Luo Hong, Tang Zuolei
Department of Anesthesiology, 363 Hospital, Wuhou, Chengdu, Sichuan 610041, P.R. China.
Department of Anesthesiology, Tianfu New District People's Hospital, Shuangliu, Chengdu, Sichuan 610200, P.R. China.
Biomed Rep. 2024 Nov 15;22(1):13. doi: 10.3892/br.2024.1891. eCollection 2025 Jan.
Remimazolam is an ultra-short-acting intravenous benzodiazepine derivative approved for sedation during gastroscopy and colonoscopy. The present study aimed to compare the safety and efficacy of remimazolam and propofol for general anesthesia with tracheal intubation by meta-analysis. A comprehensive search was conducted in databases, including PubMed, Embase, Cochrane Library and Web of Science, to identify relevant randomized controlled trials (RCTs). The search period was from the inception of these databases until February 2024. All eligible randomized controlled trials that report at least one outcome of interest were subjected to quality assessment and data extraction by two researchers independently using Review Manager 5.4 software. Data analysis was conducted using R software. A total of 14 RCTs with 1,275 patients were included for meta-analysis. Compared with propofol, remimazolam significantly reduced incidence of hypotension [odds ratio (OR)=0.31, 95% confidence interval (CI; 0.23, 0.43), P<0.0001], bradycardia [OR=0.06, 95% CI (0.00, 1.20), P=0.06] and injection pain [OR=0.02, 95% CI (0.01, 0.08), P<0.0001] with shorter time to recovery of consciousness (ROC) [mean difference (MD)=5.47 min, 95% CI (-10.70, -0.24 min), P=0.04] but longer time to loss of consciousness [MD=37.01 sec, 95% CI (24.42, 49.60 sec), P<0.0001]. Remimazolam was a safer and more effective alternative to propofol for general anesthesia with tracheal intubation and demonstrated a lower risk of adverse events with shorter time to ROC.
瑞米唑仑是一种超短效静脉注射苯二氮䓬衍生物，已被批准用于胃镜检查和结肠镜检查期间的镇静。本研究旨在通过荟萃分析比较瑞米唑仑和丙泊酚用于气管插管全身麻醉的安全性和有效性。在包括PubMed、Embase、Cochrane图书馆和Web of Science在内的数据库中进行了全面检索，以识别相关的随机对照试验（RCT）。检索期从这些数据库建立至2024年2月。所有报告至少一项感兴趣结局的合格随机对照试验由两名研究人员独立使用Review Manager 5.4软件进行质量评估和数据提取。使用R软件进行数据分析。总共纳入14项RCT，涉及1275例患者进行荟萃分析。与丙泊酚相比，瑞米唑仑显著降低了低血压发生率[比值比（OR）=0.31，95%置信区间（CI；0.23，0.43），P<0.0001]、心动过缓[OR=0.06，95%CI（0.00，1.20），P=0.06]和注射痛[OR=0.02，95%CI（0.01，0.08），P<0.0001]，意识恢复时间（ROC）更短[平均差（MD）=5.47分钟，95%CI（-10.70，-0.24分钟），P=0.04]，但意识消失时间更长[MD=37.01秒，95%CI（24.42，49.60秒），P<0.0001]。对于气管插管全身麻醉，瑞米唑仑是丙泊酚更安全、更有效的替代品，且不良事件风险更低，ROC时间更短。
