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Effect of remimazolam on inflammatory reaction after ureteroscopic lithotripsy: a randomised controlled trial
Xiaoxia Gu1, Jianhang Mo2, Dianqing Cao1
1Anesthesia operation center, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, Guangdong Province, 524001, China.
Background:
Ureteral stone lithotripsy may cause a strong inflammatory response and may be associated with patient outcomes. In clinical practice, remimazolam has been widely used for induction and maintenance of general anesthesia. The purpose of this study is to investigate the effect of remimazolam on the postoperative inflammatory response in patients undergoing ureteral lithotripsy.
Method:
The trial was registered at the China Clinical Trial Registration Center (ChiCTR2300070006) on March 31, 2023. The study included 80 patients who underwent lithotripsy for ureteral stones, and they were divided into two groups. Patients in the remimazolam group (n = 40) or propofol group (n = 40) received sufentanil and cisatracurium in combination for induction and maintenance of anesthesia. The levels of interleukin-6 (IL-6), Tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and procalcitonin (PCT) were measured before and 24 h after operation. The recovery time, recovery quality score and postoperative complications were recorded.
Result:
Compared with the propofol group, the changes of IL-6, TNF-α and CRP in the remimazolam group were significantly decreased before and after operation (p < 0.05), but the changes of PCT before and after operation were not significantly different (P > 0.05). The time of extubation was shorter in the remimazolam group than that in the propofol group (p < 0.05), but the scores of MOAA/s and Rass in the remimazolam group were lower than that in the propofol group within 20 min after operation (p < 0.05), there was no significant difference in the incidence of complications between the two groups.
Conclusion:
Remimazolam is effective in reducing the 24-hour inflammatory response after ureteral stone lithotripsy and is safe and effective for use in this procedure.
Insights
Remimazolam effectively reduces postoperative inflammation following ureteral stone lithotripsy. This anesthetic agent also offers faster recovery times, proving safe and beneficial for patients undergoing this procedure.
Area of Science:
- Anesthesiology
- Urology
- Inflammation Research
Background:
- Ureteral stone lithotripsy can trigger significant inflammatory responses, impacting patient outcomes.
- Remimazolam is a commonly used anesthetic for general anesthesia induction and maintenance.
Purpose of the Study:
- To evaluate the impact of remimazolam on the postoperative inflammatory response in patients undergoing ureteral lithotripsy.
Main Methods:
- Eighty patients undergoing ureteral lithotripsy were randomized into remimazolam and propofol groups.
- Inflammatory markers (IL-6, TNF-α, CRP, PCT) and recovery metrics were assessed pre- and post-operation.
Main Results:
- Remimazolam significantly decreased IL-6, TNF-α, and CRP levels compared to propofol.
- Extubation time was shorter with remimazolam, with no significant difference in complication rates.
Conclusions:
- Remimazolam demonstrates efficacy in mitigating the 24-hour inflammatory response post-ureteral lithotripsy.
- The study confirms remimazolam's safety and effectiveness for this surgical procedure.
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