Application effects of remimazolam and propofol on elderly patients undergoing hip replacement
Open accessAbstract
Abstract Objective To explore the anesthetic and analgesic effects of remimazolam and propofol in elderly patients undergoing hip replacement and their effects on respiratory and circulatory systems, stress and cognitive function. Methods Sixty elderly patients undergoing elective hip replacement in the hospital were selected as the research subjects, and they were divided into the remimazolam group and the propofol group according to the admission sequence of patients. The remimazolam group was anesthetized with remimazolam, and the propofol group was anesthetized with propofol. The anesthesia-related indicators, perioperative pain degree [Visual Analogue Scale (VAS)], circulatory indicators [heart rate, mean arterial pressure (MAP)] before anesthesia (T 0 ), immediately before laryngeal mask insertion (T 1 ), at 5 min after laryngeal mask insertion (T 2 ), at 30 min after laryngeal mask insertion (T 3 ) and at 5 min after laryngeal mask removal (T 4 ), stress response indicators (plasma epinephrine, norepinephrine, cortisol) before anesthesia induction and at 24 h and 72 h after surgery, cognitive function [Mini-Mental State Examination (MMSE)] and adverse reactions were compared between the two groups. Results Among the 60 enrolled patients, only 1 case was excluded due to withdrawal, thus 30 cases in the remimazolam group and 29 cases in the propofol group were included. There were statistically significant differences in the heart rate, MAP, plasma epinephrine, norepinephrine, cortisol and VAS score in the two groups from the aspects of interaction effect and time-point effect ( P < 0.05). The heart rate and MAP at T 1 , T 2 and T 3 in the two groups were significantly decreased compared with those at T 0 , but the heart rate and MAP in the remimazolam group at T 1 , T 2 and T 3 were significantly higher than those in the propofol group ( P < 0.05). There were no statistical differences in the anesthesia time, awakening time and extubation time between the remimazolam group and the propofol group ( P > 0.05). The levels of plasma epinephrine, norepinephrine and cortisol in the two groups were significantly higher at 24 h and 72 h after surgery than those before anesthesia induction, and the above levels were significantly lower in the remimazolam group than those in the propofol group ( P < 0.05). The VAS scores at each time point in the two groups were significantly reduced compared to before surgery, but there was no statistically significant difference between the two groups after surgery ( P > 0.05). The MMSE scores of the two groups were significantly lower at 1 d and 3 d after surgery compared with those before anesthesia induction, but the score in the remimazolam group was significantly higher than that in the propofol group ( P < 0.05). In addition, the incidence rates of adverse reactions were significantly lower in the remimazolam group compared to the propofol group ( P < 0.05). Conclusion Compared with propofol, remimazolam can achieve equivalent anesthetic and analgesic effects in elderly patients undergoing hip replacement. However, the latter one can significantly relieve respiratory and circulatory suppression, stress response and cognitive dysfunction, with good safety. Trial registration This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 31/12/2021 with the registration number ChiCTR2100055039 .
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
Cites
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?
Risk of bias was high in 2 trials and moderate in 2 trials for blinding of patients and personnel.
“The risk of bias was rated as high in 2 trials and moderate in 2 trials for the domain of patients and personnel blinding (15-18).”
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 [15]
The Discussion (page unavailable) says anesthesiologists could infer treatment allocation from the drugs’ different appearances, supporting a concern about blinding in this trial. It does not rate this trial’s risk of bias as high or moderate, or report ratings across four trials, so the stated counts are not supported by this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThere was no statistically significant difference in prevalence of nausea and vomiting between remimazolam and propofol (OR = 1.32; 95% CI, 0.73 to 2.39; I2 = 33%).
“Based on the fixed-effects model, the OR of remimazolam to propofol in the subgroup of nausea and vomiting was 1.32 95% CI, 0.73 to 2.39; I² = 33%) (Fig. 12), indicating that there existed no statistical conspicuous discrepancy in the prevalence of nausea and vomiting between the 2 arms.”
