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Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy

BACKGROUND: This study was conducted to investigate the effects and safety of remimazolam versus propofol on cerebral oxygen saturation and cerebral hemodynamics during the induction of general anesthesia in patients receiving carotid endarterectomy (CEA), so as to provide theoretical basis for bett...

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Autores principales: Gao, Jianling, Yang, Chengdi, Ji, Qiuyuan, Li, Jian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157955/
https://www.ncbi.nlm.nih.gov/pubmed/37142971
http://dx.doi.org/10.1186/s12871-023-02095-z
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author Gao, Jianling
Yang, Chengdi
Ji, Qiuyuan
Li, Jian
author_facet Gao, Jianling
Yang, Chengdi
Ji, Qiuyuan
Li, Jian
author_sort Gao, Jianling
collection PubMed
description BACKGROUND: This study was conducted to investigate the effects and safety of remimazolam versus propofol on cerebral oxygen saturation and cerebral hemodynamics during the induction of general anesthesia in patients receiving carotid endarterectomy (CEA), so as to provide theoretical basis for better clinical application of remimazolam. METHODS: Forty-three patients (60–75 years old) with carotid artery stenosis (carotid artery stenosis greater than 70%) were randomly divided into the remimazolam group (R group) and the propofol group (P group). Anesthesia was induced with remimazolam (0.3 mg/kg) or propofol (1.5-2 mg/kg) individually. At time of admission (T0), post-anesthesia induction (T1), consciousness disappears (T2), 1 min after loss of consciousness (T3), 2 min after loss of consciousness (T4) and pre-endotracheal intubation (T5), measurement in patients with regional cerebral oxygen saturation (SrO(2)), average blood flow velocity (Vm), resistance index (RI), mean arterial pressure (MAP), heart rate (HR) and cardiac index (CI) were recorded. RESULTS: SrO(2) increased significantly in both groups after induction of anesthesia compared with baseline (P < 0.05) and decreased after loss of consciousness (P < 0.05). There was no difference in the mean value of the relative changes in SrO(2) between the groups. Meanwhile, the Vm, RI, HR and CI of each time point between two groups showed no statistically significant difference (P > 0.05) while MAP in group P at T5 was lower than that in group R individually(P < 0.05). In each group, Vm, HR, CI and MAP at T2-T5 were all significantly reduced compared with T1, with statistically differences(P < 0.05). Specifically, there was no difference of RI at each time between or within groups(P > 0.05). CONCLUSIONS: Our study revealed that remimazolam can be administered safely and effectively during the induction of general anesthesia for carotid endarterectomy in elder population and it demonstrated superiority in hemodynamic changes compared with propofol. CLINICAL TRIAL REGISTRATION: This trial was retrospectively registered with the Chinese Clinical Trial Registry. Registration number: ChiCTR2300070370. Date of registration: April 11, 2023.
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spelling pubmed-101579552023-05-05 Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy Gao, Jianling Yang, Chengdi Ji, Qiuyuan Li, Jian BMC Anesthesiol Research BACKGROUND: This study was conducted to investigate the effects and safety of remimazolam versus propofol on cerebral oxygen saturation and cerebral hemodynamics during the induction of general anesthesia in patients receiving carotid endarterectomy (CEA), so as to provide theoretical basis for better clinical application of remimazolam. METHODS: Forty-three patients (60–75 years old) with carotid artery stenosis (carotid artery stenosis greater than 70%) were randomly divided into the remimazolam group (R group) and the propofol group (P group). Anesthesia was induced with remimazolam (0.3 mg/kg) or propofol (1.5-2 mg/kg) individually. At time of admission (T0), post-anesthesia induction (T1), consciousness disappears (T2), 1 min after loss of consciousness (T3), 2 min after loss of consciousness (T4) and pre-endotracheal intubation (T5), measurement in patients with regional cerebral oxygen saturation (SrO(2)), average blood flow velocity (Vm), resistance index (RI), mean arterial pressure (MAP), heart rate (HR) and cardiac index (CI) were recorded. RESULTS: SrO(2) increased significantly in both groups after induction of anesthesia compared with baseline (P < 0.05) and decreased after loss of consciousness (P < 0.05). There was no difference in the mean value of the relative changes in SrO(2) between the groups. Meanwhile, the Vm, RI, HR and CI of each time point between two groups showed no statistically significant difference (P > 0.05) while MAP in group P at T5 was lower than that in group R individually(P < 0.05). In each group, Vm, HR, CI and MAP at T2-T5 were all significantly reduced compared with T1, with statistically differences(P < 0.05). Specifically, there was no difference of RI at each time between or within groups(P > 0.05). CONCLUSIONS: Our study revealed that remimazolam can be administered safely and effectively during the induction of general anesthesia for carotid endarterectomy in elder population and it demonstrated superiority in hemodynamic changes compared with propofol. CLINICAL TRIAL REGISTRATION: This trial was retrospectively registered with the Chinese Clinical Trial Registry. Registration number: ChiCTR2300070370. Date of registration: April 11, 2023. BioMed Central 2023-05-04 /pmc/articles/PMC10157955/ /pubmed/37142971 http://dx.doi.org/10.1186/s12871-023-02095-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gao, Jianling
Yang, Chengdi
Ji, Qiuyuan
Li, Jian
Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title_full Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title_fullStr Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title_full_unstemmed Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title_short Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
title_sort effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157955/
https://www.ncbi.nlm.nih.gov/pubmed/37142971
http://dx.doi.org/10.1186/s12871-023-02095-z
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