Remimazolam versus propofol for procedural sedation: a meta-analysis of randomized controlled trials

被引：37

作者：

Chang, Yu ^{[1
]}

Huang, Yun-Ting ^{[2
]}

Chi, Kuan-Yu ^{[3
,4
]}

Huang, Yen-Ta ^{[1
]}

机构：

[1] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Dept Surg, Tainan, Taiwan

[2] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Anesthesiol, Tainan, Taiwan

[3] Taipei Med Univ Hosp, Dept Internal Med, Taipei, Taiwan

[4] Taipei Med Univ Hosp, Ctr Evidence Based Med, Dept Educ, Taipei, Taiwan

来源：

PEERJ | 2023年 / 11卷

关键词：

Remimazolam; Propofol; Procedural sedation; Meta-analysis; COLONOSCOPY; DISCOMFORT; ANESTHESIA; EFFICACY; SAFETY; AGENTS; PAIN;

D O I：

10.7717/peerj.15495

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background. To improve patient tolerability and satisfaction as well as minimize complications, procedural sedation has been widely used. Propofol is the most widely used agent for induction of anesthesia and sedation by anesthesiologists. With a different mechanism compared to propofol, remimazolam is a new short-acting GABA-A receptor agonist. It is an ester-based benzodiazepine. This meta-analysis aims to clarify the efficacy and safety of remimazolam versus propofol for procedure sedation.Methods. Electronic databases were searched for randomized controlled trials (RCTs) comparing efficacy or safety of remimazolam versus propofol. Meta-analysis were conducted using RStudio with "metafor"package with random-effects model.Results. A total of twelve RCTs were included in the meta-analysis. The pooled results demonstrated that patients with remimazolam for procedural sedation had lower risk of bradycardia (OR 0.28, 95% CI [0.14-0.57]), hypotension (OR 0.26, 95% CI [0.22-0.32]), and respiratory depression (OR 0.22, 95% CI [0.14-0.36]). There was no difference in the risk of developing postoperative nausea and vomiting (PONY) (OR 0.65, 95% CI [0.15-2.79]) and dizziness (OR 0.93, 95% CI [0.53-1.61]) between the remimazolam and propofol groups. Using remimazolam for procedural sedation is significantly associated with less injection pain compared to propofol (OR 0.06, 95% CI [0.03-0.13]). Regarding the sedation efficacy, there was no difference in sedation success rate or time to loss of consciousness, recover and discharge between the remimazolam and the propofol groups.Conclusions. Based on our meta-analysis, patients receiving procedural sedation with remimazolam had lower risk of bradycardia, hypotension, respiratory depression and injection pain compared with propofol. On the other hand, there was no difference in sedation success rate, risk of PONY, dizziness, time to LOC, recovery and discharge between these two sedatives.PROSPERO registration number. CRD42022362950

引用

页数：12

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