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 [15]
The Results > Adverse reactions table reports nausea and vomiting in 1 of 30 remimazolam patients and 3 of 29 propofol patients, so the paper does compare the two groups on this outcome. It does not report a significance test for nausea and vomiting separately, or the claimed pooled odds ratio, confidence interval, and I²; its reported P value concerns total adverse reactions. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe 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 [15]
In Results > Circulation indicators (Table 4; page not provided), heart rate falls less from baseline in the remimazolam group than in the propofol group, supporting a smaller heart-rate reduction. This individual study does not report the claimed pooled mean difference, confidence interval, heterogeneity statistic, or P value; the citing sentence describes those as its own statistical analysis. (LLM, conf=0.85)
Experimental — accuracy not yet measuredRisk 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).”
No meaningful change in nausea/vomiting results was obtained with sensitivity analysis and random-effects model.
“No meaningful change in the results was obtained when the sensitivity analysis and the random-effects model were used (15,17,18,20,22).”
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 [15]
The Results (Adverse reactions, Table 7; page unavailable) report nausea and vomiting counts for the two treatment groups. The Statistical analysis section (page unavailable) describes trial-level tests, but the copy reports no sensitivity analysis or random-effects model showing whether the nausea/vomiting results changed. Searches for those analyses found no supporting passage. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Pharmacokinetics and drug metabolism in the elderly
Klotz, U. (2009) · Drug Metabolism Reviews · doi:10.1080/03602530902722679 · Cited by 826 · see citing works
Detecting Dementia With the Mini-Mental State Examination in Highly Educated Individuals
O’Bryant, S. E., Humphreys, J. D., Smith, G. E., Ivnik, R. J., Graff‐Radford, N. R., Petersen, R. C., & Lucas, J. A. (2008) · Archives of Neurology · doi:10.1001/archneur.65.7.963 · Cited by 653 · see citing works
Chinese Mini Mental Status in Elderly Chinese: A Population-Based Normative Study
Li, H., Jia, J., & Yang, Z. (2016) · Journal of Alzheimer’s Disease · doi:10.3233/jad-160119 · Cited by 561 · see citing works
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
Schüttler, J., Eisenried, A., Lerch, M., Fechner, J., Jeleazcov, C., & Ihmsen, H. (2020) · Anesthesiology · doi:10.1097/aln.0000000000003103 · Cited by 338 · see citing works
Remimazolam: a review in procedural sedation
Lee, A., & Shirley, M. (2021) · Drugs · doi:10.1007/s40265-021-01544-8 · Cited by 194 · 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
Chen, S., Wang, J., Xu, X., Huang, Y., Xue, S., Wu, A., Jin, X., Wang, Q., Lyu, J., Wang, S., et al. (2020) · PubMed Central · Cited by 157 · see citing works
Self-citationRemimazolam; a role for anaesthesia/ sedation?
Sneyd, J., & Rigby-Jones, A. (2020) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0000000000000877 · Cited by 84 · see citing works
General anesthesia vs spinal anesthesia for patients undergoing total-hip arthroplasty
Pu, X., & Sun, J. (2019) · Medicine · doi:10.1097/md.0000000000014925 · Cited by 79 · see citing works
Tang, F., Yi, J.-M., Gong, H.-Y., Lu, Z.-Y., Chen, J., Fang, B., Chen, C., & Liu, Z.-Y. (2021) · World Journal of Clinical Cases · doi:10.12998/wjcc.v9.i34.10595 · Cited by 76 · see citing works
Kawasaki, S., Kiyohara, C., Tokunaga, S., & Hoka, S. (2018) · BMC Anesthesiology · doi:10.1186/s12871-018-0633-2 · Cited by 50 · see citing works
Propofol sedation with a target-controlled infusion pump in elderly patients undergoing ERCP
Ogawa, T., Tomoda, T., Kato, H., Akimoto, Y., Tanaka, S., & Okada, H. (2020) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2020.03.002 · Cited by 50 · see citing works
Effects of Orem’s Self-Care Model on the Life Quality of Elderly Patients with Hip Fractures
