Safety and efficacy comparison of remimazolam and propofol for intravenous anesthesia during gastroenteroscopic surgery of older patients: A meta-analysis

ARTICLE HIGHLIGHTS

Research background

Remimazolam is a new benzodiazepine with the advantages of rapid response, low metabolite activity, and no injection pain. An increasing number of clinical surgeries use remimazolam as the general anesthetic.

Research motivation

To the best of our knowledge, this is the first systematic review of the safety and efficacy of remimazolam as an intravenous anesthetic for gastroenteroscopy in older patients.

Research objectives

This study aimed to assess the safety and efficacy of remimazolam for sedation in older patients undergoing gastroenteroscopy.

Research methods

We searched databases of PubMed, Cochrane Library, and the Web of Science, from the original to Oct 2023. The search terms include "remimazolam", "and propofol", "and gastrointestinal endoscopy or gastroscopy", search scope was "Title and Abstract". The search was limited to human studies and literature in English.

Research results

According to a meta-analysis, remimazolam surpasses propofol in managing negative effects such as hypotension, respiratory depression, injection pain, and bradycardia and shortens patients’ discharge time. However, the absence of sufficient clinical studies indicates that there is no clear variance in the successful sadation rate and time to full alertness after surgery.

Research conclusions

In older patients undergoing endoscopy, remimazolam may be a safer option than propofol. However, further studies are required to confirm these findings.

Research perspectives

With the increasing age of China’s population, the demand for painless gastroenteroscopy in older patients is increasing. The administration of remimazolam ensures sedation during endoscopy and simultaneously reduces the occurrence of complications and adverse events during surgery.