1.5 mg kg-1 for induction and 4-10 mg kg-1 h-1 for maintenance) | ||
| 520 | |a MEASUREMENTS: The primary outcome was the time to emergence from anesthesia. The non-inferiority margin was -2.55 min in group difference. Major secondary outcomes included hypotension during induction, incidence of postoperative delirium and Modified Rankin Scale (mRs) at 30 days and 90 days after surgery | ||
| 520 | |a MAIN RESULTS: Of the 142 randomized patients, 129 completed the trial. In the modified intention-to-treat analysis, the mean time to emergence from anesthesia was 16.1 [10.4] min in the remimazolam group vs. 19.0 [11.2] min in the propofol group. The group difference was -2.9 min [95% CI -6.5, 0.7] (P = 0.003 for non-inferiority). The remimazolam group had lower rate of hypotension during induction (11.3% vs 25.4%, P = 0.03) and use of vasopressors during surgery (29.6% vs 62.0%, P < 0.001). The two groups did not differ in postoperative delirium and mRs at 30 and 90 days after surgery | ||
| 520 | |a CONCLUSIONS: In patients undergoing cerebral endovascular procedures, remimazolam did not increase the time from anesthesia vs propofol | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cerebrovascular disorder | |
| 650 | 4 | |a Emergence | |
| 650 | 4 | |a General anesthesia | |
| 650 | 4 | |a Neurosurgery | |
| 650 | 4 | |a Propofol | |
| 650 | 4 | |a Remimazolam | |
| 650 | 7 | |a remimazolam |2 NLM | |
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| 650 | 7 | |a Propofol |2 NLM | |
| 650 | 7 | |a YI7VU623SF |2 NLM | |
| 650 | 7 | |a Benzodiazepines |2 NLM | |
| 650 | 7 | |a 12794-10-4 |2 NLM | |
| 700 | 1 | |a Zhang, Jiuxiang |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yunying |e verfasserin |4 aut | |
| 700 | 1 | |a Bai, Xiaoguang |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Qingdong |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xiaohui |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Xiaofan |e verfasserin |4 aut | |
| 700 | 1 | |a Dong, Hailong |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Haopeng |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Zhihong |e verfasserin |4 aut | |
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