Xu, X., Han, J., Li, Y., Sun, X., Lin, P., Chen, Y., Gao, F., Li, Z., Zhang, S., & Sun, W. M. (2020) · Pain Research and Management · doi:10.1155/2020/5602683 · Cited by 35 · see citing works
Fetene, M. B., Mola, S., Girma, T., Aweke, Z., Neme, D., & Zemedkun, A. (2020) · Journal of Pain Research · doi:10.2147/jpr.s282462 · Cited by 23 · see citing works
Luan-Erfe, B. M., Boehme, J., Erfe, J. M., Brovman, E. Y., Bader, A. M., & Urman, R. D. (2018) · Geriatric Orthopaedic Surgery & Rehabilitation · doi:10.1177/2151459318816482 · Cited by 21 · see citing works
Lee, Y., Ko, P., Kao, S.-L., Lin, M., & Wei, J. C. (2020) · The Journal of Arthroplasty · doi:10.1016/j.arth.2020.06.085 · Cited by 20 · see citing works
Bozkurt, H., Araç, D., & Çiğdem, B. (2019) · Turkish Neurosurgery · doi:10.5137/1019-5149.jtn.25897-19.2 · Cited by 14 · see citing works
Lau, Y., Harrison, M. J., & Sutton, M. (2019) · Arthritis Care & Research · doi:10.1002/acr.23838 · Cited by 12 · see citing works
Benzodiazepines induce sequelae in immature mice with inflammation-induced status epilepticus
Nakajima, K., Hirai, S., Morio, T., & Okado, H. (2015) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2015.08.012 · Cited by 7 · see citing works
Patel, J., Fang, J. C., Taylor, L. J., Adler, D. G., & Gawron, A. J. (2019) · Endoscopy International Open · doi:10.1055/a-0829-6284 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
“4mg/kg) on circulation was also smaller than that of propofol in elderly patients who underwent hip surgery.(31) Chae et al recommended that optimal ED95 doses of RT for induction in patients aged <40, 60–80, and >80 years were 0.”
BackgroundWu, Q., Xu, F.-C., Wang, J., & Jiang, M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12237316 · Cited by 53 · see citing works
“…procedures, but all patients received general anesthesia with either a laryngeal mask airway (LMA) [46–48] or tracheal intubation [44,45,49–52] Eight studies administered flumazenil routinely after discontinuation of remimazolam, and one study had two remimazolam groups [46], one with…”
BackgroundMethodResultInfluentialRemimazolam 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
Kaneko, S., Morimoto, T., Ichinomiya, T., Murata, H., Yoshitomi, O., & Hara, T. (2022) · Journal of Anesthesia · doi:10.1007/s00540-022-03148-2 · Cited by 48 · see citing works
“These reports suggest that rapid and favorable arousal from the sedated status in patients receiving remimazolam may reduce early postoperative cognitive dysfunction [28, 29].”
BackgroundWu, X., Chenghua, W. A. N. G., Gao, H., Bai, X., ZHANG, Z., Rui, C. H. E. N., Huang, X., Li, A. N., Jing, Y. I., & Tong, R. (2023) · Minerva Anestesiologica · doi:10.23736/s0375-9393.23.17034-9 · Cited by 53 · see citing works
Xin, Y., Chu, T., Wang, J., & Xu, A. (2022) · BMC Anesthesiology · doi:10.1186/s12871-022-01805-3 · Cited by 45 · see citing works
Pereira, E. M. M., Moraes, V. R. Y., da Costa, M. G., do Nascimento, T. S., Slawka, E., Galhardo, C., & Struys, M. M. R. F. (2024) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000002042 · Cited by 48 · see citing works
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
Sekiguchi, R., Kinoshita, M., Kawanishi, R., Kakuta, N., Sakai, Y., & Tanaka, K. (2023) · BMC Anesthesiology · doi:10.1186/s12871-023-01974-9 · Cited by 39 · see citing works
“0 with reference to previous studies that examined the difference in MAP reduction between remimazolam and propofol [15, 16].”
BackgroundMethodZhu, T. (2023) · Pain Physician Journal · doi:10.36076/ppj.2023.26.e761 · Cited by 37 · see citing works
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
Kim, H., Kim, Y., Bae, J., Yoo, S., Lim, Y., & Kim, J. (2023) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2023-104415 · Cited by 36 · see citing works
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
Self-citationDuan, J., Ju, X., Wang, X., Liu, N., Xu, S.-Q., & Wang, S.-B. (2023) · Drug Design, Development and Therapy · doi:10.2147/dddt.s419146 · Cited by 25 · see citing works
“This finding aligns with previous studies, 33 indicating that remimazolam does not elevate the occurrence of postoperative complications among elderly hip replacement patients.”
