Comparison of remimazolam and dexmedetomidine for intraoperative sedation in patients undergoing lower extremity surgery under spinal anesthesia: a randomized clinical trial
Authors' conclusion
Remimazolam showed excellent sedation efficacy, minimal hemodynamic effects, and fewer adverse events in the PACU than dexmedetomidine. However, it is important to note that respiratory depression was more frequent with the use of remimazolam.
Study context
- Population
- Patients scheduled for lower extremity surgery under spinal anesthesia
- Participants
- 103 patients
- Comparison
- Remimazolam vs dexmedetomidine for intraoperative sedation
- Primary endpoint
- Rescue midazolam administration (sedation failure after loading dose or despite infusion rate adjustment)
Primary result
As reported in the abstract
Rescue midazolam administration
P < 0.001
Further findings
Time to target sedation level
- Target sedation reached more rapidly with RMZ
Recovery, PACU stay and satisfaction
- RMZ: faster recovery, shorter PACU stay, higher satisfaction scores
Safety
Bradycardia
P < 0.001
Hypertension
P < 0.001
Respiratory depression
P = 0.002
Hypotensive episodes in PACU
P < 0.001
- Respiratory depression — Patients requiring manual ventilation
- 0
Original publication
Comparison of remimazolam and dexmedetomidine for intraoperative sedation in patients undergoing lower extremity surgery under spinal anesthesia: a randomized clinical trial. Reg Anesth Pain Med. Published 6 June 2023. doi:10.
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