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Comparative Study About Different Doses of Remimazolam in Short Laparoscopic Surgery: A Randomized Controlled
Li Luo1, Jiduan Jiang2, Min Zhang1
1Department of Anesthesiology, Suining Central Hospital, Suining City, Sichuan Province, People's Republic of China.
Objective:
To study the efficacy and safety of different doses of remimazolam used for induction and maintenance in short laparoscopic surgery.
Methods:
A randomized controlled trial was conducted between May 2021 and May 2022 on patients underwent laparoscopic surgery for 30 minutes to an hour. Based on the drug used and the infusion rate, included patients were allocated into the Low-group of remimazolam (using a constant infusion rate of 6.0 mg/kg/h for induction and the rate of 1 mg/kg/h for maintenance), the Median-group (9.0 mg/kg/h for induction, 2 mg/kg/h for maintenance), the High-group (12.0 mg/kg/h for induction, 3.0 mg/kg/h for maintenance), and the Propofol group. The postoperative extubation time was used as the primary outcome.
Results:
A total of 192 patients were included in the study, with 47, 48, 48, and 49 patients in the Low-, Median-, High-, and Propofol group, respectively. There was a significant difference in postoperative extubation time, with the High-group having the highest duration of 15.21±2.34 minutes compared to the Median-group (13.17±1.71 minutes, p<0.001), Low- group (12.72±1.31 minutes, p<0.001), and the Propofol group (12.24±1.23 minutes, p<0.001). No significant difference was found between the Low-group and the Propofol group, while the Median-group still showed higher postoperative extubation time compared to the Propofol group (p=0.008).
Conclusion:
Compared to propofol, total intravenous induction and maintenance with high and median dosages of remimazolam may prolong postoperative extubation time. Remimazolam can be safely used for induction and maintenance at various doses while not increasing the likelihood of adverse events.
Insights
High doses of remimazolam for anesthesia may extend recovery time after short surgeries compared to propofol. Remimazolam is safe for anesthesia induction and maintenance across different dosages, with no increased adverse events.
Area of Science:
- Anesthesiology and pharmacology
- Clinical trial research
Background:
- Remimazolam is an ultra-short-acting benzodiazepine sedative-hypnotic.
- Its efficacy and safety in various surgical settings are under investigation.
- Optimizing anesthetic protocols is crucial for patient recovery.
Observation:
- A randomized controlled trial compared remimazolam at low, median, and high doses against propofol for short laparoscopic surgery.
- Postoperative extubation time was the primary outcome measure.
- 192 patients were analyzed across four groups.
Findings:
- The high-dose remimazolam group showed a significantly longer extubation time (15.21 min) compared to propofol (12.24 min).
- Median-dose remimazolam also resulted in a longer extubation time (13.17 min) than propofol (p=0.008).
- No significant difference in extubation time was observed between the low-dose remimazolam and propofol groups.
Implications:
- High and median doses of remimazolam may prolong recovery after short surgical procedures.
- Remimazolam demonstrates a good safety profile for anesthesia induction and maintenance.
- Further research may refine remimazolam dosing for optimal perioperative outcomes.
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