Self-citationLiu, T., Zhao, H.-C., Zhao, X., & Qu, M. (2024) · Medical Science Monitor · doi:10.12659/msm.943784 · Cited by 24 · see citing works
“However, it was suggested in another clinical trial that remimazolam improves postoperative cognitive function in patients undergoing hip replacement, compared with propofol [19].”
BackgroundChen, 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
Feng, Y., Chang, P., Liu, J., & Zhang, W. (2024) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2023.111367 · Cited by 27 · see citing works
Association of remimazolam with delirium and cognitive function
Arias, J., Wegner, G. R. M., Wegner, B. F. M., Silva, L. S., Bezerra, F., & Filardi, R. G. M. (2024) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000002107 · Cited by 9 · see citing works
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
“In elderly patients undergoing hip replacement surgery, those receiving remimazolam had lower rates of hemodynamic compromise, cognitive dysfunction and respiratory depression as compared to propofol [13,73].”
BackgroundLiu, X.-C., Zhang, L.-Y., Zhao, L., Zhou, X., Mao, W., Chen, L., Zhu, H., Xie, Y., & Li, L.-J. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1409495 · Cited by 23 · see citing works
“Four studies involving 286 elderly patients (15, 16, 18, 19) compared the time to loss of consciousness (LOC) between the remimazolam group ( N = 143) and the propofol group ( N = 143).”
InfluentialZhang, L., Wang, Z., Liu, Y., Zhang, X., & Wu, Y. (2024) · Drug Design, Development and Therapy · doi:10.2147/dddt.s456675 · Cited by 14 · see citing works
“The cognitive function decline during the emergence after remimazolam anesthesia was not reported in other studies because the first assessment of cognitive function in their trial was mainly at POD1, 20 which led to an underestimation of the effect of remimazolam on cognitive function.”
ResultInfluentialSelf-citationLu, L., Chen, B., Zhao, X., Zhai, J., Zhang, P., & Hua, Z. (2024) · Drug Design, Development and Therapy · doi:10.2147/dddt.s474275 · Cited by 20 · see citing works
“15–17 These advantages position it favorably for anesthesia in elderly patients.”
BackgroundXiao, 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
Park, J.-I., Na, H., Kim, J.-N., Ryu, J. H., Jang, H., & Shin, H.-J. (2025) · Korean Journal of Anesthesiology · doi:10.4097/kja.24493 · Cited by 17 · see citing works
“Postoperative cognitive function was assessed in six RCTs [10,19–21, 23, 26 In the subgroup analysis, postoperative cognitive function was higher in the remimazolam group than in the propofol group after general anesthesia (MD: 1.30, 95% CI [0.53–2.06], P = 0.001, I 2 = 90%; Fig.”
InfluentialEffect of remimazolam for general anesthesia on postoperative nausea and vomiting
Kim, S. Y., Sim, K. M., Na, H.-S., Koo, B., & Shin, H.-J. (2024) · Die Anaesthesiologie · doi:10.1007/s00101-024-01454-w · Cited by 16 · see citing works
WEGNER, B. M., WEGNER, G. M., SPAGNOL, L. W., COSTA, L. A., SPAGNOL, V. W., & PAIVA, D. F. (2024) · Minerva Anestesiologica · doi:10.23736/s0375-9393.24.18041-8 · Cited by 19 · see citing works
Li, H.-X., Li, B.-L., Wang, T.-H., Xu, X., Wang, F., Zhang, X., Zhang, X., Li, H.-Y., Mu, B., Sun, Y.-L., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-071912 · Cited by 14 · see citing works
So, K., Park, J., & Kim, S. H. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1265860 · Cited by 14 · see citing works
Wang, D., Liu, Z., Zhang, W., Li, S., Chen, Y., Jiang, C., Su, N., Liu, T., Li, X., & Bi, C. (2025) · Drug Design Development and Therapy · doi:10.2147/dddt.s504371 · Cited by 13 · see citing works
“17 The study revealed that patients in the remimazolam group experienced reduced respiratory and circulatory suppression, attenuated stress responses, and lower rates of cognitive dysfunction than those in the propofol group did.”
