Ri Hyun-Su, Jeon Soeun, Yeo Jinseok, Jung Hoon, Kang Christine, Choo Hyojun
Department of Anesthesia and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Anesthesia and Pain Medicine, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Republic of Korea.
Sci Rep. 2025 Aug 10;15(1):29236. doi: 10.1038/s41598-025-14976-z.
This meta-analysis aimed to evaluate the efficacy of remimazolam, a newly introduced anesthetic, in preventing postoperative nausea and vomiting (PONV) compared to other anesthetics. A systematic search of studies published up to January 2024 in PubMed, Cochrane Library, and Embase was conducted to identify randomized controlled trials (RCTs) comparing remimazolam with other anesthetics in terms of PONV. Following data synthesis, outcomes were reported as the relative risk (RR) with 95% confidence interval (95% CI). Subgroup analyses were performed according to the type of comparator anesthetic. A total of 50 RCTs involving 9,193 participants were included. The results showed no significant difference in PONV incidence between remimazolam and other anesthetic agents (RR: 0.96, 95% CI: 0.80-1.13, P = 0.607). However, subgroup analysis demonstrated that a lower incidence of overall PONV was associated with remimazolam compared with inhalation anesthetics (n = 363; RR: 0.50; 95% CI: 0.34-0.73; P < 0.001). Conversely, a higher incidence of postoperative vomiting was associated with remimazolam compared with propofol (n = 3,860; RR: 1.41; 95% CI: 1.05-1.90; P = 0.024). Overall, there was no significant difference between remimazolam and other anesthetic agents in preventing PONV. However, subgroup analysis revealed that remimazolam was more effective than inhalation anesthetics in mitigating PONV, and it was inferior to propofol in preventing postoperative vomiting.
本荟萃分析旨在评估新引入的麻醉剂瑞马唑仑与其他麻醉剂相比，在预防术后恶心呕吐（PONV）方面的疗效。对截至2024年1月在PubMed、Cochrane图书馆和Embase上发表的研究进行了系统检索，以确定在PONV方面比较瑞马唑仑与其他麻醉剂的随机对照试验（RCT）。数据合成后，结果报告为相对风险（RR）及95%置信区间（95%CI）。根据对照麻醉剂的类型进行亚组分析。共纳入50项RCT，涉及9193名参与者。结果显示，瑞马唑仑与其他麻醉剂在PONV发生率上无显著差异（RR：0.96，95%CI：0.80-1.13，P = 0.607）。然而，亚组分析表明，与吸入麻醉剂相比，瑞马唑仑导致的总体PONV发生率较低（n = 363；RR：0.50；95%CI：0.34-0.73；P < 0.001）。相反，与丙泊酚相比，瑞马唑仑导致的术后呕吐发生率较高（n = 3860；RR：1.41；95%CI：1.05-1.90；P = 0.024）。总体而言，瑞马唑仑与其他麻醉剂在预防PONV方面无显著差异。然而，亚组分析显示，瑞马唑仑在减轻PONV方面比吸入麻醉剂更有效，而在预防术后呕吐方面不如丙泊酚。
