Cargando…

Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial

BACKGROUND: The type of anaesthesia and choice of anaesthetic drugs may affect the quality of recovery after surgery. Remimazolam is a new benzodiazepine with rapid onset and offset, specifically antagonised by flumazenil. This study aimed to compare remimazolam with propofol on the quality of recov...

Descripción completa

Detalles Bibliográficos
Autores principales: Tang, Lili, Sun, Yue, Hao, Xixi, Sun, Xuemei, Xie, Cuiyu, Wang, Tingting, Hu, Chengyang, Lu, Yao, Liu, Xuesheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630608/
https://www.ncbi.nlm.nih.gov/pubmed/37942055
http://dx.doi.org/10.1016/j.bjao.2023.100237
_version_ 1785132186564820992
author Tang, Lili
Sun, Yue
Hao, Xixi
Sun, Xuemei
Xie, Cuiyu
Wang, Tingting
Hu, Chengyang
Lu, Yao
Liu, Xuesheng
author_facet Tang, Lili
Sun, Yue
Hao, Xixi
Sun, Xuemei
Xie, Cuiyu
Wang, Tingting
Hu, Chengyang
Lu, Yao
Liu, Xuesheng
author_sort Tang, Lili
collection PubMed
description BACKGROUND: The type of anaesthesia and choice of anaesthetic drugs may affect the quality of recovery after surgery. Remimazolam is a new benzodiazepine with rapid onset and offset, specifically antagonised by flumazenil. This study aimed to compare remimazolam with propofol on the quality of recovery in patients undergoing ambulatory arthroscopic surgery. METHODS: Patients aged 18–65 yr and scheduled for ambulatory arthroscopic meniscus repair were recruited and randomly assigned to receive either continuous i.v. infusion of remimazolam or plasma target-controlled infusion of propofol. The quality of recovery-15 (QoR-15) scale was administered on postoperative day 1 (POD1) as the primary outcome. Secondary outcomes included the Athens Insomnia Scale (AIS) scores and cardiovascular variables. RESULTS: In total, 120 patients were randomly assigned to the remimazolam or propofol groups and 114 patients were included in the analysis. The remimazolam group had higher total QoR-15 scores on POD1 (125 [120–127.5] vs 121.5 [119–124], with a median difference of 3 (95% confidence interval: 1–5; P=0.002). Physical independence and psychological support were higher in the remimazolam group (8.5 [8–10] vs 8 [7–9], P=0.043; 17 [13–17] vs 12.5 [12–14], P<0.001). Remimazolam lowered the number of awakenings during the first postoperative night (P=0.042) and the incidence of hypotension (P=0.04). CONCLUSIONS: Remimazolam-based total i.v. anaesthesia was associated with small improvements in the quality of recovery; however, the improvement was less than the minimally clinically important difference. CLINICAL TRIAL REGISTRATION: ChiCTR2100053014.
format Online
Article
Text
id pubmed-10630608
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-106306082023-11-07 Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial Tang, Lili Sun, Yue Hao, Xixi Sun, Xuemei Xie, Cuiyu Wang, Tingting Hu, Chengyang Lu, Yao Liu, Xuesheng BJA Open Original Research Article BACKGROUND: The type of anaesthesia and choice of anaesthetic drugs may affect the quality of recovery after surgery. Remimazolam is a new benzodiazepine with rapid onset and offset, specifically antagonised by flumazenil. This study aimed to compare remimazolam with propofol on the quality of recovery in patients undergoing ambulatory arthroscopic surgery. METHODS: Patients aged 18–65 yr and scheduled for ambulatory arthroscopic meniscus repair were recruited and randomly assigned to receive either continuous i.v. infusion of remimazolam or plasma target-controlled infusion of propofol. The quality of recovery-15 (QoR-15) scale was administered on postoperative day 1 (POD1) as the primary outcome. Secondary outcomes included the Athens Insomnia Scale (AIS) scores and cardiovascular variables. RESULTS: In total, 120 patients were randomly assigned to the remimazolam or propofol groups and 114 patients were included in the analysis. The remimazolam group had higher total QoR-15 scores on POD1 (125 [120–127.5] vs 121.5 [119–124], with a median difference of 3 (95% confidence interval: 1–5; P=0.002). Physical independence and psychological support were higher in the remimazolam group (8.5 [8–10] vs 8 [7–9], P=0.043; 17 [13–17] vs 12.5 [12–14], P<0.001). Remimazolam lowered the number of awakenings during the first postoperative night (P=0.042) and the incidence of hypotension (P=0.04). CONCLUSIONS: Remimazolam-based total i.v. anaesthesia was associated with small improvements in the quality of recovery; however, the improvement was less than the minimally clinically important difference. CLINICAL TRIAL REGISTRATION: ChiCTR2100053014. Elsevier 2023-10-28 /pmc/articles/PMC10630608/ /pubmed/37942055 http://dx.doi.org/10.1016/j.bjao.2023.100237 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Tang, Lili
Sun, Yue
Hao, Xixi
Sun, Xuemei
Xie, Cuiyu
Wang, Tingting
Hu, Chengyang
Lu, Yao
Liu, Xuesheng
Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title_full Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title_fullStr Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title_full_unstemmed Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title_short Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
title_sort effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630608/
https://www.ncbi.nlm.nih.gov/pubmed/37942055
http://dx.doi.org/10.1016/j.bjao.2023.100237
work_keys_str_mv AT tanglili effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT sunyue effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT haoxixi effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT sunxuemei effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT xiecuiyu effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT wangtingting effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT huchengyang effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT luyao effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial
AT liuxuesheng effectofgeneralanaesthesiawithremimazolamversuspropofolonpostoperativequalityofrecoveryinpatientsundergoingambulatoryarthroscopicmeniscusrepairarandomisedclinicaltrial