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Comparison of remimazolam and desflurane in emergence agitation after general anesthesia for nasal surgery: a

Sung-Ae Cho1,2, So-Min Ahn1, Woojin Kwon1

  • 1Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.

Korean Journal of Anesthesiology
|May 7, 2024
PubMed
Abstract

Insights

Remimazolam-remifentanil anesthesia significantly reduced emergence agitation compared to desflurane-nitrous oxide anesthesia. This approach also improved hemodynamic stability and reduced postoperative suffocation.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Remimazolam is an ultrashort-acting benzodiazepine with limited research on its use in total intravenous anesthesia (TIVA).
  • Emergence agitation (EA) is a concern following general anesthesia, particularly after nasal surgery.

Purpose of the Study:

  • To compare the incidence and severity of emergence agitation (EA) between remimazolam-based TIVA and desflurane anesthesia.
  • To evaluate hemodynamic changes and postoperative sense of suffocation between the two anesthetic techniques.

Main Methods:

  • A prospective randomized controlled study involving 76 patients undergoing nasal surgery.
  • Patients were randomized to receive either desflurane-nitrous oxide (DN) or remimazolam-remifentanil (RR) for anesthesia maintenance.
  • Emergence agitation was assessed using three validated scales, alongside hemodynamic monitoring and assessment of postoperative suffocation.

Main Results:

  • The remimazolam-remifentanil group showed a significantly lower incidence of EA across all assessed scales (P < 0.001).
  • Significant differences in heart rate changes during emergence were observed between the groups (P = 0.002).
  • The incidence of postoperative sense of suffocation was lower in the remimazolam-remifentanil group (P = 0.027).

Conclusions:

  • Remimazolam-remifentanil anesthesia effectively reduces the incidence and severity of emergence agitation in patients undergoing nasal surgery.
  • This anesthetic regimen offers advantages in managing hemodynamics and mitigating postoperative sense of suffocation.
Keywords:
DesfluraneEmergence deliriumGeneral anesthesiaIntravenous anesthesiaNasal surgical proceduresRemimazolam.

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