Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

doi:10.4240/wjgs.v16.i5.1320

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May 27, 2024 (publication date) through Mar 9, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. May 27, 2024; 16(5): 1320-1327
Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1320

Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

Yu-Fu Deng, Xue-Run Jiang, Zeng-Guang Feng

Yu-Fu Deng, Xue-Run Jiang, Zeng-Guang Feng, Department of Anesthesiology, Xiangtan Central Hospital, Xiangtan 411100, Hunan Province, China

Author contributions: Deng YF designed the research and wrote the first manuscript; Deng YF, Jiang XR and Feng ZG contributed to conceiving the research and analyzing data; Deng YF conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Xiangtan Central Hospital.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: We have no financial relationships to disclose.

Data sharing statement: All data and materials are available from the corresponding author.

Corresponding author: Zeng-Guang Feng, BMed, Director, Department of Anesthesiology, Xiangtan Central Hospital, No. 120 Heping Road, Xiangtan 411100, Hunan Province, China. FZG17320275@163.com

Received: February 19, 2024
Revised: April 2, 2024
Accepted: April 9, 2024
Published online: May 27, 2024
Processing time: 94 Days and 2.3 Hours

Abstract

BACKGROUND

Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients. Thus, a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.

AIM

To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine (DEX) in gastrointestinal surgery in obese patients.

METHODS

The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023, comprising 30 patients who received DEX intervention (control group) and 30 patients who received remimazolam besylate intervention (research group). Heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), blood oxygen saturation (SpO₂), safety (nausea and vomiting, bradycardia, hypotension, and apnea), anesthesia and examination indices [induction time, anesthesia recovery time, and postanesthesia care unit (PACU) discharge time], sedation effect (Ramsay Sedation Scale), and postoperative pain visual analog scale were comparatively analyzed before anesthesia (T0), during anesthesia (T1), and after anesthesia (T2).

RESULTS

At T1, the research group showed significantly smaller changes in HR, RR, MAP, and SpO₂ than the control group, with a significantly lower adverse reaction rate and shorter induction, anesthesia recovery, and PACU discharge times. Additionally, the intra- and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.

CONCLUSION

Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

Keywords: Remimazolam besylate; Dexmedetomidine; Obesity; Gastrointestinal surgery; Effectiveness; Safety

Core Tip: This study primarily compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine (DEX) in gastrointestinal surgery for obese patients. Our findings confirmed that remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients, with a high safety profile and value in clinical promotion, thereby providing a reliable clinical reference for anesthesia management optimization in gastrointestinal surgery for obese patients.