Comparison of core body temperatures in patients administered remimazolam or propofol during robotic-assisted and laparoscopic radical prostatectomy
Open accessAbstract
Background and Objectives: Different types of anesthetics affect thermoregulatory mechanisms, such as the redistribution of body temperature, loss of skin heat, or inhibition of thermoregulatory vasoconstriction. Therefore, we compared remimazolam with propofol in terms of core body temperature in patients undergoing robotic-assisted and laparoscopic radical prostatectomy. Materials and methods: Ninety patients were randomly assigned to either the propofol−remifentanil (PR) group or the remimazolam−remifentanil (RR) group. The PR group (n = 45) received effect-site concentrations of 6.0 μg/mL of propofol and 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium and maintenance with effect-site concentrations of 2−4 μg/mL of propofol and 3 ng/mL of remifentanil. The RR group (n = 45) received remimazolam 6 mg/kg/h by continuous intravenous infusion and the effect-site concentration of 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium, remimazolam 1−3 mg/kg/h, and remifentanil 3 ng/mL. The primary outcome was core body temperature, and secondary outcomes included vasoconstriction threshold (°C) and time to onset of vasoconstriction (min). Results: The core body temperature in the RR group was significantly higher at 60, 80, 100, 120, 140, 160, and 180 min after induction than in the PR group (p < 0.01). The vasoconstriction threshold was significantly higher in the RR group (35.2 ± 0.4) than in the PR group (34.8 ± 0.3) (p < 0.01). The time to onset of vasoconstriction was significantly less in the RR group (150.5 ± 10.2) than in the PR group (158.5 ± 8.4) (p < 0.01). However, the incidence of intraoperative hypothermia was not significant between two groups. Conclusions: Remimazolam appears to reduce vasoconstriction threshold less than and had a faster onset of vasoconstriction, resulting in superior thermoregulatory control.
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There was no difference in prevalence of bradycardia between remimazolam and propofol groups.
“There was no difference when the prevalence of bradycardia between the 2 groups was compared (17,19).”
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).”
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 [19]
The Study Design and Patient Selection section describes this paper's own trial, and the Results section reports outcomes for its patients. A search for assessments of five included trials and for quality or risk-of-bias ratings found no passage addressing the citing paper's high-quality classification. (LLM, conf=0.76)
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- Authors
- Lee, C., Lee, C., Lee, J., Jang, G., Kim, B., & Park, S.
- Affiliations
- Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine Hospital, 895 Muwang-ro, Iksan 54538, Korea
- Wonkwang University Hospital (KR)
- Department of Obstetrics and Gynecology, Wonkwang University School of Medicine Hospital, 895 Muwang-ro, Iksan 54538, Korea
- Venue
- Medicina
- Publisher
- MDPI AG
- Published
- 2022-05-23
- Volume
- 58
- Issue
- 5
- Pages
- 690
- ISSN
- 1010-660X (ISSN-L)
- 1648-9144
- PMC
- PMC9144657
- OpenAlex
- W4282932045
- Cited by
- 12
- References
- 16
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 1 · 2023: 3
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Medicina (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Wonkwang University
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- remimazolam, propofol, core body temperature, intraoperative hypothermia, thermoregulation, robot-assisted radical prostatectomy, laparoscopic radical prostatectomy, remifentanil, rocuronium, anesthetic comparison, hypothermia prevention, vasopressor requirement, postoperative recovery time
- MeSH terms
- Rocuronium, Remifentanil, Benzodiazepines, Body Temperature, Humans, Male, Laparoscopy, Prostatectomy, Propofol, Robotic Surgical Procedures
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