经导管主动脉瓣置换术后在监测麻醉护理下使用雷马唑仑与右美托咪定对恢复的影响:倾向得分匹配、非劣效性研究。

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Korean Journal of Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI:10.4097/kja.24138
Ji-Hyeon Kim, Jae-Sik Nam, Wan-Woo Seo, Kyung-Woon Joung, Ji-Hyun Chin, Wook-Jong Kim, Dae-Kee Choi, In-Cheol Choi
{"title":"经导管主动脉瓣置换术后在监测麻醉护理下使用雷马唑仑与右美托咪定对恢复的影响:倾向得分匹配、非劣效性研究。","authors":"Ji-Hyeon Kim, Jae-Sik Nam, Wan-Woo Seo, Kyung-Woon Joung, Ji-Hyun Chin, Wook-Jong Kim, Dae-Kee Choi, In-Cheol Choi","doi":"10.4097/kja.24138","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery. Remimazolam is a novel benzodiazepine with a short recovery time. This study hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR.</p><p><strong>Methods: </strong>In this retrospective observational study, remimazolam was compared to dexmedetomidine in patients who underwent TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary outcome was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. Propensity score matching was used to compare timely recovery between remimazolam and dexmedetomidine, applying a non-inferiority margin of -10%.</p><p><strong>Results: </strong>The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity score matching, 164 patients in each group were included in the analysis. Regarding timely recovery after TAVR, remimazolam was non-inferior to dexmedetomidine (152 of 164 [92.7%] in the remimazolam group versus 153 of 164 [93.3%] in the dexmedetomidine group, risk difference [95% CI]: -0.6% [-6.7%, 5.5%]). The use of remimazolam was associated with fewer postoperative vasopressors/inotropes (21 of 164 [12.8%] vs. 39 of 164 [23.8%]) and temporary pacemakers (TPMs) (76 of 164 [46.3%] vs. 108 of 164 [65.9%]) compared to dexmedetomidine.</p><p><strong>Conclusions: </strong>In patients undergoing TAVR under MAC, remimazolam was non-inferior to dexmedetomidine in terms of timely recovery. Remimazolam may be associated with better postoperative recovery profiles, including a lesser need for vasopressors/inotropes and TPMs.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467503/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of remimazolam versus dexmedetomidine on recovery after transcatheter aortic valve replacement under monitored anesthesia care: a propensity score-matched, non-inferiority study.\",\"authors\":\"Ji-Hyeon Kim, Jae-Sik Nam, Wan-Woo Seo, Kyung-Woon Joung, Ji-Hyun Chin, Wook-Jong Kim, Dae-Kee Choi, In-Cheol Choi\",\"doi\":\"10.4097/kja.24138\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery. Remimazolam is a novel benzodiazepine with a short recovery time. This study hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR.</p><p><strong>Methods: </strong>In this retrospective observational study, remimazolam was compared to dexmedetomidine in patients who underwent TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary outcome was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. Propensity score matching was used to compare timely recovery between remimazolam and dexmedetomidine, applying a non-inferiority margin of -10%.</p><p><strong>Results: </strong>The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity score matching, 164 patients in each group were included in the analysis. Regarding timely recovery after TAVR, remimazolam was non-inferior to dexmedetomidine (152 of 164 [92.7%] in the remimazolam group versus 153 of 164 [93.3%] in the dexmedetomidine group, risk difference [95% CI]: -0.6% [-6.7%, 5.5%]). The use of remimazolam was associated with fewer postoperative vasopressors/inotropes (21 of 164 [12.8%] vs. 39 of 164 [23.8%]) and temporary pacemakers (TPMs) (76 of 164 [46.3%] vs. 108 of 164 [65.9%]) compared to dexmedetomidine.</p><p><strong>Conclusions: </strong>In patients undergoing TAVR under MAC, remimazolam was non-inferior to dexmedetomidine in terms of timely recovery. Remimazolam may be associated with better postoperative recovery profiles, including a lesser need for vasopressors/inotropes and TPMs.</p>\",\"PeriodicalId\":17855,\"journal\":{\"name\":\"Korean Journal of Anesthesiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467503/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Korean Journal of Anesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4097/kja.24138\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4097/kja.24138","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:在监测麻醉护理(MAC)下进行经导管主动脉瓣置换术(TAVR)强调早期恢复。雷马唑仑是一种新型苯二氮卓类药物,恢复时间短。本研究假设,就TAVR术后恢复而言,雷马唑仑不劣于右美托咪定:在这项回顾性观察研究中,对 2020 年 7 月至 2022 年 7 月期间在一家三级学术医院接受 MAC 下 TAVR 的患者进行了雷马唑仑与右美托咪定的比较。主要研究结果是 TAVR 术后的及时康复,即术后第一天内从重症监护室出院。采用倾向得分匹配法比较雷马唑仑和右美托咪定的及时恢复情况,非劣效性差值为-10%:研究共纳入 464 名患者,其中 218 人接受了雷马唑仑治疗,246 人接受了右美托咪定治疗。经过倾向评分匹配后,每组各有164名患者纳入分析。在TAVR术后及时恢复方面,雷马唑仑的效果不劣于右美托咪定(雷马唑仑组164例中有152例[92.7%],右美托咪定组164例中有153例[93.3%],风险差异[95% CI]:-0.6% [-6.7% to 5.5%])。与右美托咪定相比,使用瑞马唑仑可减少术后使用血管加压剂/肌注(164例中的21例[12.8%]对164例中的39例[23.8%])和临时起搏器(TPM)(164例中的76例[46.3%]对164例中的108例[65.9%]):结论:对于在 MAC 下接受 TAVR 的患者,就及时恢复而言,雷马唑仑不优于右美托咪定。雷马唑仑可能与更好的术后恢复情况有关,包括对血管抑制剂/肌注和TPM的需求较少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Effects of remimazolam versus dexmedetomidine on recovery after transcatheter aortic valve replacement under monitored anesthesia care: a propensity score-matched, non-inferiority study.

