Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double-blind, controlled trial

Liu, Tianxiao; Lai, Ting; Chen, Jing; Lu, Yizhi; He, Fang; Chen, Yanhua; Xie, Yubo

doi:10.1002/prp2.851

Cited by 146Anesthesia and Sedative AgentsHemodynamic Monitoring and TherapyVeterinary Pharmacology and Anesthesia

Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double-blind, controlled trial

Open access

Liu, Tianxiao, Lai, Ting, Chen, Jing, Lu, Yizhi, He, Fang, Chen, Yanhua, Xie, Yubo·2021·Pharmacology Research & Perspectives

DOI 10.1002/prp2.851PMC PMC8363771

Open this paper in CoChat — free account

Abstract

Background: The stability of hemodynamics during anesthesia induction in patients undergoing valve replacement surgery is particularly important. Remimazolam is a new type of benzodiazepine drug, with supposed advantages of rapid induction, rapid recovery, stable hemodynamics, and mild respiratory inhibition. Aim: To evaluate the effect of remimazolam anesthesia induction on hemodynamics in patients undergoing valve replacement surgery. Methods: This randomized, double‐blind, controlled trial enrolled consecutive patients undergoing mitral valve replacement (MVR)/aortic valve replacement (AVR)/double‐valve replacement (DVR) surgery on cardiopulmonary bypass (CPB). The study was conducted according to the Consolidated Standards of Reporting Trials statement. Participants were randomly assigned to receive either remimazolam or propofol induction of 30 patients each. All patients, data collectors, and data analyzers were blinded to the group allocation. The primary outcomes were the fluctuations in hemodynamic parameters (the difference of maximum or minimum heart rate to baseline, ▲HR, the difference of maximum or minimum mean arterial pressure to baseline, ▲MAP), the occurrence of cardiovascular events (hypotension, severe bradycardia), and the cumulative norepinephrine doses used per patient, averaged per group during induction. The secondary outcomes were hemodynamic parameters (heart rate, HR, mean arterial pressure, MAP, bispectral index, BIS, plasma lactic acid, Lac, and blood glucose, Glu values). Results: A total of 60 patients with heart valve replacement were included in the final analysis, with 30 patients in each group. The ▲MAP was significantly lower in the remimazolam group than in the propofol group during induction ( p < .05). The incidences of hypotension and the cumulative norepinephrine doses used per patient, averaged per group during induction were significantly lower in the remimazolam group than in the propofol group ( p < .05). Conclusion: Remimazolam may be safe and effective for induction and may as an alternative to propofol during anesthesia induction in patients undergoing valve replacement surgery.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1002/prp2.851