Au, E., Zhao, K., Belley-Côté, É., Song, Y., Al-Hazzani, W., Sadeghirad, B., Wang, E., Young, J., Kashani, H., Kavosh, M. S., et al. (2024) · British Journal of Anaesthesia · doi:10.1016/j.bja.2023.11.045 · Cited by 12 · see citing works
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
“At the same time, it can avoid the excessive and long-term sedation associated with propofol anesthesia and has a mild inhibitory effect on the central nervous system of patients [67].”
BackgroundChai, B., Guo, J., Xu, Z., Chen, T., Wang, H., Zhu, Z., Zhong, J., Chen, K., Du, J., & Kang, X. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05984-9 · Cited by 12 · see citing works
“Multiple studies have shown that remimazolam has better hemodynamic stability in older patients [19, 20] and improves perioperative safety in these individuals, which may be related to its capacity to better maintain systemic vascular resistance levels and its weaker effect on cardiac systolic…”
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
“Following this assessment of the eligible studies, further studies were eliminated as a result of the following reasons: Finally, 16 studies [15–30] were selected for this analysis as shown in Fig.”
Wang, Y., Gou, Z.-H., Wang, G.-M., Ye, L.-R., Chen, L., & Wang, Q. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1567794 · Cited by 11 · see citing works
Current and Developing Approaches for Facilitating Emergence from General Anesthesia
Vincent, K. F., Pal, D., Xie, Z., Fox, A. P., White, E. R., Kelz, M. B., García, P. S., Calderon, D. P., Plourde, G., Vlisides, P. E., et al. (2025) · Anesthesiology · doi:10.1097/aln.0000000000005600 · Cited by 11 · see citing works
Lee, S., Kim, M. K., Kang, H. Y., Choi, J., Kim, M. K., & You, A. H. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1288243 · Cited by 9 · see citing works
Hu, J., Huang, Y., Li, J., Yang, J., Pan, P., Xiang, S., Ding, Y., Yang, P., & Liu, C. (2025) · Drug Design Development and Therapy · doi:10.2147/dddt.s565045 · Cited by 9 · see citing works
“21 Subsequently, both groups administered sequential intravenous boluses of sufentanil 0.5 μg/kg and rocuronium 0.6 mg/kg, followed by mask ventilation with 100% oxygen.”
InfluentialKim, T. K., Kwak, H., Jung, W., Choi, G. B., Park, S. Y., & Kim, J. Y. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165285 · Cited by 8 · see citing works
The efficacy and safety of remimazolam besylate, ciprofol, and propofol during hysteroscopy
Shan, W., Gao, S., Ai, M., Lan, H., Duan, G., Dong, X., Xu, Q., Wu, Y., & Wu, J. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1427755 · Cited by 8 · see citing works
“However, prior research found no signi fi cant difference in the awakening time between propofol and remimazolam (Zhang S. et al., 2022).”
Adverse event signal analysis of remimazolam using the FDA adverse event reporting system database
Liu, H.-T., Li, Z., Yan, S., & Ming, S. (2025) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.14588 · Cited by 5 · see citing works
Dong, L., Sun, T., Yang, J., Zhou, Y., Liu, X., Liu, Z., Lv, H., Ma, Z., & Chen, Y. (2024) · World Journal of Surgery · doi:10.1002/wjs.12273 · Cited by 8 · see citing works
Shimizu, T., Kanazawa, T., Yoshida, T., Sakura, T., Shimizu, K., Iwasaki, T., & Morimatsu, H. (2024) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2024.08.038 · Cited by 8 · see citing works
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 maintains a heart rate better than propofol [17].”
