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Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched,
Yuji Suzuki1, Shingo Kawashima1, Hiroshi Makino1
1Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Background:
Remimazolam is a novel ultrashort-acting benzodiazepine that has recently become available for general anesthesia. However, the incidence of postoperative nausea and vomiting (PONV) associated with remimazolam remains unknown. In this propensity score-matched, retrospective, observational study, we compared the rates of PONV between remimazolam and propofol.
Methods:
In this retrospective observational study, propensity score-matching was performed to minimize selection bias. Patients who received total intravenous anesthesia with remimazolam or propofol at the Hamamatsu University Hospital between August 2020 and July 2021 were enrolled in the study. Data on patient demographics, anesthetic agents, and PONV within the first 24 h were collected and analyzed.
Results:
Of the 1,239 patients who met the study selection criteria, 585 received remimazolam and 684 received propofol. After propensity score matching, 333 matched pairs were further analyzed. Patient demographics and the anesthetic agents used were comparable between the matched cohorts. The incidence of PONV was significantly higher in the remimazolam group than in the propofol group (35% vs. 21%, P < 0.001).
Conclusions:
The incidence of PONV is higher with remimazolam anesthesia than with propofol anesthesia. The findings of this study require confirmation in larger prospective randomized controlled trials.
Insights
Postoperative nausea and vomiting (PONV) occurred more frequently in patients receiving remimazolam anesthesia compared to propofol. Further research is needed to confirm these findings on PONV incidence.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Remimazolam is a new ultrashort-acting benzodiazepine used for general anesthesia.
- The incidence of postoperative nausea and vomiting (PONV) with remimazolam is not well-established.
Purpose of the Study:
- To compare the incidence of PONV between remimazolam and propofol anesthesia.
- To investigate the safety profile of remimazolam regarding PONV.
Main Methods:
- Retrospective, observational study with propensity score matching.
- Comparison of PONV rates in patients receiving remimazolam versus propofol for total intravenous anesthesia.
- Analysis of data from 1,239 patients (333 matched pairs).
Main Results:
- The incidence of PONV was significantly higher in the remimazolam group (35%) compared to the propofol group (21%).
- Propensity score matching ensured comparability between the remimazolam and propofol cohorts.
Conclusions:
- Remimazolam anesthesia is associated with a higher incidence of PONV than propofol anesthesia.
- Larger prospective randomized controlled trials are recommended to validate these findings.
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