Cites

21 of 21 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The remimazolam group had a lower ΔHR than the propofol group (MD = -4.99; 95% CI, -7.97 to -2.00; I2 = 42%; P = 0.001).
“Our statistical analysis revealed significant discrepancies between the 2 groups, wherein the remimazolam group having a lower 𝛥 HR (MD = -4.99; 95% CI, -7.97 to -2.00; I² = 42%; P = 0.001) (Fig. 4).”
From Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2023) · cites this paper as [21]
The Results (Primary outcomes, Table 2) state that ΔHR did not differ significantly between groups. In this trial, the remimazolam group had a numerically higher ΔHR than the propofol group (9.3 versus 6.5 beats/min; p = .238), contrary to the claimed lower ΔHR. The reported pooled MD, confidence interval, and I² are not results of this trial. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
After removing Liu et al. (21), the lower ΔHR in the remimazolam group persisted (MD = -6.03, 95% CI: -9.22 to -2.85, I2 = 0%, P = 0.0002).
“Upon removal of the study by Liu et al (21), a substantial dissimilarity in 𝛥 HR between the 2 study arms persisted, thereby bolstering the position of the remimazolam group (MD = -6.03, 95% CI: -9.22 to -2.85, I² = 0%, P = 0.0002).”
From Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2023) · cites this paper as [21]
Risk of bias was moderate in 5 papers for other biases because of singular gender or type of surgery.
“The risk of bias was rated as moderate in 5 papers for the domain of other biases because of their singular gender or type of surgery (15,19-22).”
From Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2023) · cites this paper as [21]
Five of the included trials were regarded as high-quality.
“Among these trials, 5 were regarded high-quality (18-22) (Figs. 2, 3).”
From Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2023) · cites this paper as [21]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Epidemiology of valvular heart disease in the adult
Iung, B., & Vahanian, A. S. (2011) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2010.202 · Cited by 727 · cited 2× · see citing works
“The inclusion criteria were as follows: (1) Scheduled for MVR/AVR/DVR on CPB; (2) Age 35– 65 years; (3) Cardiac function graded as New York Heart Association class II or III; and (4) American Society of Anesthesiologists (ASA) grade III.”
BackgroundMethod
Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial
Doi, M., Morita, K., Takeda, J., Sakamoto, A., Yamakage, M., & Suzuki, T. (2020) · Journal of Anesthesia · doi:10.1007/s00540-020-02788-6 · Cited by 484 · see citing works
A Placebo- and Midazolam-Controlled Phase I Single Ascending-Dose Study Evaluating the Safety, Pharmacokinetics, and Pharmacodynamics of Remimazolam (CNS 7056): Part I. Safety, Efficacy, and Basic Pharmacokinetics
Antonik, L. J., Goldwater, D. R., Kilpatrick, G., Tilbrook, G., & Borkett, K. (2012) · Anesthesia and Analgesia · doi:10.1213/ane.0b013e31823f0c28 · Cited by 321 · see citing works
Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy
Pastis, N., Yarmus, L., Schippers, F., Ostroff, R., Chen, A. C., Akulian, J., Wahidi, M., Shojaee, S., Tanner, N., Callahan, S., et al. (2019) · Chest · doi:10.1016/j.chest.2018.09.015 · Cited by 289 · see citing works
A phase III study evaluating the efficacy and safety of remimazolam (CNS 7056) compared with placebo and midazolam in patients undergoing colonoscopy.
Rex, D., Bhandari, R., Desta, T., Demicco, M., Schaeffer, C., Etzkorn, K., Barish, C., Pruitt, R., Cash, B., Quirk, D., et al. (2018) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2018.04.2351 · Cited by 260 · see citing works
Pain on injection of propofol
Tan, C. H., & Onsiong, M. K. (1998) · Anaesthesia · doi:10.1046/j.1365-2044.1998.00405.x · Cited by 244 · see citing works
Safety and efficacy of remimazolam in induction and maintenance of general anesthesia in high-risk surgical patients (ASA Class III): results of a multicenter, randomized, double-blind, parallel-group comparative trial
Doi, M., Hirata, N., Suzuki, T., Morisaki, H., Morimatsu, H., & Sakamoto, A. (2020) · Journal of Anesthesia · doi:10.1007/s00540-020-02776-w · Cited by 242 · see citing works
An audit of audit and continued educational and professional development
Clark, M. X., Knights, D., & Henley, M. (2001) · Anaesthesia · doi:10.1111/j.1365-2044.2001.02279.x · Cited by 220
A Placebo- and Midazolam-Controlled Phase I Single Ascending-Dose Study Evaluating the Safety, Pharmacokinetics, and Pharmacodynamics of Remimazolam (CNS 7056): Part II. Population Pharmacokinetic and Pharmacodynamic Modeling and Simulation
Wiltshire, H. R., Kilpatrick, G. J., Tilbrook, G. S., & Borkett, K. M. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e318241f68a · Cited by 215 · see citing works
Remimazolam: Pharmacologic Considerations and Clinical Role in Anesthesiology
Wesołowski, A., Zaccagnino, M. P., Malapero, R. J., Kaye, A., & Urman, R. (2016) · Pharmacotherapy · doi:10.1002/phar.1806 · Cited by 191 · see citing works
Remimazolam: first approval
Keam, S. J. (2020) · Drugs · doi:10.1007/s40265-020-01299-8 · Cited by 188 · cited 1× · see citing works
“The exclusion criteria were as follows: (1) Severe cardiac dysfunction, ASA grade IV or above; (2) Allergic or contraindicated to benzodiazepines, opioids, propofol or their components; (3) Hypertension of grade 3 or above; (4) Dysfunction of the liver or kidney; and (5) Participation in another study within 4 weeks b…”
Background
Faculty Opinions recommendation of Pharmacokinetics and Pharmacodynamics of Remimazolam (CNS 7056) after Continuous Infusion in Healthy Male Volunteers: Part I. Pharmacokinetics and Clinical Pharmacodynamics.
Obara, S. (2020) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.737217924.793576094 · Cited by 124
Remimazolam besilate, a benzodiazepine, has been approved for general anesthesia!!
Masui, K. (2020) · Journal of Anesthesia · doi:10.1007/s00540-020-02755-1 · Cited by 123 · see citing works
Propofol causes more hypotension than etomidate in patients with severe aortic stenosis: a double‐blind, randomized study comparing propofol and etomidate
Bendel, S., Ruokonen, E., Pölönen, P., & Uusaro, A. (2007) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.2006.01206.x · Cited by 78
Recent Developments in Drugs for GI Endoscopy Sedation
Goudra, B., Gouda, G., & Mohinder, P. (2020) · Digestive Diseases and Sciences · doi:10.1007/s10620-020-06044-5 · Cited by 72 · see citing works
Potential strategy for assessing QT/QTc interval for drugs that produce rapid changes in heart rate: electrocardiographic assessment of the effects of intravenous remimazolam on cardiac repolarization
Kleiman, R. B., Darpo, B., Thorn, M., Stoehr, T., & Schippers, F. (2020) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14270 · Cited by 37 · see citing works
New Hypnotic Drug Development and Pharmacologic Considerations for Clinical Anesthesia.
Tanious, M. K., Beutler, S. S., Kaye, A., & Urman, R. (2017) · Anesthesiology Clinics · doi:10.1016/j.anclin.2017.01.017 · Cited by 27 · see citing works
Novel anesthetic agent remimazolam as an alternative for the asleep-awake-asleep technique of awake craniotomy
Sato, T., Kato, Y., Yamamoto, M., & Nishiwaki, K. (2020) · JA Clinical Reports · doi:10.1186/s40981-020-00398-5 · Cited by 23 · see citing works
Cardiac remodeling in aortic and mitral valve disease: a simulation study with clinical validation.
Maksuti, E., Westerhof, B., Ugander, M., Donker, D. W., Carlsson, M., & Broomé, M. (2019) · Journal of applied physiology · doi:10.1152/japplphysiol.00791.2018 · Cited by 19 · see citing works
Anesthetic Considerations for the Transcatheter Management of Mitral Valve Disease.
Gregory, S. H., Sodhi, N., Zoller, J. K., Quader, N., Ridley, C. H., Maniar, H. S., Lasala, J., & Zajarías, A. (2019) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.05.054 · Cited by 18 · cited 2×
“The inclusion criteria were as follows: (1) Scheduled for MVR/AVR/DVR on CPB; (2) Age 35– 65 years; (3) Cardiac function graded as New York Heart Association class II or III; and (4) American Society of Anesthesiologists (ASA) grade III.”
BackgroundMethod
Etomidate vs propofol in coronary heart disease patients undergoing major noncardiac surgery: A randomized clinical trial
Dai, Z.-L., Cai, X., Gao, W., Lin, M., Lin, J., Jiang, Y.-X., & Jiang, X. (2021) · World Journal of Clinical Cases · doi:10.12998/wjcc.v9.i6.1293 · Cited by 15

Flagged first, then by citations

2 of the 23 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

[1]Domenech B, Pomar JL, Prat‐González S, et al. Valvular heart disease epidemics. J Heart Valve Dis. 2016; 25: 1‐ 7. 29505225
[2]Hollenberg SM. Valvular heart disease in adults: etiologies, classification, and diagnosis. FP Essent. 2017; 457: 11‐ 16. 28671804
[9]Eisenried A, Schüttler J, Lerch M, et al. Pharmacokinetics and pharmacodynamics of remimazolam (CNS 7056) after continuous infusion in healthy male volunteers: part II. Pharmacodynamics of electroencephalogram effects. Anesthesiology. 2020; 132: 652‐ 666. 31972657

