Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial
Abstract Background Remimazolam recently became available as a sedative. The comparison of the respiratory suppression effects of remimazolam and propofol under deep sedation for colonoscopy was not thoroughly unclear, particularly with regard to the novel metric of time to first airway intervention...
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BMC
2025-04-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02519-1 |
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| author | Zhengjia Wang Renshu Zhan Liqun Mo Jin Zhang Jie Hu Shoupeng Tan Qiongzhen He Ping Li Wekong Sun Xiaobin Wang Jun Jiang Li Liu Yingying Zhang Yiping Bai |
| author_facet | Zhengjia Wang Renshu Zhan Liqun Mo Jin Zhang Jie Hu Shoupeng Tan Qiongzhen He Ping Li Wekong Sun Xiaobin Wang Jun Jiang Li Liu Yingying Zhang Yiping Bai |
| author_sort | Zhengjia Wang |
| collection | DOAJ |
| description | Abstract Background Remimazolam recently became available as a sedative. The comparison of the respiratory suppression effects of remimazolam and propofol under deep sedation for colonoscopy was not thoroughly unclear, particularly with regard to the novel metric of time to first airway intervention. The goal of this study was to systemically compare the respiration profiles of the patients sedated with remimazolam and propofol at the comparable sedation level in the patients undergoing colonoscopy. Methods Four hundred-fifty outpatients were randomly assigned to remimazolam (Group Rem, n = 225) and propofol (Group Pro, n = 225). The target sedation level was the modified Observer’s Assessment of Alertness/Sedation ≤ 2. The primary outcome was elapsed time from anesthesia induction to first airway intervention. Secondary outcomes included incidence and severity of hypoxia and apnea, minute ventilation (MV), tidal volume (TV), and respiratory rate (RR). Results The elapsed time from induction to the first airway intervention was 11 ± 8 min in Group Rem (n = 208) vs. 5 ± 6 min in Group Pro (n = 208, P < 0.001). Patients in Group Rem required less frequent airway intervention and had a lower incidence of and shorter duration of apnea than patients in Group Pro (all P < 0.001). MV at 1 min, 2 min, 4 min post-induction, and at the end of the procedure were higher in Group Rem than those in Group Pro (P < 0.001). Conclusions Patients sedated with remimazolam vs. propofol during colonoscopy maintain improved respiration and require less frequent airway intervention, and have lower incidence of adverse events. Clinical trial registration and registry URL ChiCTR2000034527, registered at www.chictr.org.cn |
| format | Article |
| id | doaj-art-d5ece9d368394fd3aa54a90fbaec384e |
| institution | DOAJ |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-d5ece9d368394fd3aa54a90fbaec384e2025-08-20T03:06:49ZengBMCEuropean Journal of Medical Research2047-783X2025-04-013011910.1186/s40001-025-02519-1Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trialZhengjia Wang0Renshu Zhan1Liqun Mo2Jin Zhang3Jie Hu4Shoupeng Tan5Qiongzhen He6Ping Li7Wekong Sun8Xiaobin Wang9Jun Jiang10Li Liu11Yingying Zhang12Yiping Bai13Department of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of Pharmacology and Toxicology, University of Mississippi Medical CenterDepartment of Anesthesiology, Xuyong County People’s HospitalDepartment of Anesthesiology, The Second People’s Hospital of GuangyuanDepartment of Anesthesiology, Guangyuan Mental Health CenterDepartment of Anesthesiology, The People’s Hospital of YuechiDepartment of Anesthesiology, Cangxi People’s HospitalDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of General Surgery (Thyroid Surgery), The Affiliated Hospital of Southwest Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical UniversityAbstract Background Remimazolam recently became available as a sedative. The comparison of the respiratory suppression effects of remimazolam and propofol under deep sedation for colonoscopy was not thoroughly unclear, particularly with regard to the novel metric of time to first airway intervention. The goal of this study was to systemically compare the respiration profiles of the patients sedated with remimazolam and propofol at the comparable sedation level in the patients undergoing colonoscopy. Methods Four hundred-fifty outpatients were randomly assigned to remimazolam (Group Rem, n = 225) and propofol (Group Pro, n = 225). The target sedation level was the modified Observer’s Assessment of Alertness/Sedation ≤ 2. The primary outcome was elapsed time from anesthesia induction to first airway intervention. Secondary outcomes included incidence and severity of hypoxia and apnea, minute ventilation (MV), tidal volume (TV), and respiratory rate (RR). Results The elapsed time from induction to the first airway intervention was 11 ± 8 min in Group Rem (n = 208) vs. 5 ± 6 min in Group Pro (n = 208, P < 0.001). Patients in Group Rem required less frequent airway intervention and had a lower incidence of and shorter duration of apnea than patients in Group Pro (all P < 0.001). MV at 1 min, 2 min, 4 min post-induction, and at the end of the procedure were higher in Group Rem than those in Group Pro (P < 0.001). Conclusions Patients sedated with remimazolam vs. propofol during colonoscopy maintain improved respiration and require less frequent airway intervention, and have lower incidence of adverse events. Clinical trial registration and registry URL ChiCTR2000034527, registered at www.chictr.org.cnhttps://doi.org/10.1186/s40001-025-02519-1RemimazolamVentilationColonoscopySedationAnesthesia |
| spellingShingle | Zhengjia Wang Renshu Zhan Liqun Mo Jin Zhang Jie Hu Shoupeng Tan Qiongzhen He Ping Li Wekong Sun Xiaobin Wang Jun Jiang Li Liu Yingying Zhang Yiping Bai Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial European Journal of Medical Research Remimazolam Ventilation Colonoscopy Sedation Anesthesia |
| title | Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial |
| title_full | Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial |
| title_fullStr | Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial |
| title_full_unstemmed | Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial |
| title_short | Comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy: a prospective multicenter randomized controlled trial |
| title_sort | comparison of effect of remimazolam and propofol on respiration of patients under deep sedation for colonoscopy a prospective multicenter randomized controlled trial |
| topic | Remimazolam Ventilation Colonoscopy Sedation Anesthesia |
| url | https://doi.org/10.1186/s40001-025-02519-1 |
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