Remimazolam vs. propofol for induction and maintenance of general anesthesia: A systematic review and meta-analysis of emergence agitation risk in surgical populations
Pooled resultResult — go to the resultRelative risk 0.82 95 % CI 0.41–1.65Authors' conclusion
The use of remimazolam for the induction and maintenance of general anesthesia does not lead to a higher occurrence of EA in adult patients undergoing surgery, relative to propofol. However, in patients with ASA III-IV, remimazolam may be linked to a greater risk of POD than propofol.
Study context
- Population
- Surgical patients undergoing GA
- Participants
- 3,031 patients · 19 RCTs
- Comparison
- Remimazolam vs propofol for induction and maintenance of GA
- Outcome
- Incidence of emergence agitation (EA)
Methodological detailssubgroup analysis
- Subgroup analysis
Pooled result
As reported in the abstract
Relative risk
0.82
95 % CI 0.41–1.65
P = 0.585
Further pooled results
Postoperative delirium (POD) incidence, extubation time, emergence time, post-anesthesia care unit (PACU) LOS
- No significant intergroup differences
Extubation time and PACU LOS without routine postoperative antagonist (subgroup)
- Prolonged with remimazolam vs propofol
Extubation, emergence times and PACU discharge time after flumazenil antagonism (subgroup)
- Extubation and emergence times shorter with remimazolam; PACU discharge time comparable
Safety
Postinduction and intraoperative hypotension; Postoperative nausea and vomiting (PONV), intraoperative awareness, hypoxemia
- Hypotension significantly reduced with remimazolam vs propofol
- PONV, intraoperative awareness and hypoxemia comparable
Original publication
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