Sorted by citations

Short-Chain Fatty Acid Propionate Protects From Hypertensive Cardiovascular Damage
Bartolomaeus, H., Balogh, A., Yakoub, M., Homann, S., Markó, L., Höges, S., Tsvetkov, D., Krannich, A., Wundersitz, S., Avery, E. G., et al. (2019) · Circulation · doi:10.1161/circulationaha.118.036652 · Cited by 822 · see citing works
Remimazolam: An Updated Review of a New Sedative and Anaesthetic
Hu, Q.-X., Liu, X., Wen, C., Li, D., & Lei, X.-F. (2022) · Drug Design, Development and Therapy · doi:10.2147/dddt.s384155 · Cited by 185 · see citing works
“pharmacologically inactive, it does not affect liver and kidney function and can be safely used among patients with impaired liver or renal function.(28,29) No significant differences were observed in the pharmacokinetics of remimazolam between healthy individuals and patients with end-stage renal disease.”
Background
Remimazolam – current knowledge on a new intravenous benzodiazepine anesthetic agent
Kim, S.-H., & Fechner, J. (2022) · Korean Journal of Anesthesiology · doi:10.4097/kja.22297 · Cited by 136 · see citing works
“[24] compared two groups of 30 patients each that were induced with remimazolam 0.”
The use of remimazolam versus propofol for induction and maintenance of general anesthesia: A systematic review and meta-analysis
Ko, C.-C., Hung, K.-C., Illias, A. M., Chiu, C., Yu, C.-H., Lin, C.-M., Chen, I.-W., & Sun, C.-K. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1101728 · Cited by 94 · see citing works
“Of the eight studies involving operations under general anesthesia with tracheal intubation, six involved non-cardiac procedures and two focused on valve surgery (Liu et al., 2021; Tang et al., 2021).”
BackgroundMethodInfluential
The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: A randomized trial
Qiu, Y., Gu, W., Zhao, M., Zhang, Y.-Y., & Wu, J.-X. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.938940 · Cited by 77 · see citing works
Remimazolam for induction of anesthesia in elderly patients with severe aortic stenosis: a prospective, observational pilot study
Nakanishi, T., Sento, Y., Kamimura, Y., Tsuji, T., Kako, E., & Sobue, K. (2021) · BMC Anesthesiology · doi:10.1186/s12871-021-01530-3 · Cited by 70 · see citing works
“Although remimazolam was reported to be less hypotensive than propofol [9, 11], it should be noted that remimazolam can cause moderate hypotension after LoC.”
BackgroundMethod
Remimazolam besylate versus propofol for long-term sedation during invasive mechanical ventilation: a pilot study
Tang, Y., Yang, X.-B., Yu, Y., Shu, H.-Q., Yuan, Y., Liu, H., Zou, X., Yuan, S.-Y., & Shang, Y. (2022) · Critical Care · doi:10.1186/s13054-022-04168-w · Cited by 56
“Studies have shown that remimazolam besylate was expected to be relatively safe with regard to potential risks of cardiovascular depression complications [11, 12].”
Background
Propofol Versus Remimazolam on Cognitive Function, Hemodynamics, and Oxygenation During One-Lung Ventilation in Older Patients Undergoing Pulmonary Lobectomy: A Randomized Controlled Trial.
Kuang, Q., Zhong, N., Ye, C.-S., Zhu, X.-P., & Wei, F.-S. (2023) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2023.06.027 · Cited by 46 · see citing works
Sedative effect of remimazolam combined with alfentanil in colonoscopic polypectomy: a prospective, randomized, controlled clinical trial
Xin, Y., Chu, T., Wang, J., & Xu, A. (2022) · BMC Anesthesiology · doi:10.1186/s12871-022-01805-3 · Cited by 45 · see citing works
Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil: a single-centre, double-blind, randomised controlled trial.
Takaki, R., Yokose, M., Mihara, T., Saigusa, Y., Tanaka, H., Yamamoto, N., Masui, K., & Goto, T. (2024) · British Journal of Anaesthesia · doi:10.1016/j.bja.2024.04.013 · Cited by 45 · see citing works
Comparison of Remimazolam Tosilate and Etomidate on Hemodynamics in Cardiac Surgery: A Randomised Controlled Trial
Hu, B.-L., Zhang, M., Wu, Z., Zhang, X.-Y., Zou, X., Tan, L., Song, T., & Li, X. (2023) · Drug Design, Development and Therapy · doi:10.2147/dddt.s401969 · Cited by 44 · see citing works
“3mg/kg) on hemodynamic fluctuation was significantly smaller than that of propofol in patients who underwent cardiac surgery.(17) In another study, Zhang et al demonstrated that the influence of RT (0.”
Background
Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Zhu, T. (2023) · Pain Physician Journal · doi:10.36076/ppj.2023.26.e761 · Cited by 37 · see citing works
Effects of Remimazolam vs. Sevoflurane Anesthesia on Intraoperative Hemodynamics in Patients with Gastric Cancer Undergoing Robotic Gastrectomy: A Propensity Score-Matched Analysis
Lee, B., Kim, M., Kong, H.-J., Shin, H., Yang, S.-H., Kim, N. Y., & Chae, D. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11092643 · Cited by 36 · see citing works
“Among its many advantages, hemodynamic stability has been proposed as the main benefit [6,11].”
BackgroundResult
Effect of remimazolam vs propofol on emergence from general anesthesia in patients undergoing cerebral endovascular procedures: A randomized controlled, non-inferiority trial.
Zhang, J.-B., Zhang, J.-X., Wang, Y.-Y., Bai, X.-G., Guo, Q., Liu, W., Li, H., Zhu, F.-Q., Wang, X., Jiang, X.-F., et al. (2023) · Journal of clinical anesthesia · doi:10.1016/j.jclinane.2023.111356 · Cited by 33 · see citing works
Profile of Remimazolam in Anesthesiology: A Narrative Review of Clinical Research Progress
Wang, M., Zhao, X., Yin, P., Bao, X.-X., Tang, H.-L., & Kang, X. (2022) · Drug Design, Development and Therapy · doi:10.2147/dddt.s375957 · Cited by 32 · see citing works
“A recently published double-blind clinical trial explored the effect of remimazolam anesthesia induction on hemodynamics in patients undergoing valve replacement.(29) A total of 60 patients were randomly assigned to the remimazolam group (0.”
Remimazolam in a Pediatric Patient With a Suspected Family History of Malignant Hyperthermia
Petkus, H., Willer, B., & Tobias, J. (2022) · Journal of Medical Cases · doi:10.14740/jmc3977 · Cited by 31 · see citing works
“Following the successful use of remimazolam as the primary agent for procedural sedation, there has also been preliminary experience with its use as a supplement to general anesthesia during intraoperative care [11-15].”
Background
Remimazolam and serious adverse events
Kempenaers, S., Hansen, T. G., & de Velde, M. V. (2023) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000001902 · Cited by 30 · see citing works
Comparison of Remimazolam-Flumazenil versus Propofol for Rigid Bronchoscopy: A Prospective Randomized Controlled Trial
Pan, Y., Chen, M., Gu, F., Chen, J.-Y., Zhang, W., Huang, Z., Zhu, D., Song, J., Fang, J., Yu, W., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010257 · Cited by 29 · see citing works
Self-citation
Effects of remimazolam on hemodynamic changes during cardiac ablation for atrial fibrillation under general anesthesia: a propensity-score-matched retrospective cohort study
Nam, S. W., Yim, S., Choi, C. I., Park, I., Joung, K.-W., & Song, I. (2023) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-023-02514-2 · Cited by 29 · see citing works
“Remimazolam vs propofol use also reduces the incidence of hypotension and cumulative norepinephrine requirement in patients undergoing valve replacement surgery.(4)”
Background
Remimazolam-flumazenil provides fast recovery from general anesthesia compared to propofol during radiofrequency catheter ablation of atrial fibrillation
Lee, S., Lee, J., Hwang, S. Y., Ju, J., Nam, K., Ahn, H., Lee, S.-R., Choi, E., Jeon, Y., & Cho, Y. (2024) · Scientific Reports · doi:10.1038/s41598-024-63578-8 · Cited by 25