Background: Minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery. Remimazolam is a novel benzodiazepine with a short recovery time. This study hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR.

Methods: In this retrospective observational study, remimazolam was compared to dexmedetomidine in patients who underwent TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary outcome was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. Propensity score matching was used to compare timely recovery between remimazolam and dexmedetomidine, applying a non-inferiority margin of -10%.

Results: The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity score matching, 164 patients in each group were included in the analysis. Regarding timely recovery after TAVR, remimazolam was non-inferior to dexmedetomidine (152 of 164 [92.7%] in the remimazolam group versus 153 of 164 [93.3%] in the dexmedetomidine group, risk difference [95% CI]: -0.6% [-6.7%, 5.5%]). The use of remimazolam was associated with fewer postoperative vasopressors/inotropes (21 of 164 [12.8%] vs. 39 of 164 [23.8%]) and temporary pacemakers (TPMs) (76 of 164 [46.3%] vs. 108 of 164 [65.9%]) compared to dexmedetomidine.

Conclusions: In patients undergoing TAVR under MAC, remimazolam was non-inferior to dexmedetomidine in terms of timely recovery. Remimazolam may be associated with better postoperative recovery profiles, including a lesser need for vasopressors/inotropes and TPMs.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
期刊最新文献
Controlled hypotension under rapid ventricular pacing technique in patients with cerebral arteriovenous malformation: a case report. Comparison of postoperative outcomes after cranial neurosurgery using propofol-based total intravenous anesthesia versus inhalation anesthesia: a nationwide cohort study in South Korea. Comparison of remimazolam and midazolam for preventing intraoperative nausea and vomiting during cesarean section under spinal anesthesia: a randomized controlled trial. Current evidence on the use of sugammadex for neuromuscular blockade antagonism during electroconvulsive therapy - a narrative review. Dexmedetomidine alleviates CoCl2-induced hypoxic cellular damage in INS-1 cells by regulating autophagy.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1