Comparison between remimazolam and propofol anaesthesia for interventional neuroradiology: a randomised controlled trial - 14/01/24
Abstract |
Background |
General anaesthesia can immobile patients during interventional neuroradiology to improve image quality. Remimazolam, an ultrashort-acting benzodiazepine, is advantageous for haemodynamic stability. This study compared remimazolam and propofol anaesthesia during neuroradiology procedures regarding intraoperative hypotensive events and rapid recovery.
Methods |
This single-masked randomised-controlled study included 76 participants who underwent elective endovascular embolisation in a single centre. Patients were randomised between a continuous remimazolam infusion (n = 38) or a target-controlled propofol infusion group (n = 38). In the remimazolam group, flumazenil (0.2 mg) was administered at the end of the procedure. Phenylephrine was titrated to maintain the mean arterial pressure within ± 20% of the baseline value. The primary outcome was the total phenylephrine dose during the procedure.
Results |
The total phenylephrine dose was 0.0 [0.0–30.0] μg in the remimazolam group and 30.0 [0.0–205.0] μg in the propofol group (p = 0.001). Hypotensive events were observed in 11 (28.9%) patients in the remimazolam group and 23 (60.5%) patients in the propofol group (p = 0.001). Recovery times to spontaneous breathing, eye-opening, extubation, and orientation were shorter in the remimazolam group than in the propofol group (all p < 0.001).
Conclusions |
Remimazolam anaesthesia showed superior haemodynamic stability compared with propofol anaesthesia during neuroradiology procedures. Systematic use of flumazenil enabled rapid recovery from remimazolam anaesthesia.
Registration |
University Hospital Medical Information Network Clinical Trials Registry; Registration number: UMIN000047384; URL: ctr_view.cgi?recptno=R000054046
Le texte complet de cet article est disponible en PDF.Keywords : Flumazenil, Intervention, Neuroradiology, Propofol, Remimazolam
Abbreviations : BIS, MAP, PTC, TCI, TOF
Plan
Vol 43 - N° 2
Article 101337- avril 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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