Remimazolam and Its Place in the Current Landscape of Procedural Sedation and General Anesthesia
Brohan, M., Brohan, J., & Goudra, B. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154362 · Cited by 23 · see citing works
“A randomized controlled trial by Liu et al. demonstrated that the change in mean arterial pressure in elderly patients undergoing aortic valve replacement was lower in the group treated with remimazolam than in those treated with propofol [74].”
Result
Efficacy and safety of remimazolam compared with propofol in hypertensive patients undergoing breast cancer surgery: a single-center, randomized, controlled study
Huang, Y.-Q., Yan, T., Lu, G.-H., Luo, H., Lai, Z.-M., & Zhang, L. (2023) · BMC Anesthesiology · doi:10.1186/s12871-023-02364-x · Cited by 23 · see citing works
“Although many studies have reported that remimazolam is preferred to propofol in hemodynamic stability, they mainly target healthy people and patients undergoing gastro-endoscopy and cardiac surgery [28–32], and studies on patients with hypertension have not been reported.”
Background
Total intravenous anesthesia induced and maintained by a combination of remimazolam and remifentanil without a neuromuscular blocking agent: a prospective, observational pilot study
Park, I., Cho, M., Nam, S., Hwang, J.-W., Do, S., & Na, H. (2022) · BMC Anesthesiology · doi:10.1186/s12871-022-01779-2 · Cited by 23 · see citing works
“Remimazolam is known to cause less cardiovascular depression than propofol during general anesthesia [10, 18].”
Background
Effect of remimazolam versus propofol on hypotension after anesthetic induction in patients undergoing coronary artery bypass grafting: A randomized controlled trial.
Ju, J., Lee, D.-J., Chung, J., Lee, S., Cho, Y., Jeon, Y., & Nam, K. (2024) · Journal of clinical anesthesia · doi:10.1016/j.jclinane.2024.111580 · Cited by 22
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, L., Sun, Y., Hao, X., Sun, X., Xie, C., Wang, T., Hu, C., Lu, Y., & Liu, X.-S. (2023) · BJA Open · doi:10.1016/j.bjao.2023.100237 · Cited by 22 · see citing works
“Physical independence and psychological support, two of the ﬁve QoR-15 domains, were also higher in the R group (8.5 [8 e 10] vs 8 [7 e 9], P ¼ 0.043; 17 [13 e 17] vs 12.5 [12 e 14], P < 0.001).”
BackgroundResultInfluentialSelf-citation
Comparison of remimazolam and propofol induction on hemodynamic response in hypertensive patients
Choi, E., Jang, Y.-J., & Park, S.-J. (2023) · Medicine · doi:10.1097/md.0000000000034358 · Cited by 22 · see citing works
“during general anesthesia.[9,13] However, no studies have compared the induction period hemodynamics of remimazolam and propofol in patients with hypertension.”
Background
Remimazolam to prevent hemodynamic instability during catheter ablation under general anesthesia: a randomized controlled trial
Yim, S.-H., Choi, C.-I., Park, I., Koo, B., Oh, A.-Y., & Song, I. (2024) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/s12630-024-02735-z · Cited by 21 · see citing works
“7 We planned to perform intention-to-treat analyses.”
Effect of remimazolam vs. propofol on hemodynamics during general anesthesia induction in elderly patients: Single-center, randomized controlled trial
He, M.-F., Gong, C.-J., Chen, Y.-N., Chen, R.-B., & Qian, Y.-N. (2023) · Journal of Biomedical Research · doi:10.7555/jbr.37.20230110 · Cited by 20
Self-citation
Remimazolam in Cardiac Anesthesia: Analysis of Recent Data.
Ripoll, J. G., Orjuela, R. B., Kanaparthi, A., Soto, J. C. D., ElSaban, M., Peclat, T. R., Wieruszewski, P., Abcejo, A. S., Chang, M. G., Bittner, E. A., et al. (2024) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2024.08.030 · Cited by 19 · see citing works
Prevention of postoperative nausea and vomiting after gynaecological day surgery under remimazolam general anesthesia: a randomized double-blind controlled study
Yi, F.-X., Xiao, H.-H., Zhu, T., Man, Y., & Ji, F.-C. (2022) · BMC Anesthesiology · doi:10.1186/s12871-022-01835-x · Cited by 19 · see citing works
Remimazolam alleviates myocardial ischemia/reperfusion injury and inflammation via inhibition of the NLRP3/IL-1β pathway in mice
Liu, X., Shui, G.-J., Wang, Y., Chen, T., Zhang, P., Liu, L., Li, C.-H., Li, T., & Wang, X. (2025) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2025.5498 · Cited by 18 · see citing works
“A recent clinical study demonstrated that Rema alleviated the surgical stress response in cardiac surgery and adverse cardiac reactions; however, the specific underlying mechanisms are yet to be fully understood (14,15).”
Clinical experience with remimazolam in pediatric anesthesiology: An educational focused review
Tobias, J. D. (2024) · Paediatric anaesthesia · doi:10.1111/pan.14970 · Cited by 18 · see citing works
“29 Nam and colleagues retrospectively compared the effects of remimazolam versus desflurane on the hemodynamic changes and doses of vasoactive agents during general anesthesia for cardiac ablation for atrial fibrillation.”
Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures
Fujimoto, D., Obata, N., & Mizobuchi, S. (2024) · Journal of Anesthesia · doi:10.1007/s00540-024-03339-z · Cited by 18 · see citing works
Remimazolam vs Etomidate: Haemodynamic Effects in Hypertensive Elderly Patients Undergoing Non-Cardiac Surgery
Chen, J.-J., Zou, X., Hu, B.-L., Yang, Y., Wang, F., Zhou, Q., & Shen, M. (2023) · Drug Design, Development and Therapy · doi:10.2147/dddt.s425590 · Cited by 18 · see citing works
Self-citation
Comparison of hypotension incidence between remimazolam and propofol in patients with hypertension undergoing neurosurgery: prospective, randomized, single-blind trial
Choi, S.-H., Min, K., Park, E. K., & Park, S. (2024) · BMC Anesthesiology · doi:10.1186/s12871-024-02578-7 · Cited by 17
“According to Liu et al. [23], the incidence of hypotension during induction was 16.7% for remimazolam and 43.3% for propofol.”
BackgroundInfluential
Comparison of the Incidence of Postoperative Acute Kidney Injury Following the Administration of Remimazolam or Sevoflurane in Elderly Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial
Lee, S.-H., Kang, H.-Y., Ahn, Y. N., & You, A. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13050789 · Cited by 16 · see citing works
Anesthetic efficacy with remimazolam compared with propofol: a systematic review and meta-analysis of randomized controlled trials
Xing, Y., Lang, Z.-K., Wang, X.-R., Liu, J., Han, X.-X., Zhou, J., & Leng, Y.-F. (2025) · International Journal of Surgery · doi:10.1097/js9.0000000000002737 · Cited by 15 · see citing works
Effect of remimazolam on intraoperative hemodynamic stability in patients undergoing cerebrovascular bypass surgery: a prospective randomized controlled trial
Koo, C.-H., Lee, S.-U., Kim, H., Lee, S., Bae, Y., Oh, A.-Y., Jeon, Y.-T., & Ryu, J.-H. (2025) · Korean Journal of Anesthesiology · doi:10.4097/kja.24538 · Cited by 15 · see citing works
“In patients undergoing cardiac surgery, it has been report-ed that this new drug provides greater hemodynamic stability than propofol, as indicated by a lower occurrence rate of hypotension and evidence of a reduced need for vasoactive agents [12,13].”
A Comparison of Remimazolam versus Propofol on Blood Pressure Changes During Therapeutic Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial
Xiao, Y.-Y., Zou, H.-D., Qin, X.-J., Zhu, R., & Dai, R.-P. (2024) · Anesthesia and Analgesia · doi:10.1213/ane.0000000000007309 · Cited by 15 · see citing works
“11.0), we set the assumed mean difference at 9.2 mm Hg, with an SD of 9.1 mm Hg (assuming equal variance), with a significance level of 0.025 and 90% power, and accounting for a 20% drop-out rate, a sample size of 40 patients per group was estimated.”