BackgroundRi, H., Jeon, S., Yeo, J., Jung, H., Kang, C., & Choo, H. (2025) · Scientific Reports · doi:10.1038/s41598-025-14976-z · Cited by 10 · see citing works
Xin, Y., Chu, T., Zhou, S., & Xu, A. (2023) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2023.110821 · Cited by 6 · see citing works
Ursoleo, J. D., Bottussi, A., Erdoes, G., Huang, J., & Monaco, F. (2025) · Anaesthesia Critical Care & Pain Medicine · doi:10.1016/j.accpm.2025.101555 · Cited by 6 · see citing works
Kainuma, A., Koyama, A., Kinoshita, M., Iida, J., & Sawa, T. (2024) · JA Clinical Reports · doi:10.1186/s40981-024-00716-1 · Cited by 7 · see citing works
“Another report indicated that the maintenance dose of remimazolam ranged from 0.3 to 0.5 mg/kg/h when used with remifentanil [8].”
MethodInfluentialXu, Q.-Q., Cheng, X., Sun, H., Su, G.-R., Fei, Y., Wang, C., & Han, C. (2024) · Drug Design, Development and Therapy · doi:10.2147/dddt.s489167 · Cited by 3 · see citing works
“However, the data is contrary to Zhang’ study, 23 in which the cortisol level significantly lower in the remimazolam group concluded that remimazolam relieve stress response better than propofol.”
Horill, S., Zhou, X., Zhou, X., Dong, H., & Jin, W. (2024) · JCA advances. · doi:10.1016/j.jcadva.2024.100041 · Cited by 5 · see citing works
Fan, J.-J., Zhang, Z., Wang, J., Han, D.-W., Zhen, Y., Fan, J., Wang, S., & Wang, F. (2024) · Clinical Therapeutics · doi:10.1016/j.clinthera.2024.09.020 · Cited by 4 · see citing works
Song, J.-C., Wang, X.-X., Fu, X., Chen, W., Tang, S.-H., Deng, F., Yang, H., & Liu, W. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1331103 · Cited by 6 · see citing works
“In a study focused on hip replacement surgery, older patients who received remimazolam for general anaesthesia had significantly higher Mini-Mental State Examination scores at 1 and 3 days after surgery than those who received propofol (9).”
BackgroundSelf-citationLong, D., Chen, K., Li, Y., He, P., Li, X.-N., Qin, X.-J., Wang, Y.-P., & Xiao, Y.-Y. (2024) · Drug Design, Development and Therapy · doi:10.2147/dddt.s473700 · Cited by 5 · see citing works
“34,35 Similar to Sun’s study, 35 we did not observe changes in IL-6 and TNF-α in the early postoperative period.”
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
“49 From the results of this clinical trial, the remimazolam groups had more stable hemodynamics and lower incidences of hypotension than the propofol group.”
Impact of Ketamine and Propofol on Cognitive Function in Elderly Patients: A Systematic Review
de Vel, G. V., Mun, S., Zia, S. U. D., Chalasani, R., Shukla, P. S., & Malasevskaia, I. A. (2025) · Cureus · doi:10.7759/cureus.79091 · Cited by 4 · see citing works
Qin, F., Lian, Z., Huang, Y., & Tian, D. (2023) · Journal of Anesthesia and Translational Medicine · doi:10.58888/2957-3912-2023-03-01 · Cited by 4 · see citing works
Feng, Y., Jia, J., Cheng, Y.-X., Lin, J., Zhang, X.-Y., Wang, Y., & Zuo, Y.-B. (2025) · Drug Design, Development and Therapy · doi:10.2147/dddt.s531034 · Cited by 2 · see citing works
Sevoflurane or remimazolam anaesthesia and emergence agitation after nasal surgery in adults
Jang, H. J., Jo, J.-Y., Yoon, J.-P., Kim, W., Ku, S., & Choi, S.-S. (2025) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000002267 · Cited by 3 · see citing works
He, Y., Li, Z., Zou, Y., Zhou, W., Sui, X., Yi, X., & An, Y. (2025) · Respiratory Research · doi:10.1186/s12931-025-03365-9 · Cited by 3 · see citing works
Shen, W., Li, L., Zhang, Z., Liu, M., & Shi, J. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2025.1699225 · Cited by 3 · see citing works
“Some studies have suggested that remimazolam may attenuate stress hormone secretion (24), potentially contributing to analgesic effects.”
