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June 20, 2026Journal of Neurosurgical Anesthesiology

Remimazolam Versus Propofol for Anesthesia in Intracranial Neurosurgeries: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Authors

DADavi Ricardo Soares Gama de AmorimUniversidade de PernambucoFVFilipe Giordano ValerioUniversidade Federal FluminenseRSRafaela Pereira SilvaCentro Universitário do Maranhão

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Overview

Systematic review compares remimazolam and propofol for anesthesia outcomes in neurosurgery, revealing implications for recovery timing.

Key Points

  • This review aims to assess the efficacy and hemodynamic stability of remimazolam versus propofol in intracranial neurosurgeries.
  • Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs)
  • Included 7 RCTs with a total of 770 patients undergoing intracranial procedures
  • Evaluated outcomes such as recovery characteristics, heart rate, mean arterial pressure, and hypotension incidence.
  • Remimazolam resulted in a shorter recovery time (MD: -1.74 min; 95% CI: -3.40 to -0.08; P=0.040)
  • No significant differences were observed in anesthesia duration (MD: -3.31 min; P=0.286) and heart rate (MD: -1.79 bpm; P=0.625)
  • Similar hemodynamic profile noted between remimazolam and propofol regarding MAP and hypotension incidence.

Cite This Study

Amorim et al. (2026) studied this question.

synapsesocial.com/papers/6a362fbcdb0793dc1a53713dhttps://doi.org/10.1097/ana.0000000000001128
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The use of remimazolam versus propofol for induction and maintenance of general anesthesia: A systematic review and meta-analysis2023 · 92 citations
  2. 2Effect of Remimazolam on Hemodynamic Stability in Patients Undergoing Cardiac Surgery: A Grade-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials2025 · 1 citations
  3. 3Comparison of hypotension incidence between remimazolam and propofol in patients with hypertension undergoing neurosurgery: prospective, randomized, single-blind trial2024 · 18 citations
  4. 4Comparative Analysis of the Hemodynamic Effects of Remimazolam and Propofol During General Anesthesia: A Retrospective Study2024 · 7 citations
  5. 5Remimazolam-based total intravenous vs. sevoflurane-based balanced general anesthesia on perioperative outcomes in adult surgical patients: a systematic review and meta-analysis2026