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Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study

BACKGROUND: Remimazolam tosilate (RT) is a new type of γ-aminobutyric acid subtype A (GABA(A)) receptor agonist, having the possibility to be an ideal sedative drug for procedural sedation. At present, there are few studies on the effect of RT on respiratory depression in elderly patients. We aimed...

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Autores principales: Hu, Bailong, Jiang, Ke, Shi, Wenyan, Xiao, Shixiang, Zhang, Shili, Zhang, Yongguo, Zhou, Yuancheng, Tan, Chengwei, Tan, Songjiang, Zou, Xiaohua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733689/
https://www.ncbi.nlm.nih.gov/pubmed/36506792
http://dx.doi.org/10.2147/DDDT.S391147
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author Hu, Bailong
Jiang, Ke
Shi, Wenyan
Xiao, Shixiang
Zhang, Shili
Zhang, Yongguo
Zhou, Yuancheng
Tan, Chengwei
Tan, Songjiang
Zou, Xiaohua
author_facet Hu, Bailong
Jiang, Ke
Shi, Wenyan
Xiao, Shixiang
Zhang, Shili
Zhang, Yongguo
Zhou, Yuancheng
Tan, Chengwei
Tan, Songjiang
Zou, Xiaohua
author_sort Hu, Bailong
collection PubMed
description BACKGROUND: Remimazolam tosilate (RT) is a new type of γ-aminobutyric acid subtype A (GABA(A)) receptor agonist, having the possibility to be an ideal sedative drug for procedural sedation. At present, there are few studies on the effect of RT on respiratory depression in elderly patients. We aimed to evaluate the effect of RT on respiratory depression in elderly patients undergoing gastroscopy. METHODS: This prospective, randomized, single-blinded trial recruited patients from eight centers in China between May 2022 and July 2022. A total of 346 elderly patients undergoing gastroscopy were randomly divided into RT group (0.2 mg/kg) or propofol group (1.5 mg/kg), respectively. The primary outcome was the incidence of respiratory depression. Secondary outcomes include the incidence of sedative-related adverse events, the success rate of sedation, time to fully alert, time to loss of consciousness (LOC), time to ready for discharge, as well as the the patients, endoscopists and anethetists’ satisfaction. RESULTS: The incidence of respiratory depression was significantly reduced in the RT group compared with the propofol group (9.8% vs 17.9%, P=0.042). The time of LOC and fully alert in the RT group were longer than that in the propofol group (P < 0.05). The incidences of hypotention (50.9% vs 32.4%, P=0.001) and hypotension requiring treatment (5.8% vs 1.7%, P=0.031) were significantly higher in the propofol group than that in the RT group. The incidence and severity of injection pain were more frequently recorded in the propofol group than that in the RT group (40.5% vs 12.1%, P<0.05). There were no statistically significant differences between the two groups in terms of sedation success rates, time to ready for discharge, endoscopists and anethetists’ satisfaction and other sedative-related adverse events. CONCLUSION: RT may be a suitable alternative sedative agent for elderly patients undergoing gastroscopy due to its safety profile.
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spelling pubmed-97336892022-12-10 Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study Hu, Bailong Jiang, Ke Shi, Wenyan Xiao, Shixiang Zhang, Shili Zhang, Yongguo Zhou, Yuancheng Tan, Chengwei Tan, Songjiang Zou, Xiaohua Drug Des Devel Ther Original Research BACKGROUND: Remimazolam tosilate (RT) is a new type of γ-aminobutyric acid subtype A (GABA(A)) receptor agonist, having the possibility to be an ideal sedative drug for procedural sedation. At present, there are few studies on the effect of RT on respiratory depression in elderly patients. We aimed to evaluate the effect of RT on respiratory depression in elderly patients undergoing gastroscopy. METHODS: This prospective, randomized, single-blinded trial recruited patients from eight centers in China between May 2022 and July 2022. A total of 346 elderly patients undergoing gastroscopy were randomly divided into RT group (0.2 mg/kg) or propofol group (1.5 mg/kg), respectively. The primary outcome was the incidence of respiratory depression. Secondary outcomes include the incidence of sedative-related adverse events, the success rate of sedation, time to fully alert, time to loss of consciousness (LOC), time to ready for discharge, as well as the the patients, endoscopists and anethetists’ satisfaction. RESULTS: The incidence of respiratory depression was significantly reduced in the RT group compared with the propofol group (9.8% vs 17.9%, P=0.042). The time of LOC and fully alert in the RT group were longer than that in the propofol group (P < 0.05). The incidences of hypotention (50.9% vs 32.4%, P=0.001) and hypotension requiring treatment (5.8% vs 1.7%, P=0.031) were significantly higher in the propofol group than that in the RT group. The incidence and severity of injection pain were more frequently recorded in the propofol group than that in the RT group (40.5% vs 12.1%, P<0.05). There were no statistically significant differences between the two groups in terms of sedation success rates, time to ready for discharge, endoscopists and anethetists’ satisfaction and other sedative-related adverse events. CONCLUSION: RT may be a suitable alternative sedative agent for elderly patients undergoing gastroscopy due to its safety profile. Dove 2022-12-05 /pmc/articles/PMC9733689/ /pubmed/36506792 http://dx.doi.org/10.2147/DDDT.S391147 Text en © 2022 Hu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Hu, Bailong
Jiang, Ke
Shi, Wenyan
Xiao, Shixiang
Zhang, Shili
Zhang, Yongguo
Zhou, Yuancheng
Tan, Chengwei
Tan, Songjiang
Zou, Xiaohua
Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title_full Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title_fullStr Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title_full_unstemmed Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title_short Effect of Remimazolam Tosilate on Respiratory Depression in Elderly Patients Undergoing Gastroscopy: A Multicentered, Prospective, and Randomized Study
title_sort effect of remimazolam tosilate on respiratory depression in elderly patients undergoing gastroscopy: a multicentered, prospective, and randomized study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733689/
https://www.ncbi.nlm.nih.gov/pubmed/36506792
http://dx.doi.org/10.2147/DDDT.S391147
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