Yuan, W., Liang, X., Zhang, R., & Shen, J. (2026) · Clinical Therapeutics · doi:10.1016/j.clinthera.2026.02.015 · Cited by 3 · see citing works
Zhu, Z. (2024) · Acta Cirúrgica Brasileira · doi:10.1590/acb399324 · Cited by 3 · see citing works
Wang, F., Zhuo, H., & Zhang, H. (2025) · British Journal of Hospital Medicine · doi:10.12968/hmed.2025.0255 · Cited by 3 · see citing works
Xiao, H.-H., Gu, X.-X., Shi, X., Yu, S., Ji, R.-Y., Ji, F.-C., & Nie, P. (2025) · Drug Design, Development and Therapy · doi:10.2147/dddt.s542292 · Cited by 3 · see citing works
“…at a rate of 6 mg/kg/h or 12 mg/kg/h until the patient falls asleep; 16 the other is administration based on body weight at a dose of 0.2–0.4 mg/kg. 17 In studies calculating the dosage of remimazolam based on the induction dose per kilogram, the total body weight of patients has been used for the…”
InfluentialLiu, C., Li, J., He, J., Zhang, J., Bo, L., Yang, J., Ma, Y., Qin, J., Yang, Y., & Sun, Z. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1653593 · Cited by 2 · see citing works
Self-citationHuang, Q., Zou, Y., Chen, W., Liu, K., Hu, T., Pan, B., Ling, Y., & Kong, G. (2024) · Signa Vitae · doi:10.22514/sv.2024.029 · Cited by 2 · see citing works
“Previous studies have shown that the main advantage of remi-mazolam over propofol is that it has less of an effect on blood pressure [ 4, 5, 9].”
BackgroundYuan, L., Huang, Y., & Cheng, Y. (2024) · Actas Españolas de Psiquiatría · doi:10.62641/aep.v52i3.1657 · Cited by 2 · see citing works
“The MMSE has a total possible score of 30 points, and a score 27 suggests cognitive impairment in the patient [7].”
BackgroundResearch Progress of Remazolam for General Anesthesia in Elderly Patients
Jiang, X. (2023) · Advances in Clinical Medicine · doi:10.12677/acm.2023.13112553 · Cited by 1 · see citing works
Shi, Y., Zuo, C., Zhang, Y., Zhou, C., Zhang, F., & Zhao, X. (2024) · Medicine · doi:10.1097/md.0000000000037199 · Cited by 2 · see citing works
“[8] The use of esmolol is ideal for suppressing sympathetic stimulation, thereby decreasing the LVOT gradient and improving the cardiac output.”
BackgroundImpact of Anemia on Outcomes Following Total Hip Replacement Surgery and Patient Prognosis
Hu, Z., Zhao, X., & Chen, Z. T. (2025) · Orthopaedic Surgery · doi:10.1111/os.70208 · Cited by 1 · see citing works
Luo, H., Zhou, C., Qu, Y., & Kuang, X. (2025) · Clinical Pharmacology Advances and Applications · doi:10.2147/cpaa.s563154 · Cited by 1 · see citing works
Liu, X., Zhang, T., Zhao, L., Zhou, X., Zhang, L., Mao, W., Chen, L., Xie, Y., & Li, L. (2026) · Drug Design Development and Therapy · doi:10.2147/dddt.s575369 · Cited by 1 · see citing works
“11,20,21 Notes : Data are presented as number (percentage).”
Nørholt, C. H., Skov, S. N., Nielsen, P. F., Christensen, S., Andersen, L. W., & Granfeldt, A. (2025) · ASAIO Journal · doi:10.1097/mat.0000000000002485 · Cited by 1 · see citing works
Sun, J.-J., Luo, W., Wen, L., Xiao, Y.-Y., & Dai, R.-P. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-097541 · Cited by 1 · see citing works
“15 Extensive studies have reported that it can be safely and optimally used for painless gastroscopy, 16 orthopaedic surgery, 17–19 heart valve replacement surgery 20 and intensive care unit (ICU) sedation.”
