Why the study?
Remimazolam confers a lower risk of hypotension than propofol, but no studies have compared the efficacy of remimazolam and propofol administered using target-controlled infusion.
Does remimazolam improve hemodynamic stability compared to target-controlled propofol during induction of anesthesia in middle-aged and elderly adults?
Population
Forty adults aged 45-80 years with ASA Physical Status 1-2
Comparison
Remimazolam (12 mg/kg/h) vs propofol (3 μg/mL, TCI) with remifentanil
Design
Single-center randomized controlled trial
Key result
Remimazolam did not significantly differ from target-controlled propofol in the maximum decrease of mean arterial pressure during induction of general anesthesia (mean difference 1.7 mmHg, p=0.613).
Authors
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Remimazolam shows no hemodynamic edge over TCI propofol here; leaves open whether larger trials would detect differences in hypotension risk.
RCT (n=40)
Single-blind
Sealed envelope system
No
Does remimazolam improve hemodynamic stability compared to target-controlled propofol during induction of anesthesia in middle-aged and elderly adults?
Mean Difference: 1.7 (95% CI -8.2–4.9)
Absolute Event Rate: -41.1% vs -42.8%
p-value: p=0.613
Remimazolam and target-controlled propofol result in similar hemodynamic changes during the induction of general anesthesia in middle-aged and elderly patients.
Sekiguchi et al. (2023) conducted an RCT in General anesthesia induction (n=40). Remimazolam vs. Target-controlled propofol (3 μg/mL) was evaluated on Maximum change in mean arterial pressure (MAP) after induction (MD 1.7, 95% CI -8.2 to 4.9, p=0.613). Remimazolam did not significantly differ from target-controlled propofol in the maximum decrease of mean arterial pressure during induction of general anesthesia (mean difference 1.7 mmHg, p=0.613).
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