Influential
Anti‐inflammatory potential of remimazolam: A laboratory and clinical investigation
Tsukimoto, S., Kitaura, A., Kuroda, H., Imaizumi, U., Yoshino, F., Yoshida, A., Nakao, S., Ohta, N., Nakajima, Y., & Sanuki, T. (2024) · Immunity, Inflammation and Disease · doi:10.1002/iid3.1218 · Cited by 15
Determination of the 95% effective dose of remimazolam tosylate in anesthesia induction inhibits endotracheal intubation response in senile patients
Qu, L., Liu, M., Ouyang, R., Li, T., Long, D., Jiang, Y., Wang, C.-Y., & Cheng, L.-Q. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1136003 · Cited by 15
Effect-site concentration of remimazolam at loss and recovery of responsiveness during general anesthesia: a simulation study
Kim, K. M., Bang, J.-Y., Lee, J.-M., Yang, H., Choi, B.-M., & Noh, G.-J. (2022) · Anesthesia and Pain Medicine · doi:10.17085/apm.21121 · Cited by 15
Safety and efficacy of remimazolam for general anesthesia in elderly patients undergoing laparoscopic cholecystectomy: a randomized controlled trial
So, K., Park, J., & Kim, S. H. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1265860 · Cited by 14 · see citing works
Effects of Remimazolam versus Sevoflurane on Hemodynamics in Patients Undergoing Coil Embolization of Cerebral Aneurysm: A Prospective Randomized Controlled Trial
Ko, E., Je, L., Kim, J., Song, Y. J., & Lim, C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13133958 · Cited by 13
“The most notable advantage of remimazolam as a general anesthetic agent is its lower cardiovascular depressant effect than that of propofol or inhalation anesthetic agents [7–9].”
Background
An Adequate Infusion Rate of Remimazolam for Induction of General Anesthesia in Adult Patients: A Prospective Up-and-Down Dose-Finding Study
Jeong, H., Kim, H.-R., & Ahn, H. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12051763 · Cited by 13 · see citing works
“Patients who were induced by remimazolam showed a significantly lower incidence of hypotensive adverse events [9,10], and less need for vasopressors compared to patients who were induced by propofol [11].”
Background
Benefits of remimazolam as an anesthetic sedative for older patients: A review
Jin, N., & Xue, Z.-Q. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e25399 · Cited by 12 · see citing works
“…acid and glucose levels of patients who received propofol, there were no significant changes in patients who received remimazolam before and after tracheal intubation; additionally, there was no hypoxia or excessive stress leading to tissue perfusion dysfunction during the induction process [68].”
Background
Remimazolam Use in Cardiac Anesthesia: A Narrative Review.
Muncan, B., & Bennett-Guerrero, E. (2024) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2024.07.045 · Cited by 11 · see citing works
Comparison emergence of sedation, using dexmedetomidine and remimazolam, in spinal anaesthesia - double blinded randomized controlled trial
Hong, S., Park, J.-Y., Rhee, K. Y., & Kim, S.-H. (2024) · International Journal of Medical Sciences · doi:10.7150/ijms.95736 · Cited by 10 · see citing works
Adverse Drug Events Observed with the Newly Approved Remimazolam in Comparison to Propofol for General Anesthesia in Patients Undergoing Surgery: A Meta-analysis
Huang, L., Liu, H., Zou, X., Ding, J., & Tao, S. (2024) · Advances in Therapy · doi:10.1007/s12325-024-02820-1 · Cited by 11 · see citing works
Remimazolam for cardiovascular anesthesia
Hirata, N. (2023) · Journal of Anesthesia · doi:10.1007/s00540-023-03242-z · Cited by 11
Efficacy and safety of remimazolam vs. propofol for general anesthesia with tracheal intubation: Systematic review and meta‑analysis
Luo, H., & Tang, Z.-L. (2024) · Biomedical Reports · doi:10.3892/br.2024.1891 · Cited by 10 · see citing works
“It also decreases surgical stress response and respiratory depression without significant myocardial depression, resulting in fewer anesthesia‑associated adverse reac‑ tions (23,31,35).”
Anesthetic Management Using Remimazolam for Transcatheter Edge-to-Edge Repair of the Mitral Valve in Patients With Reduced Ejection Fraction: A Case Report of Two Cases
Ito, H., Kameyama, A., Furuta, M., Yoshida, M., Onishi, K., & Kawakami, M. (2022) · Cureus · doi:10.7759/cureus.30706 · Cited by 10
“A small randomized control trial reported that anesthesia induction with remimazolam during cardiac surgery was associated with fewer fluctuations in mean blood pressure [5].”
Background
Novel anesthetics in pediatric practice: is it time?
Useinovic, N., & Jevtovic-Todorovic, V. (2022) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0000000000001156 · Cited by 10 · see citing works
“In patients undergoing valve replacement surgery, induction of anesthesia with remimazolam resulted in significantly fewer hypotensive episodes and a decreased use of vasopressors [26].”
Effect of Remimazolam on Induction and Maintenance of General Anesthesia in Kidney Transplant Patients
Chen, L., Qin, W., Wu, J.-D., Zhao, G., Jiang, X., Li, M., Huang, Z.-J., & Du, X.-K. (2024) · International Journal of General Medicine · doi:10.2147/ijgm.s464530 · Cited by 9
“This may be due to the small impact of benzodiazepines on myocardial contractility and a slight increase in HR. 20 In addition, remimazolam can reduce autonomic nervous system activity during general anesthesia induction and maintain a balance of sympathetic and parasympathetic nervous system…”
Background
Comparative Analysis of the Hemodynamic Effects of Remimazolam and Propofol During General Anesthesia: A Retrospective Study
Tsukimoto, S., Kitaura, A., Yamamoto, R., Hirase, C., Nakao, S., Nakajima, Y., & Sanuki, T. (2024) · Cureus · doi:10.7759/cureus.58340 · Cited by 7 · see citing works
Effects of Propofol, Low and High Doses of Remimazolam on Hemodynamic and Inflammatory Response in Laparoscopic Surgery
Deng, W., Zeng, Z., Liu, Q., Deng, J., Wang, L., Li, H., & Zhang, Y.-N. (2024) · Drug Design, Development and Therapy · doi:10.2147/dddt.s459885 · Cited by 8
“With the advancement and establishment of laparoscopic minimally invasive technology alongside the formulation of guidelines for rapid rehabilitation surgery, 1,2 laparoscopic surgery has been increasingly adopted in clinical practice.”
Method
Effect of acute normovolemic hemodilution in patients undergoing cardiac surgery with remimazolam anesthesia
Takahashi, Y., Yoshii, R., Amaya, F., Sawa, T., & Ogawa, S. (2023) · Journal of Anesthesia · doi:10.1007/s00540-023-03290-5 · Cited by 8
Bibliometric Analysis of Global Trends in Remimazolam-Related Research Over the Past 15 Years: Compared with Propofol
Hu, X.-Y., Wang, B.-B., Hu, L., Han, D.-S., & Wu, J. (2023) · Drug Design, Development and Therapy · doi:10.2147/dddt.s411829 · Cited by 8 · see citing works
Assessing the Safety of Total Intravenous Anesthesia with Remimazolam in General Anesthesia for Transcatheter Aortic Valve Implantation of Severe Aortic Valve Stenosis: A Case Series
Kim, Y., Heo, H., Lee, J.-H., Cho, H., & Kim, G. (2022) · Medicina · doi:10.3390/medicina58111680 · Cited by 8
Remimazolam and propofol combination in ischemic cerebrovascular disease endovascular treatment: a randomized study
Liu, T., Qin, L., Su, M., Wei, Y., Yu, H., Wei, H.-T., Xie, Y.-B., & Chen, J. (2025) · Scientific Reports · doi:10.1038/s41598-025-08403-6 · Cited by 7
“Several studies have shown that remimazolam reduces the occurrence of hypotension during anesthesia in elderly patients compared to propofol 5–7 .”
Self-citation
