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Effect of remimazolam vs propofol on emergence from general anesthesia in patients undergoing cerebral endovascular procedures: A randomized controlled, non-inferiority trial.
Zhang, Junbao; Zhang, Jiuxiang; Wang, Yunying; Bai, Xiaoguang; Guo, Qingdong; Liu, Wei; Li, Hui; Zhu, Fei; Wang, Xiaohui; Jiang, Xiaofan; Dong, Hailong; Zhang, Haopeng; Lu, Zhihong.
Afiliación
  • Zhang J; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Zhang J; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Wang Y; Department of Aerospace Physiology, Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Bai X; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Guo Q; Department of Neurosurgery, the First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Liu W; Department of Neurosurgery, the First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Li H; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Zhu F; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Wang X; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Jiang X; Department of Neurosurgery, the First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Dong H; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China.
  • Zhang H; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China. Electronic address: zhanghaopeng@fmmu.edu.cn.
  • Lu Z; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi 710032, China. Electronic address: deerlu@fmmu.edu.cn.
J Clin Anesth ; 93: 111356, 2024 05.
Article en En | MEDLINE | ID: mdl-38056052
STUDY OBJECTIVE: This study aimed to compare the time to emergence from general anesthesia with remimazolam versus propofol in patients undergoing cerebral endovascular procedures. DESIGN: A prospective, double-blind, randomized controlled, non-inferiority trial. SETTING: An academic hospital. PATIENTS: Adult patients scheduled for cerebral endovascular procedures. INTERVENTIONS: Patients were randomized at a 1:1 ratio to undergo surgery under general anesthesia with remimazolam (0.1 mg kg-1 for induction and 0.3-0.7 mg kg-1 h-1 for maintenance) or propofol (1-1.5 mg kg-1 for induction and 4-10 mg kg-1 h-1 for maintenance). MEASUREMENTS: The primary outcome was the time to emergence from anesthesia. The non-inferiority margin was -2.55 min in group difference. Major secondary outcomes included hypotension during induction, incidence of postoperative delirium and Modified Rankin Scale (mRs) at 30 days and 90 days after surgery. MAIN RESULTS: Of the 142 randomized patients, 129 completed the trial. In the modified intention-to-treat analysis, the mean time to emergence from anesthesia was 16.1 [10.4] min in the remimazolam group vs. 19.0 [11.2] min in the propofol group. The group difference was -2.9 min [95% CI -6.5, 0.7] (P = 0.003 for non-inferiority). The remimazolam group had lower rate of hypotension during induction (11.3% vs 25.4%, P = 0.03) and use of vasopressors during surgery (29.6% vs 62.0%, P < 0.001). The two groups did not differ in postoperative delirium and mRs at 30 and 90 days after surgery. CONCLUSIONS: In patients undergoing cerebral endovascular procedures, remimazolam did not increase the time from anesthesia vs propofol.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Propofol / Delirio del Despertar / Hipotensión Límite: Adult / Humans Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Propofol / Delirio del Despertar / Hipotensión Límite: Adult / Humans Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China