Neuroanesthesia & neurocritical care
Effects of remimazolam and propofol on sleep rhythm and delirium after spinal surgery in elderly patients
Authors' conclusion
The use of remimazolam in elderly patients undergoing spinal surgery has a minimal impact on postoperative melatonin and cortisol secretion rhythms and sleep patterns, and may reduce the incidence of POD and alleviate postoperative sleep disturbances.
Study context
- Population
- Elderly patients scheduled for elective spinal surgery (posterior lumbar interbody fusion) under GA, November 2023 to January 2024
- Participants
- 120 patients
- Comparison
- Remimazolam vs propofol for induction and maintenance of GA
- Rn = 60
- Pn = 60reference
Main finding
As reported in the abstract
- Melatonin concentrations significantly higher, cortisol significantly lower and Pittsburgh Sleep Quality Index (PSQI) scores significantly reduced in R vs P at 04:00 on postoperative delirium (POD) 1 and 2 (P < 0.05)
- Incidence of POD and postoperative sleep disturbance significantly lower in R vs P (P < 0.05)
Further findings
Extubation time and PACU stay
- Significantly shorter in R vs P (P < 0.05)
PSQI and resting visual analog scale (VAS) pain scores · postoperative day 1
- Significantly lower in R vs P (P < 0.05)
Surgery and anaesthesia duration, total and effective analgesia pump presses, supplemental analgesia rates
- No statistically significant differences between groups (P > 0.05)
Safety
Intraoperative hypotension, postoperative nausea, vomiting, dizziness and respiratory depression
- No statistically significant differences between groups (P > 0.05)
Original publication
Effects of remimazolam and propofol on sleep rhythm and delirium after spinal surgery in elderly patients. Perioper Med (Lond). Published 11 February 2025. doi:10.
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