Effect of ciprofol compared with propofol on hemodynamics in bronchoscope procedures during anesthetic induction: a randomized double-blind controlled study
Chen, F., Xing, F., Huang, J., Zhu, J.-W., Jiang, Y., & Li, C. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1545736 · Cited by 7
Remimazolam tosilate infusion has a lower incidence of hypotension than propofol infusion during painless colonoscopy
Li, S.-T., Zhang, Y., Wang, H.-B., Ye, G., Yao, N., & Zhu, X. (2023) · Anaesthesia, Pain & Intensive Care · doi:10.35975/apic.v27i6.2341 · Cited by 7
“21 20-23 This study provided more reliable evidence for the use of remimazolam as the best option for patients receiving outpatient painless endoscopy.”
Background
Anesthetic Management Using Remimazolam in a Hemodialysis Patient.
Nishioka, Y., Miyake, S., Hamaoka, M., Miyake, K., Fujimoto, M., Higuchi, H., & Miyawaki, T. (2023) · Anesthesia Progress · doi:10.2344/anpr-70-02-06 · Cited by 7 · see citing works
Discontinuation of the development of remimazolam for ICU sedation in Japan: background and rationale
Saito, J., & Hirota, K. (2026) · Journal of Intensive Care · doi:10.1186/s40560-026-00849-8 · Cited by 6
Remimazolam alleviates cerebral ischemia–reperfusion injury of rats by inhibiting NF-κB/NLRP3 inflammasome pyroptosis
Liu, T., Chen, J., Shi, M., Li, C., Dai, W., Chen, C., & Xie, Y.-B. (2025) · Scientific Reports · doi:10.1038/s41598-025-31205-9 · Cited by 6
“…randomized controlled trial showed that remimazolam induction causes less hemodynamic fluctuation in patients undergoing cardiac valve replacement surgery compared to propofol 46 —a critical advantage for stroke patients, who are highly sensitive to hypotension-induced cerebral hypoperfusion.”
Self-citation
Remimazolam Reduces Vasopressor Use Post-Induction and During Maintenance of General Anesthesia in Patients Undergoing Laparoscopic Gynecology: A Propensity Score-Matched Analysis
Seong, H., Cho, J., Yoon, S. Z., & Choi, S.-U. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13216407 · Cited by 6
“Most importantly, remimazolam has minimal cardio-vascular depressant effects and can reduce the incidence of hypotension [8,9].”
BackgroundResult
Effect of remimazolam and propofol anesthesia on autonomic nerve activities during Le Fort I osteotomy under general anesthesia: blinded randomized clinical trial
Tsuji, Y., Koshika, K., & Ichinohe, T. (2024) · Journal of dental anesthesia and pain medicine · doi:10.17245/jdapm.2024.24.4.273 · Cited by 6
“We believe this is the reason for the higher HR and tendency of SBP to remain higher in Group R than in Group P. Remimazolam has been reported to show lower incidence rates of hypotension during general anesthesia induction than propofol [17].”
Background
Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases
Oyoshi, T., Mitsuta, Y., Uemura, Y., Tajima, K., & Hirata, N. (2023) · JA Clinical Reports · doi:10.1186/s40981-023-00662-4 · Cited by 6 · see citing works
“Remimazolam provides favorable circulatory stability and is safely used in cardiac surgery [8–10].”
Background
Remimazolam dosing for intraoperative sedation in elderly patients undergoing hip replacement with combined spinal-epidural anesthesia.
Song, Y., & Zou, X. (2023) · European Review for Medical and Pharmacological Sciences · doi:10.26355/eurrev_202308_33399 · Cited by 6
Effect of remimazolam tosilate versus etomidate on hemodynamics in patients undergoing valve replacement surgery: study protocol for a randomized controlled trial
Hu, B.-L., Zhou, H.-Y., Zou, X., Tan, L., Song, T., Zellmer, L., & Li, X. (2022) · Trials · doi:10.1186/s13063-022-06962-x · Cited by 6
“A recent study showed that remimazolam was superior to propofol during anesthesia induction in patients undergoing valve replacement surgery [28].”
Background
Efficacy and safety of remimazolam for induction and maintenance of general anesthesia in day surgery: a randomized controlled non-inferiority clinical trial
Liang, K., Nong, X.-L., Liang, Z.-J., Rana, N., Chen, N.-Q., & Lin, Y.-N. (2025) · BMC Anesthesiology · doi:10.1186/s12871-025-03322-5 · Cited by 5
“Given the cardiovascular depressive effects of anesthetic agents, the decrease in blood pressure and HR observed during anesthesia induction in both groups was anticipated [24].”
Remimazolam mitigates oxidative stress response in patients undergoing one-lung ventilation
Li, S.-S., Sana, S., & Wang, D. (2025) · Frontiers in Surgery · doi:10.3389/fsurg.2025.1456827 · Cited by 5
“In cardiac valve replacement surgery, remimazolam resulted in lower hemodynamic ﬂ uctuations, hypotension, and norepinephrine usage compared to propofol (24).”
The Effects of Remimazolam and Inhalational Anesthetics on the Incidence of Postoperative Hyperactive Delirium in Geriatric Patients Undergoing Hip or Femur Surgery Under General Anesthesia: A Retrospective Observational Study
Kim, J., Lee, S., Yoo, B. H., Lim, Y., & Jun, I. (2025) · Medicina · doi:10.3390/medicina61020336 · Cited by 5 · see citing works
“It is hemodynamically stable, causing fewer incidences of hypotension in elderly patients during anesthesia induction than propofol [15].”
General anesthesia with remimazolam for emergency cesarean section in a patient with acute infective endocarditis: a case report
Yamamoto, S., Oyama, Y., Sasaki, M., Miyagoshi, M., Matsumoto, S., & Kitano, T. (2023) · JA Clinical Reports · doi:10.1186/s40981-023-00645-5 · Cited by 5
“A previous study suggested that the likelihood of hypotension is lower with remimazolam than with propofol in patients with heart failure of NYHA class II or III [3].”
Background
Effective concentration of remifentanil for successful i-gel insertion during remimazolam induction
Choi, J.-J., Jung, W., Chang, Y., Yoo, S., & Kwak, H. (2022) · Korean Journal of Anesthesiology · doi:10.4097/kja.22606 · Cited by 5
Optimal remimazolam infusion rate for general anesthesia induction in elderly patients: a dose determination study by the k-in-a-row method.
Jeong, H., & Ahn, H. J. (2025) · Korean Journal of Anesthesiology · doi:10.4097/kja.25446 · Cited by 4
Remimazolam-Remifentanil versus Propofol-Remifentanil for Spontaneous Ventilation During Fiberoptic Bronchoscopy: A Randomized Controlled Trial
Huang, J., Huang, H., Gao, H.-X., Lin, L.-R., Ling, X., Zhou, Q., & Lin, X.-Z. (2025) · Current Medical Science · doi:10.1007/s11596-025-00111-6 · Cited by 4
“This cardioprotective profile extends to high-risk populations including older adults [37] and cardiac surgery patients [38].”
Model-Informed Precision Dosing of Remimazolam in General Anesthesia Patients
Chen, Y.-T., Zhang, Z., Zhang, X.-F., Peng, Y., Jiao, Z., & Wu, J.-X. (2025) · Drug Design, Development and Therapy · doi:10.2147/dddt.s495604 · Cited by 4 · see citing works
“Other studies 6,7 have also indicated that during heart valve surgery and coronary artery bypass grafting, remimazolam provides more hemodynamically stable conditions during anesthesia induction compared to propofol, while also reducing the dosage of vasopressors required.”
Self-citation
Effect of Remimazolam and Propofol on Blood Glucose and Serum Inflammatory Markers in Patients with Type 2 Diabetes: A Clinical Trial with Prospective Randomized Control
Kim, S. H., Yoon, S. M., Ahn, J.-H., & Choi, Y. (2025) · Medicina · doi:10.3390/medicina61030523 · Cited by 4
“Another study comparing propofol and remimazolam found no significant differences in lactic acid and glucose levels before and after tracheal intubation in patients receiving remimazolam [33].”
Effect of remimazolam on intra-operative hypotension
He, T.-Y., Zhong, R.-P., Zhong, W.-B., Huang, G.-M., & Liu, X.-C. (2024) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000002057 · Cited by 4 · see citing works
