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July 28, 2023MedicineOpen Access

Comparison of remimazolam and propofol induction on hemodynamic response in hypertensive patients

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Key result

Remimazolam induction resulted in a significantly lower incidence of hypotension and better preservation of blood pressure compared to propofol in hypertensive patients.

Why the study?

Hypertensive patients experience more profound hemodynamic variations and higher risk of hypoperfusion-induced organ damage from hypotensive episodes during general anesthesia induction than normotensive patients.

Does remimazolam improve hemodynamic stability compared to propofol during general anesthesia induction in hypertensive patients?

Comparison

Remimazolam vs propofol

Design

Randomized trial

Follow-up

5 minutes after tracheal intubation

Authors

ECEun Kyung ChoiYeungnam University CollegeYJYoungjun JangYeungnam University CollegeSPSang‐Jin ParkChonnam National University

Discussion

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Member takes

Overview

Remimazolam may confer greater hemodynamic stability than propofol during induction in hypertensive patients; leaves open whether this reduces organ injury or warrants practice change.

Study Design

Type

RCT (n=96)

Structured PICO

Does remimazolam improve hemodynamic stability compared to propofol during general anesthesia induction in hypertensive patients?

P
Population
96 hypertensive patients undergoing induction of general anesthesia.
I
Intervention
Remimazolam induction (6 mg/kg/hour until loss of consciousness, followed by 1 mg/kg/hour until 5 minutes after tracheal intubation)
C
Comparator
Propofol induction (slow bolus of 1.5 to 2 mg/kg, followed by 3 to 6 mg/kg/hour 5 minutes after tracheal intubation)
O
Outcome
Hemodynamic parameters (mean blood pressure, systolic blood pressure, diastolic blood pressure, heart rate) and incidence of hypotension during the induction period (up to 5 minutes after tracheal intubation)surrogate

Remimazolam provides better hemodynamic stability and a lower incidence of hypotension compared to propofol during anesthesia induction in hypertensive patients.

Cite This Study

Choi et al. (2023) conducted an RCT in Hypertension requiring general anesthesia (n=96). Remimazolam vs. Propofol was evaluated on Hemodynamic parameters (MBP, SBP, DBP, HR) and incidence of hypotension. Remimazolam induction resulted in a significantly lower incidence of hypotension and better preservation of blood pressure compared to propofol in hypertensive patients.

synapsesocial.com/papers/6a7a5cdf756812e395898cd4https://doi.org/10.1097/md.0000000000034358
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Also Consider

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

  1. 1Comparison of hemodynamics during induction of general anesthesia with remimazolam and target-controlled propofol in middle-aged and elderly patients: a single-center, randomized, controlled trial2023 · 39 citations
  2. 2Effect of remimazolam vs. propofol on hemodynamics during general anesthesia induction in elderly patients: Single-center, randomized controlled trial2023 · 16 citations
  3. 3Comparison of hemodynamics during induction of general anesthesia with remimazolam and target-controlled propofol in middle-aged and elderly patients: A single-center, randomized, controlled trial2022 · 5 citations
  4. 4Comparative Analysis of the Hemodynamic Effects of Remimazolam and Propofol During General Anesthesia: A Retrospective Study2024 · 7 citations
  5. 5Comparison of hypotension incidence between remimazolam and propofol in patients with hypertension undergoing neurosurgery: prospective, randomized, single-blind trial2024 · 18 citations