Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials
<i>Background and Objectives</i>: This meta-analysis evaluates the safety and efficacy of remimazolam versus propofol for sedation during colonoscopy, focusing on hemodynamic and respiratory outcomes. <i>Materials and Methods</i>: A comprehensive search of CENTRAL, Embase, Pu...
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2025-04-01
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| author | Bon-Wook Koo Hyo-Seok Na Sang-Hi Park Seunguk Bang Hyun-Jung Shin |
| author_facet | Bon-Wook Koo Hyo-Seok Na Sang-Hi Park Seunguk Bang Hyun-Jung Shin |
| author_sort | Bon-Wook Koo |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: This meta-analysis evaluates the safety and efficacy of remimazolam versus propofol for sedation during colonoscopy, focusing on hemodynamic and respiratory outcomes. <i>Materials and Methods</i>: A comprehensive search of CENTRAL, Embase, PubMed, Scopus, and Web of Science up to January 2025 identified randomized controlled trials (RCTs). Outcomes included hypotension (primary outcome), bradycardia, respiratory depression, injection pain, sedation onset time, emergence time, procedure success rate, and recovery room stay. Effect sizes were reported as relative risks (RR) or mean differences (MD) using random-effects models. <i>Results</i>: Fourteen RCTs with 3290 participants were included. Remimazolam significantly reduced the risk of hypotension (RR: 0.44, 95% CI [0.39, 0.51], <i>p</i> = 0.0000), bradycardia (RR: 0.36, 95% CI [0.25, 0.53], <i>p</i> = 0.0000), respiratory depression (RR: 0.32, 95% CI [0.22, 0.45], <i>p</i> = 0.0000), and injection pain (RR: 0.14, 95% CI [0.09, 0.24], <i>p</i> = 0.0000) compared to propofol. Remimazolam had slower sedation onset (MD: 15.97 s, 95% CI [8.30, 23.64], <i>p</i> = 0.0000) but allowed faster emergence (MD: −0.91 min, 95% CI [−1.69, −0.13], <i>p</i> = 0.023) and shorter recovery room stays (MD: −2.20 min, 95% CI [−3.23, −1.17], <i>p</i> = 0.0000). Both drugs had similar procedure success rates. <i>Conclusions</i>: Remimazolam demonstrates superior safety and efficacy compared to propofol, reducing risks of hypotension, bradycardia, respiratory depression, and injection pain while enabling faster recovery. These findings support remimazolam as a viable sedative for colonoscopy, though further large-scale studies are needed to confirm these results. |
| format | Article |
| id | doaj-art-e4b26fb13ffa44e89d4dfc59f7fb0258 |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-04-01 |
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| series | Medicina |
| spelling | doaj-art-e4b26fb13ffa44e89d4dfc59f7fb02582025-08-20T03:13:48ZengMDPI AGMedicina1010-660X1648-91442025-04-0161464610.3390/medicina61040646Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled TrialsBon-Wook Koo0Hyo-Seok Na1Sang-Hi Park2Seunguk Bang3Hyun-Jung Shin4Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju-si 28644, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Daejeon 34943, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea<i>Background and Objectives</i>: This meta-analysis evaluates the safety and efficacy of remimazolam versus propofol for sedation during colonoscopy, focusing on hemodynamic and respiratory outcomes. <i>Materials and Methods</i>: A comprehensive search of CENTRAL, Embase, PubMed, Scopus, and Web of Science up to January 2025 identified randomized controlled trials (RCTs). Outcomes included hypotension (primary outcome), bradycardia, respiratory depression, injection pain, sedation onset time, emergence time, procedure success rate, and recovery room stay. Effect sizes were reported as relative risks (RR) or mean differences (MD) using random-effects models. <i>Results</i>: Fourteen RCTs with 3290 participants were included. Remimazolam significantly reduced the risk of hypotension (RR: 0.44, 95% CI [0.39, 0.51], <i>p</i> = 0.0000), bradycardia (RR: 0.36, 95% CI [0.25, 0.53], <i>p</i> = 0.0000), respiratory depression (RR: 0.32, 95% CI [0.22, 0.45], <i>p</i> = 0.0000), and injection pain (RR: 0.14, 95% CI [0.09, 0.24], <i>p</i> = 0.0000) compared to propofol. Remimazolam had slower sedation onset (MD: 15.97 s, 95% CI [8.30, 23.64], <i>p</i> = 0.0000) but allowed faster emergence (MD: −0.91 min, 95% CI [−1.69, −0.13], <i>p</i> = 0.023) and shorter recovery room stays (MD: −2.20 min, 95% CI [−3.23, −1.17], <i>p</i> = 0.0000). Both drugs had similar procedure success rates. <i>Conclusions</i>: Remimazolam demonstrates superior safety and efficacy compared to propofol, reducing risks of hypotension, bradycardia, respiratory depression, and injection pain while enabling faster recovery. These findings support remimazolam as a viable sedative for colonoscopy, though further large-scale studies are needed to confirm these results.https://www.mdpi.com/1648-9144/61/4/646remimazolampropofolcolonoscopysedationhemodynamicsrespiratory insufficiency |
| spellingShingle | Bon-Wook Koo Hyo-Seok Na Sang-Hi Park Seunguk Bang Hyun-Jung Shin Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials Medicina remimazolam propofol colonoscopy sedation hemodynamics respiratory insufficiency |
| title | Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Comparison of the Safety and Efficacy of Remimazolam and Propofol for Sedation in Adults Undergoing Colonoscopy: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | comparison of the safety and efficacy of remimazolam and propofol for sedation in adults undergoing colonoscopy a meta analysis of randomized controlled trials |
| topic | remimazolam propofol colonoscopy sedation hemodynamics respiratory insufficiency |
| url | https://www.mdpi.com/1648-9144/61/4/646 |
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