Effect of Remimazolam on Transcranial Electrical Motor-evoked Potential in Spine Surgery: A Prospective, Preliminary, Dose-escalation Study
Kurita, S., Furutani, K., Mitsuma, Y., Deguchi, H., Kamoda, T., Kamiya, Y., & Baba, H. (2024) · Journal of Neurosurgical Anesthesiology · doi:10.1097/ana.0000000000000983 · Cited by 4
“11,12 Although a previous report suggested that midazolam might have an inhibitory effect on MEPs, the inhibition might be milder than that of propofol.”
Retrospective Study on the Incidence of Postoperative Nausea and Vomiting and Hypotension During Orthognathic Surgery Using Propofol or Remimazolam.
Kaneko, R., Koshika, K., Shionoya, M., Shimizu, K., Sendai, Y., Matsuura, N., & Ichinohe, T. (2024) · Anesthesia Progress · doi:10.2344/23-00002 · Cited by 4
Remimazolam for General Anesthesia in a Patient with Severe Aortic Stenosis Undergoing High-Risk Surgery: A Case Report
Kim, B., Kim, M. S., Lee, J. H., Lee, D., Kim, H.-B., Oh, S., & Kim, H. (2022) · Medicina · doi:10.3390/medicina58101372 · Cited by 4
“Other recent studies have reported that remimazolam induces general anesthesia without hemodynamic instability in patients undergoing transcatheter aortic valve replacement or surgical aortic/mitral valve replacement [7,9].”
Background
Remimazolam for Procedural Sedation During Cardioversion
Hughes, M., Kramer, C., Corridore, M., McKee, C., & Tobias, J. D. (2025) · Cardiology Research · doi:10.14740/cr2080 · Cited by 3
Effectiveness Analysis of Sevoflurane Combined with Propofol or Remimazolam Anesthesia in Pediatric Laparoscopic Inguinal Hernia Repair and Its Impact on Hemodynamics and Postoperative Pain
Liu, R., Wang, Z.-Y., Meng, Y.-Y., Chen, W., & Zhou, M. (2025) · Journal of investigative surgery · doi:10.1080/08941939.2025.2500438 · Cited by 3 · see citing works
“Reportedly, remimazolam has an advantage of stable hemodynamics compared with other anesthetics [30].”
Increased Incidence of Postoperative Nausea and Vomiting With Remimazolam Compared to Propofol Following Breast Surgery: A Single-Center, Retrospective Cohort Study
Ryo, M., Hayashi, T., Miyasaka, K. W., Yonekura, Y., Fujita, N., & Abe, S. (2025) · Cureus · doi:10.7759/cureus.86592 · Cited by 3
Efficacy and safety of continuous infusion of remimazolam for sedation in elderly patients undergoing colonoscopic polypectomy: A non-inferiority prospective controlled clinical trial
Tian, Z., Yan, T., Bi, Y., Xin, Y., Zhou, S.-Q., Chu, T.-T., & Xu, A. (2025) · Journal of Anesthesia and Translational Medicine · doi:10.1016/j.jatmed.2025.05.001 · Cited by 3 · see citing works
“51,52 Based on the results and analysis above, the patients in the R1 and R2 groups achieved a similar sedation efficacy as the patients in the P group.”
Effect of propofol and ciprofol in patients undergoing bronchoscopy: protocol for a double-blind, randomised controlled trial
Tang, J.-X., Chen, F., Huang, J., Li, D.-L., & Li, C. (2025) · BMJ Open · doi:10.1136/bmjopen-2023-083068 · Cited by 3
Is remimazolam the elusive anesthetic on/off switch?
Renew, J. (2024) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/s12630-024-02736-y · Cited by 3
“15 Its role as a general anesthetic is also being studied and early efforts, such as work from Yim et al. , show promising results.”
Effect of remimazolam on electroencephalogram burst suppression in elderly patients undergoing cardiac surgery: Protocol for a randomized controlled noninferiority trial
Ma, Z.-M., Hu, J.-H., Ying, Y.-Y., Chen, X., Xu, J.-Y., Huo, W.-W., Liu, H., Ji, F.-H., & Peng, K. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e23879 · Cited by 3 · see citing works
Hemodynamic and Perioperative Effects of Remimazolam Versus Propofol in Adult Cardiac Surgery: A Grade-Assessed Systematic Review and Meta-Analysis.
Salameh, H., Khalili, H., Hashem, W., Assi, S., & Nazzal, Z. A. S. (2026) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2026.07.006 · Cited by 2 · see citing works
Safety and efficacy of remimazolam in general anaesthesia during laparoscopic cholecystectomy: A systematic review and meta-analysis of randomised controlled trials
Abuelazm, M. T., Alanazi, S. E. T., Altemani, R. F. H., Aljaber, S., Almosa, A., Aljuraifani, A., Alrugaibah, M., Albalawi, M., Alwisiydi, F., & Muawad, R. (2026) · Indian Journal of Anaesthesia · doi:10.4103/ija.ija_908_25 · Cited by 2 · see citing works
“[10] [10–12] In addition, RMZ produces minimal to no pain during injection and displays the antiemetic properties intrinsic to benzodiazepines.”
Effects of remimazolam on hemodynamics in children with congenital heart disease undergoing cardiac catheterization
Li, H., Song, Z., Jiang, X.-W., Liu, W., Jiang, Y., & Wei, R. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1714645 · Cited by 2
Intraoperative hypotension after remimazolam or propofol induction with sevoflurane maintenance in angiotensin II receptor blockers-treated patients: a randomized controlled trial
Kim, H. J., Kim, N., Kim, J., Park, J. H., Shin, H. J., Yang, J.-H., & Kim, S. Y. (2025) · Scientific Reports · doi:10.1038/s41598-025-23469-y · Cited by 2
Effect of Remimazolam on Hemodynamic Stability in Patients Undergoing Cardiac Surgery: A Grade-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Jamal, A., Khan, S., Qadri, M., Shah, M. A., Ahmed, U., Iftikhar, H., Uddin, M., Bacha, Z., Khalid, A. A., Khan, A., et al. (2025) · Cardiology in Review · doi:10.1097/crd.0000000000001100 · Cited by 2 · see citing works
Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial.
Shen, J.-J., Wang, L., Liu, Y., Li, T., Zhu, L., Li, Z., Shi, J., & Lv, H. (2025) · Surgery · doi:10.1016/j.surg.2025.109661 · Cited by 2
Comparative Effects of Remimazolam and Propofol on Intraoperative Hypertension and Hypotension During Robot-Assisted Laparoscopic Gynecologic Surgery: A Retrospective Analysis
Lee, J.-M., Lee, J., Kang, S.-H., Jung, K.-H., Yeo, H., & Joo, Y. (2025) · Medicina · doi:10.3390/medicina61091721 · Cited by 2 · see citing works
“Previous studies have consistently shown that remimazolam anesthesia provides stable hemodynamic profiles, often reflected in higher mean arterial pressure compared to other agents [9,12–14 , 22 ].”
Effects of Esketamine Combined With Remimazolam Tosylate on Hemodynamics During Cardiovascular Anesthesia
Xi, L., Liu, H., Tang, X., & Jiang, Z.-Z. (2025) · Clinical and Translational Science · doi:10.1111/cts.70232 · Cited by 2
“This increases chloride into the neuronal membrane, inhibiting neuronal excitability and producing sedative and analgesic effects [22–24].”
Safety and efficacy of remimazolam compared with propofol for general anesthesia during cold knife conization: a single-center, randomized controlled trial
Zhang, X., Li, H.-X., Chen, Y.-R., Wang, B.-N., Zheng, H., & Yan, T. (2025) · BMC Anesthesiology · doi:10.1186/s12871-025-03066-2 · Cited by 2 · see citing works
“…for the induction and maintenance of anesthesia for bronchoscopy [13, 14] and gastrointestinal endoscopy [15–17] and in critically ill [18] and cardiac surgery [19–21] patients, and the results of these studies indicate that, compared with other sedatives, remima-zolam is safe and effective.”
Self-citation
Remimazolam in perioperative management of Eisenmenger syndrome: a case report
Hashimoto, K., Matsumoto, T., Mizota, T., Kai, S., & Egi, M. (2024) · JA Clinical Reports · doi:10.1186/s40981-024-00692-6 · Cited by 2
“Another RCT similarly revealed a significantly lower incidence of hypotension in the group using remimazolam for anesthesia induction compared with propofol [5].”
BackgroundResult

