Remimazolam has similar anesthetic effect and superior safety compared to propofol in elderly patients: A meta-analysis of randomized controlled trials.
World J Surg
; 2024 Jul 02.
Article
in En
| MEDLINE
| ID: mdl-38955808
ABSTRACT
BACKGROUND:
The superiority between remimazolam and propofol for anesthesia is controversial in elderly patients (≥60 years). This meta-analysis aimed to systematically compare anesthetic effect and safety profile between remimazolam and propofol in elderly patients under any surgery.METHODS:
Cochrane Library, Web of Science, and PubMed were searched until December 25, 2023 for relevant randomized controlled trials.RESULTS:
Ten studies with 806 patients receiving remimazolam (experimental group) and 813 patients receiving propofol (control group) were included. Time to loss of consciousness [standard mean difference (SMD) (95% confidence interval (CI) 1.347 (-0.362, 3.055), p = 0.122] and recovery time [SMD (95% CI) -0.022 (-0.300, 0.257), p = 0.879] were similar between experimental and control groups. Mean arterial pressure at baseline minus 1 min after induction [SMD (95% CI) -1.800 (-3.250, -0.349), p = 0.015], heart rate at baseline minus 1 min after induction [SMD (95% CI) -1.041 (-1.537, -0.545), p < 0.001], incidences of hypoxemia [relative risk (RR) (95% CI) 0.247 (0.138, 0.444), p < 0.001], respiratory depression [RR (95% CI) 0.458 (0.300, 0.700), p < 0.001], bradycardia [RR (95% CI) 0.409 (0.176, 0.954), p = 0.043], hypotension [RR (95% CI) 0.415 (0.241, 0.714), p = 0.007], and injection pain [RR (95% CI) 0.172 (0.113, 0.263), p < 0.001] were lower in the experimental group compared to the control group. Postoperative nausea and vomiting was not different between groups [RR (95% CI) 1.194 (0.829, 1.718), p = 0.341]. Moreover, this meta-analysis displayed a low risk of bias, minimal publication bias, and good robustness.CONCLUSION:
Remimazolam shows comparative anesthetic effect and better safety profile than propofol in elderly patients under any surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
World J Surg
Year:
2024
Document type:
Article
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