Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia
Remimazolam has advantages such as hemodynamic stability and rapid onset. We investigated the effects of induction doses on hemodynamics and recovery profiles for remimazolam compared to propofol in older patients. Sixty-nine patients aged >65 years were randomly assigned to either the propofol a...
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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/16/5285 |
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| author | Tae Kwang Kim Hyun Jeong Kwak Wol Seon Jung Gyu Bin Choi Sung Yong Park Jong Yeop Kim |
| author_facet | Tae Kwang Kim Hyun Jeong Kwak Wol Seon Jung Gyu Bin Choi Sung Yong Park Jong Yeop Kim |
| author_sort | Tae Kwang Kim |
| collection | DOAJ |
| description | Remimazolam has advantages such as hemodynamic stability and rapid onset. We investigated the effects of induction doses on hemodynamics and recovery profiles for remimazolam compared to propofol in older patients. Sixty-nine patients aged >65 years were randomly assigned to either the propofol anesthesia group (P group) or the remimazolam anesthesia group with an induction dose of 6 mg/kg/h (R6 group) or 12 mg/kg/h (R12 group), followed by 1 mg/kg/h. P group was anesthetized with 4 µg/mL of propofol effect-site concentration (Ce) with target-control infusion, followed by 2.5–3 µg/mL of Ce. The primary outcome was the difference between the baseline mean arterial pressure (MAP) and the lowest MAP during anesthesia (ΔMAP). ΔMAP was comparable between the P, R6, and R12 groups (43.8 ± 13.8 mmHg, 39.2 ± 14.3 mmHg, and 39.2 ± 13.5 mmHg, <i>p</i> = 0.443). However, the frequencies of vasoactive drug use were 54.5%, 17.4%, and 30.4% (<i>p</i> = 0.029), and the median doses of ephedrine 3 (0–6) mg, 0 (0–0) mg, and 0 (0–0) mg (<i>p</i> = 0.034), which were significantly different. This study showed remimazolam anesthesia with an induction dose of 6 mg/kg/h, rather than 12 mg/kg/h, could reduce the requirement for vasoactive drugs compared to propofol anesthesia. |
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| last_indexed | 2024-03-10T23:50:22Z |
| publishDate | 2023-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-5818d868ed53434ca1fdad9ff76497722023-11-19T01:40:54ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011216528510.3390/jcm12165285Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol AnesthesiaTae Kwang Kim0Hyun Jeong Kwak1Wol Seon Jung2Gyu Bin Choi3Sung Yong Park4Jong Yeop Kim5Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Republic of KoreaRemimazolam has advantages such as hemodynamic stability and rapid onset. We investigated the effects of induction doses on hemodynamics and recovery profiles for remimazolam compared to propofol in older patients. Sixty-nine patients aged >65 years were randomly assigned to either the propofol anesthesia group (P group) or the remimazolam anesthesia group with an induction dose of 6 mg/kg/h (R6 group) or 12 mg/kg/h (R12 group), followed by 1 mg/kg/h. P group was anesthetized with 4 µg/mL of propofol effect-site concentration (Ce) with target-control infusion, followed by 2.5–3 µg/mL of Ce. The primary outcome was the difference between the baseline mean arterial pressure (MAP) and the lowest MAP during anesthesia (ΔMAP). ΔMAP was comparable between the P, R6, and R12 groups (43.8 ± 13.8 mmHg, 39.2 ± 14.3 mmHg, and 39.2 ± 13.5 mmHg, <i>p</i> = 0.443). However, the frequencies of vasoactive drug use were 54.5%, 17.4%, and 30.4% (<i>p</i> = 0.029), and the median doses of ephedrine 3 (0–6) mg, 0 (0–0) mg, and 0 (0–0) mg (<i>p</i> = 0.034), which were significantly different. This study showed remimazolam anesthesia with an induction dose of 6 mg/kg/h, rather than 12 mg/kg/h, could reduce the requirement for vasoactive drugs compared to propofol anesthesia.https://www.mdpi.com/2077-0383/12/16/5285general anesthesiaelderlyremimazolampropofolhemodynamics |
| spellingShingle | Tae Kwang Kim Hyun Jeong Kwak Wol Seon Jung Gyu Bin Choi Sung Yong Park Jong Yeop Kim Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia Journal of Clinical Medicine general anesthesia elderly remimazolam propofol hemodynamics |
| title | Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia |
| title_full | Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia |
| title_fullStr | Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia |
| title_full_unstemmed | Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia |
| title_short | Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia |
| title_sort | effects of remimazolam anesthesia with two induction doses on hemodynamics and recovery profile in older patients comparison with propofol anesthesia |
| topic | general anesthesia elderly remimazolam propofol hemodynamics |
| url | https://www.mdpi.com/2077-0383/12/16/5285 |
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