Evidence map›Paper›PMID 37237331›Full record

Trial reportBMC anesthesiology2023

Efficacy and safety of remimazolam tosilate versus propofol in patients undergoing day surgery: a prospective randomized controlled trial.

Wenchen Luo, Minli Sun, Jie Wan, Zhenyu Zhang, Jian Huang, Jinlin Zhang, Wanxia Xiong, Lirong Xia, Peiyao Xu, Changhong Miao and 3 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 7 pooled it
12.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 7 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Article
  15. Article
  16. Review
  17. Evaluating Remimazolam for Procedural Sedation.Current neuropharmacology · 2025
    Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Wenchen Luo *Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Minli Sun *Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Jie Wan *School of Anesthesiology, Xuzhou Medical University, Xuzhou, People's Republic of China.
Zhenyu Zhang *Department of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Jian HuangDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Jinlin ZhangDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Wanxia XiongDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Lirong XiaJiangsu Jiangyin People's Hospital, Jiangyin, Jiangsu, People's Republic of China.
Peiyao XuDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Changhong MiaoDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China.
Xuesong ZhangDepartment of Anesthesiology, Zhongshan Wusong Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.
Mingyue LiuDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China. lmyy93@163.com.
Jing ZhongDepartment of Anesthesiology, Zhongshan Hospital Fudan University, Shanghai, 200032, People's Republic of China. jzhong12@fudan.edu.cn.
Fudan University · CNThe First Affiliated Hospital, Sun Yat-sen University · CNZhongshan Hospital · CNJiangyin People's Hospital · CNSun Yat-sen University · CNXuzhou Medical College · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRemimazolam tosilate (RT) is a novel short-acting GABA (A) receptor agonist that has a rapid recovery from procedural sedation and can be fully reversed by flumazenil. To date, there have been relatively few articles comparing RT and propofol for general anesthesia. This study aimed to assess the efficacy and safety of RT with or without flumazenil compared with propofol in general anesthesia for day surgery.

methods115 patients scheduled for day surgery were randomized into three groups: RT (n = 39), RT + flumazenil (n = 38) and propofol (n = 38). The primary endpoints were anesthesia induction time and time until fully alert. Anesthesia success rate, bispectral index (BIS) values, injection pain, opioid and vasopressor dosages, postoperative recovery profiles and perioperative inflammatory and cognitive changes were assessed. Any adverse events were recorded.

resultsInduction times were similar among the three groups (P = 0.437), but the median time until fully alert in patients treated with RT was longer than that of the propofol or RT + flumazenil groups (17.6 min vs. 12.3 min vs. 12.3 min, P < 0.001). The three groups had comparable postoperative recovery quality and inflammatory and cognitive state changes (P > 0.05). Smaller percentages of patients who received RT (26.3%) and RT + flumazenil (31.6%) developed hypotension during anesthesia maintenance compared with propofol (68.4%), and consequently less ephedrine (P < 0.001) and phenylephrine (P = 0.015) were needed in the RT group. Furthermore, serum triglyceride levels were lower (P < 0.001) and injection pain was much less frequent in the RT with or without flumazenil groups compared with the propofol group (5.3% vs. 0% vs. 18.4%).

conclusionRT permits rapid induction and comparable recovery profile compared with propofol in general anesthesia for day surgery, but has a prolonged recovery time without flumazenil. The safety profile of RT was superior to propofol in terms of hypotension and injection pain.

trial registrationThe study was registered at Chinese Clinical Trial Registry http://www.chictr.org.cn/ (Registration date: 19/7/2021; Trial ID: ChiCTR2100048904).

Indexed as

Ambulatory Surgical ProceduresAnesthesia, GeneralBenzodiazepinesPropofolAdolescentAdultAgedFemaleFlumazenilGABA AgonistsHumansHypotensionMaleMiddle AgedProspective StudiesYoung AdultBenzodiazepinesFlumazenilGABA AgonistsPropofolremimazolamDay surgeryFlumazenilGeneral anesthesiaPropofolRemimazolam tosilate

Identifiers

PMID37237331
PMCPMC10214677
OpenAlexW4378380230

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.