Effectiveness and safety of remimazolam tosilate versus propofol for sedation in patients undergoing gastrointestinal endoscopy: a randomized controlled trial.

IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY International Journal of Clinical Pharmacy Pub Date : 2024-07-31 DOI:10.1007/s11096-024-01774-2
Dongbin Li, Yu Wang, Yang Xing, Zicen Zhao, Liya Chang, Yufang Leng
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Abstract

Background: Remimazolam tosilate is a new type of benzodiazepine currently used for gastrointestinal endoscopy and can be combined with alfentanil.

Aim: This trial compared the effectiveness and safety of remimazolam with alfentanil to propofol with alfentanil in patients undergoing gastrointestinal endoscopy.

Method: One hundred and sixty-six patients were randomly divided into propofol-alfentanil anaesthesia (Group P) and remimazolam-alfentanil anaesthesia (Group R). The primary outcomes were perioperative haemodynamic variables, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) preoperatively (T0); after anaesthesia induction (T1); when the gastroscope passed through the oropharynx (T2); 3 min (T3), 5 min (T4) and 7 min (T5) after T2; at the end of surgery (T6); and when patients successfully awakened (T7). The secondary outcomes included induction and awakening time, patient satisfaction, operator satisfaction, and adverse event occurrences.

Results: Compared with those in Group P, the SBP in Group R was significantly higher at T1, T2, T3, and T6 (P < 0.05); the DBP and MAP were significantly higher at T1, T2, T3, T5, and T6 (P < 0.05); the HR was significantly faster at T1 to T6 (P < 0.05); the SpO2 was significantly higher at T1 to T4 (P < 0.05); the incidences of hypoxemia, hypotension, and drug injection pain were significantly lower in Group R (P < 0.05); the incidence of hiccups was higher (P < 0.05); the awakening time was shorter in Group R (P < 0.05); and the operator satisfaction score was high (P < 0.05).

Conclusion: Compared to propofol with alfentanil, remimazolam with alfentanil can be used safely and effectively for sedation in patients undergoing gastrointestinal endoscopy, with less impact on the patient's circulatory and respiratory systems and a lower incidence of adverse events.

Trial registration: This trial protocol was registered in the Chinese Clinical Trial Registry (ChiCR2300077252, date: 2023-11-02).

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胃肠道内窥镜检查患者镇静时使用甲磺酸瑞马唑仑与异丙酚的有效性和安全性:随机对照试验。
背景:甲苯磺酸雷马唑仑是一种新型苯二氮卓药物,目前用于胃肠道内窥镜检查,可与阿芬太尼合用:目的:本试验比较了瑞马唑仑联合阿芬太尼与异丙酚联合阿芬太尼对接受消化道内窥镜检查的患者的有效性和安全性:166 名患者被随机分为异丙酚-阿芬太尼麻醉组(P 组)和瑞美唑仑-阿芬太尼麻醉组(R 组)。主要结果为围手术期血流动力学变量,包括术前(T0)收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO2);麻醉诱导后(T1);胃镜通过口咽时(T2);T2 后 3 分钟(T3)、5 分钟(T4)和 7 分钟(T5);手术结束时(T6);以及患者成功苏醒时(T7)。次要结果包括诱导和苏醒时间、患者满意度、操作者满意度和不良事件发生率:与 P 组相比,R 组患者在 T1、T2、T3 和 T6 阶段的 SBP 明显更高(P 2),而 P 组患者在 T1 至 T4 阶段的 SBP 明显更高(P 结论:与 P 组相比,R 组患者在 T1、T2、T3 和 T6 阶段的 SBP 明显更高(P 3),而 P 组患者在 T1 至 T4 阶段的 SBP 明显更高(P 4):与异丙酚联合阿芬太尼相比,瑞马唑仑联合阿芬太尼可安全有效地用于消化内镜检查患者的镇静,对患者循环系统和呼吸系统的影响较小,不良反应发生率较低:本试验方案已在中国临床试验注册中心注册(ChiCR2300077252,日期:2023-11-02)。
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来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
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