Liu Huan, Zhou Mingxia, Chen Xiangdong, Esmaeili Elham, Sun Meng, Wu Zhilin
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
PLoS One. 2025 Mar 20;20(3):e0319044. doi: 10.1371/journal.pone.0319044. eCollection 2025.
The postoperative quality of recovery holds significant economic and prognostic implications. Numerous studies have investigated the postoperative quality of recovery following surgery. However, the impact of intraoperative intravenous remimazolam on postoperative recovery has yielded conflicting results.
In this qualitative review of randomized controlled clinical trials assessing the use of intraoperative remimazolam, we present the effects of intravenous remimazolam on postoperative recovery quality in noncardiac surgery patients. We conducted a comprehensive search of PubMed, MEDLINE, Web of Science and Cochrane Library for randomized controlled trials published up to September 23, 2024, without any language restrictions, to investigate the impact of intraoperative intravenous remimazolam on the quality of postoperative recovery following noncardiac surgery. The primary outcome measure was the quality of postoperative recovery assessed using global QoR-40 scores or QoR-15 scores. Secondary outcomes included five dimensions of quality of postoperative recovery: physical comfort, emotional state, physical independence, psychological support, and pain. As well as time to extubation, VAS score, PACU stay, and days in hospital. We analyzed the pooled data using a random-effects model.
This meta-analysis included 18 studies published between 2022 and 2024 involving 1720 patients. The quality of postoperative recovery was assessed using the QoR-15 or QoR-40 questionnaires. The pooled results showed no significant difference in QoR scores between the two groups on the first postoperative day (SMD = 0.12; 95% CI -0.13-0.36; I2 = 78%; p = 0.35). Furthermore, differences in QoR dimensions, PACU duration, extubation time, and length of hospital stay were not observed.
Our analysis showed that the quality of recovery after general anaesthesia in the remimazolam group was similar to that of conventional sedation. Therefore, remimazolam may be used as a potential anaesthetic agent as an alternative to conventional sedation for non-cardiac surgical anaesthesia.
术后恢复质量具有重要的经济和预后意义。众多研究已对手术后的恢复质量进行了调查。然而，术中静脉注射瑞马唑仑对术后恢复的影响却产生了相互矛盾的结果。
在这项对评估术中使用瑞马唑仑的随机对照临床试验的定性综述中，我们阐述了静脉注射瑞马唑仑对非心脏手术患者术后恢复质量的影响。我们对PubMed、MEDLINE、科学网和考克兰图书馆进行了全面检索，以查找截至2024年9月23日发表的随机对照试验，无任何语言限制，以研究术中静脉注射瑞马唑仑对非心脏手术后恢复质量的影响。主要结局指标是使用全球恢复质量-40评分（QoR-40）或恢复质量-15评分（QoR-15）评估的术后恢复质量。次要结局包括术后恢复质量的五个维度：身体舒适度、情绪状态、身体独立性、心理支持和疼痛。以及拔管时间、视觉模拟评分（VAS）、麻醉后监护病房（PACU）停留时间和住院天数。我们使用随机效应模型分析汇总数据。
这项荟萃分析纳入了2022年至2024年间发表的18项研究，涉及1720例患者。使用QoR-15或QoR-40问卷评估术后恢复质量。汇总结果显示，术后第一天两组的QoR评分无显著差异（标准化均数差[SMD]=0.12；95%置信区间[-0.13，0.36]；I²=78%；p=0.35）。此外，未观察到QoR维度、PACU持续时间、拔管时间和住院时间的差异。
我们的分析表明，瑞马唑仑组全身麻醉后的恢复质量与传统镇静相似。因此，瑞马唑仑可作为一种潜在的麻醉药物，作为传统镇静的替代品用于非心脏手术麻醉。
