Remimazolam-based anesthesia with flumazenil allows faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery: A randomized controlled trial

被引：5

作者：

Toyota, Yukari ^{[1
]}

Kondo, Takashi ^{[1
,4
]}

Oshita, Kyoko ^{[2
]}

Haraki, Toshiaki ^{[2
]}

Narasaki, Soshi ^{[1
]}

Kido, Kenshiro ^{[1
]}

Kamiya, Satoshi ^{[1
]}

Nakamura, Ryuji ^{[1
]}

Saeki, Noboru ^{[1
]}

Horikawa, Yousuke T. ^{[3
]}

Tsutsumi, Yasuo M. ^{[1
]}

机构：

[1] Hiroshima Univ Hosp, Dept Anesthesiol & Crit Care, Hiroshima, Japan

[2] JA Hiroshima Gen Hosp, Dept Anesthesiol, Hiroshima, Japan

[3] Sharp Rees Stealy Med Grp, Dept Pediat, San Diego, CA USA

[4] Hiroshima Univ Hosp, Dept Anesthesiol & Crit Care, 1-2-3 Kasumi,Minami Ku, Hiroshima 7348551, Japan

来源：

MEDICINE | 2023年 / 102卷 / 46期

基金：

日本学术振兴会;

关键词：

emergence; flumazenil; general anesthesia; propofol; remimazolam; OUTPATIENT ANESTHESIA; DESFLURANE; EXTUBATION; CRITERIA; TIME;

D O I：

10.1097/MD.0000000000036081

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Remimazolam is a novel, ultrashort-acting benzodiazepine that can be antagonized by flumazenil. This study aimed to determine whether remimazolam-based anesthesia with flumazenil provides a more rapid emergence than propofol-based anesthesia in older patients undergoing spinal surgery.Methods: This was a prospective, single-blind, randomized controlled trial. Forty-four patients > 75 years old who had undergone spinal surgery were enrolled in this study. They were randomly assigned to the remimazolam or propofol group (1:1) using a computer randomization system stratified by age and body weight. For anesthesia induction and maintenance, remifentanil was administered at a defined dose in both groups, and remimazolam or propofol was adjusted to maintain the bispectral index or state entropy monitoring within 40-60. All anesthetics were discontinued simultaneously after the postoperative X-ray and 0.5 mg flumazenil was administered to the remimazolam group. The primary outcome was extubation time after discontinuing anesthesia, and the secondary outcomes were time to eye opening, obeying commands, and achieving a white fast-track score (WFTS) of 12.Results: Thirty-nine patients were finally analyzed: remimazolam group (n = 20), propofol group (n = 19). There were no significant differences in intraoperative variables, such as operative time, anesthesia time, and patient background, between the 2 groups. Extubation times were significantly shorter in the remimazolam group than in the propofol group (4 vs 8 minutes, P < .001). The time to eye opening, obeying commands, and achieving a WFTS of 12 were significantly shorter in the remimazolam group (P < .001, for all comparisons).Conclusion: Remimazolam-based anesthesia with flumazenil resulted in a faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery.

引用

页数：6

共 24 条

[1] Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane [J].