Remimazolam inhibits cough during emergence from general anesthesia in thyroid surgeriesPreprint
Li, D., Yi, S., Zhang, X.-L., Kang, X., Tong, F., & Kong, M. (2023) · Research Square · doi:10.21203/rs.3.rs-3613850/v1 · Cited by 1 · see citing works
Yang, F., Guo, L., Lai, X., Zhang, Z., Wang, D., Peng, S., & Xie, H. (2022) · Research Square · doi:10.21203/rs.3.rs-1820076/v1
Conde, C. B. C., Inocêncio, M. L. D. M., ANACLETO, B. R. L., Guedes, P. A. M. N., dos Santos, Í. T. V., Lessa, D. S. D. S., Neto, J. E. D. S., Filho, A. B. P., Cavalcante, M. P., da Costa, L. T., et al. (2024) · Contribuciones a las Ciencias Sociales · doi:10.55905/revconv.17n.6-317
Wu, J., Cai, S., Wang, C.-M., & Wang, X.-S. (2025) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2025.102455 · Cited by 1 · see citing works
Self-citationApplication of Remimazolam in Anesthesia for Elderly Patients Undergoing Orthopedic Surgery
Zhu, Z.-W. (2025) · Advances in Clinical Medicine · doi:10.12677/acm.2025.1541058
Tashiro, Y., Hayashi, D., Namizato, D., Ise, Y., & Ishikawa, M. (2025) · Journal of Nippon Medical School · doi:10.1272/jnms.jnms.2025_92-403
Ma, Q.-R. (2025) · Advances in Clinical Medicine · doi:10.12677/acm.2025.15123670
Xin, Y., Chu, T., Wang, J., & Xu, A. (2022) · Figshare · doi:10.6084/m9.figshare.20501851
Advances in the Application of Remimazolam in Laryngeal Mask Airway General Anesthesia
李, 雯. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.161182
Ren, W., Zheng, K. J., Song, J., Zhang, L., & Gao, S. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1680473
“…the efficacy and safety of remimazolam in elderly patients (aged ≥ 60 years) undergoing various surgeries, including cardiovascular and orthopedic procedures, and demonstrated that remimazolam does not increase the incidence of POD and is associated with favorable hemodynamic stability (25, 26).”
Oliceridine for Analgesia in Elderly Patients Undergoing Kyphoplasty: From a Clinical Trial
Miao, C., Weng, D., Liu, C., Huang, Q., Chen, K., & Zou, B. (2026) · Pain Research and Management · doi:10.1155/prm/2881787
Ma, T.-T., Tong, J., & Liu, M. (2026) · World Journal of Gastrointestinal Oncology · doi:10.4251/wjgo.v18.i8.121785
Asai, T., Osawa, R., & Uchida, R. (2026) · Journal of Anesthesia · doi:10.1007/s00540-026-03900-y
Peng, D., Zhong, Z., Zou, P., Yuan, L., Song, C., Zhou, B., Liao, B., Wang, S., & Zeng, J. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1942031
- Authors
- Zhang, J., Wang, X., Zhang, Q., Wang, Z., & Zhu, S.
- Affiliations
- Anhui Medical University (CN)
- Corresponding author
- Wang, Xin
- Venue
- BMC Anesthesiology
- Published
- 2022-04-23
- Volume
- 22
- Issue
- 1
- Pages
- 118-118
- ISSN
- 1471-2253 (ISSN-L)
- PMC
- PMC9034563
- OpenAlex
- W4224861518
- Cited by
- 86
- References
- 21
- Citations by year
- 2026: 9 · 2025: 27 · 2024: 26 · 2023: 19 · 2022: 5
- FWCI
- 21.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Anesthesiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Anhui Medical University
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
- Keywords
- remimazolam, propofol, total hip arthroplasty, elderly patients, inhalational anesthesia, perioperative analgesia, hemodynamic response, stress response, epinephrine, norepinephrine, cortisol, postoperative cognitive function, postoperative pain, adverse drug reactions, laryngeal mask airway, recovery time, postoperative delirium
- MeSH terms
- Aged, Analgesics, Anesthesia, General, Anesthetics, Benzodiazepines, Epinephrine, Humans, Hydrocortisone, Norepinephrine, Prospective Studies, Propofol
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
