Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1272-1283
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1272
Safety and efficacy comparison of remimazolam and propofol for intravenous anesthesia during gastroenteroscopic surgery of older patients: A meta-analysis
Fang-Zhuo Li, Cheng Zhao, Yi-Xun Tang, Ji-Tong Liu
Fang-Zhuo Li, Yi-Xun Tang, Ji-Tong Liu, Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410005, Hunan Province, China
Cheng Zhao, Department of Anesthesiology, Zhangjiajie People's Hospital, Zhangjiajie 427000, Hunan Province, China
Author contributions: Li FZ and Zhao C conducted the systematic review and data collection and proposed an explanation that played an important role in the writing of the paper; Li FZ and Tang YX carefully evaluated and verified the manuscript and confirmed the funding; Li FZ analyzed and reviewed the data; Liu JT reviewed the papers; supervised and critically evaluated the work, and confirmed the manuscript; This article was written and approved by all authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised in accordance with this checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ji-Tong Liu, MD, Chief Doctor, Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), No. 61 Jiefang East Road, Wucheng District, Changsha 410005, Hunan Province, China.
Received: December 22, 2023
Peer-review started: December 22, 2023
First decision: January 9, 2024
Revised: January 21, 2024
Accepted: February 5, 2024
Article in press: February 5, 2024
Published online: March 6, 2024
Processing time: 70 Days and 1.2 Hours
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.