Authors: Liu, T., Lai, T., Chen, J., Lu, Y., He, F., Chen, Y., & Xie, Y.
Affiliations: First Affiliated Hospital of GuangXi Medical University (CN)
Corresponding author: Chen, Yanhua
Xie, Yubo
ORCID: Liu, Tianxiao
Lai, Ting
Chen, Yanhua
Xie, Yubo
Venue: Pharmacology Research & Perspectives
Publisher: Wiley
Published: 2021-08-13
Volume: 9
Issue: 5
Pages: e00851-e00851
ISSN: 2052-1707 (ISSN-L)
DOI: 10.1002/prp2.851
PMC: PMC8363771
OpenAlex: W3193194912
Cited by: 146
References: 23
Citations by year: 2026: 9 · 2025: 37 · 2024: 37 · 2023: 31 · 2022: 30 · 2021: 2
FWCI: 28.69
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
Locations: Pharmacology Research & Perspectives (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Natural Science Foundation of Guangxi Province (2018GXNSFAA294007)
Topics: Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
Health Sciences › Veterinary › Small Animals › Veterinary Pharmacology and Anesthesia
Keywords: remimazolam, propofol, anesthesia induction, hemodynamic stability, valve replacement, mitral valve replacement, aortic valve replacement, cardiopulmonary bypass, hypotension, bradycardia, norepinephrine requirement, benzodiazepines
MeSH terms: Adult, Aged, Aortic Valve, Benzodiazepines, Bradycardia, Cardiopulmonary Bypass, Double-Blind Method, Female, Heart Rate, Hemodynamics, Humans, Hypotension, Intraoperative Complications, Male, Middle Aged, Mitral Valve, Norepinephrine, Sympathomimetics, Propofol, Anesthetics, Intravenous, Heart Valve Prosthesis Implantation, Arterial Pressure

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double-blind, controlled trial

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Record

About these checks