SynthesisEuropean journal of clinical pharmacology2024
Remimazolam versus propofol for sedation in gastrointestinal endoscopy and colonoscopy within elderly patients: a meta-analysis of randomized controlled trials.
Synthesis in European journal of clinical pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06777758 (The Comparison of Remimazolam or Propofol Used Alone Versus in Combination for Moderate Sedation During Endoscopic Examination and Treatment.), which is not on this map. Cited by 30 papers, 4 of them syntheses that pooled 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.
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.
The Comparison of Remimazolam or Propofol Used Alone Versus in Combination for Moderate Sedation During Endoscopic Examination and Treatment.
Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Propofol Versus Remimazolam in Gastrointestinal Endoscopy: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.Digestive diseases and sciences · 2026Pooled it
- RemimazolamPeerJ · 2026Pooled it
- Efficacy and safety of remimazolam for sedation during gynaecologic procedures: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Safety and efficacy of remimazolam versus propofol sedation in gynecological procedures: a meta-analysis of East Asian randomized trials.Frontiers in medicine · 2025Pooled it
- Short-term light sedation with remimazolam besylate versus propofol in the ICU (SHOSREB): a multicentre, randomized, single-blind, controlled trial.Intensive care medicine · 2026Trial
- Efficacy and Recovery of Remimazolam Versus Midazolam in Sedated Colonoscopy: A Multicenter Randomized Controlled Trial in Japan.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Trial
- Efficacy and recovery of remimazolam versus midazolam in sedated upper gastrointestinal endoscopy: a multicenter randomized controlled trial in Japan (RECOVER Study).Journal of gastroenterology · 2026Trial
- Comparison of anesthesia induction with ciprofol, propofol, and etomidate in elderly patients undergoing gastrointestinal endoscopy: a single center, prospective, double blind randomized controlled trial.Frontiers in aging · 2026Trial
- Effect of Lidocaine Spray on the Sedative Dose of Remimazolam During Gastroscopy in Adults: A Prospective, Randomized Dose-Response Trial Using an Up-Down Sequential Allocation Method.Drug design, development and therapy · 2026Trial
- Safety and efficacy of remimazolam compared with propofol for general anesthesia during cold knife conization: a single-center, randomized controlled trial.BMC anesthesiology · 2025Trial
- Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2025Trial
- Dose-Response Study of Remimazolam Combined With Remifentanil for Attenuating Stress Response During Laryngeal Mask Airway Insertion in Elderly Female Patients: A Prospective Double-Blinded Study.Drug design, development and therapy · 2025Trial
- Comparison of Remimazolam and Propofol in Recovery of Elderly Outpatients Undergoing Gastrointestinal Endoscopy: A Randomized, Non-Inferiority Trial.Drug design, development and therapy · 2024Trial
- Efficacy and safety of remimazolam versus propofol in elderly patients undergoing gastrointestinal endoscopy: a systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2026Article
- Sedation in Gastrointestinal Endoscopy: From Drug-Centered Protocols to Personalized, Technology-Supported Pathways: A Narrative Review.Journal of clinical medicine · 2026Review
- Propofol Sedation with a Target-Controlled Infusion Pump and Bispectral Index Monitoring System in Older Patients Undergoing Antegrade Balloon-Assisted Enteroscopy.Digestive diseases and sciences · 2026Article
- Article
- Flumazenil reversal of remimazolam-induced sedation: a narrative review of safety, pharmacokinetics, and clinical considerations.Frontiers in medicine · 2026Review
- Current and Emerging Sedation Practices for Colonoscopy: A Narrative Review of Pharmacological Agents, High-Risk Populations, and Safety Considerations.Journal of clinical medicine · 2025Review
- Effects of non-intubation anesthesia based on a fentanyl-reduced regimen on hypoxemia during bronchoscopy for older patients: study protocol for a randomized controlled trial.Journal of thoracic disease · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePropofol has become the sedative of choice for endoscopy and colonoscopy. However, it has shown associations with various adverse effects, specifically in the geriatric population. In contrast, remimazolam is a novel benzodiazepine, demonstrating a superior clinical safety profile. Hence, this systematic review and meta-analysis aims to clarify the efficacy and safety of remimazolam versus propofol in elderly patients (≥ 60 years) undergoing gastrointestinal endoscopic and colonoscopy procedures.
methodsElectronic databases including PubMed, Cochrane Library, ScienceDirect, and Google Scholar were explored from inception till January 7, 2024. The Cochrane Risk of Bias Tool for Randomized Controlled Trials (RoB-2) was utilized to evaluate the quality of each included study reported in this meta-analysis.
resultsSeven randomized control trials were included, resulting in the pooling of 1,466 patients (remimazolam: 731 patients; propofol: 735 patients). Propofol demonstrated a significantly lower time to loss of consciousness (P < 0.00001, 4 studies, 784 patients) and a greater sedation success after first dose (P = 0.05, 5 studies, 1,271 patients). Remimazolam reported a significantly lower risk of bradycardia (P = 0.02, 5 studies, 1,323 patients), hypoxemia (P < 0.00001, 6 studies, 1,389 patients), and pain on injection site (P < 0.00001, 5 studies, 1,184 patients). No statistically significant differences in sedation time, number of supplemental doses, procedural parameters, and other adverse outcomes were reported.
conclusionAs per the results of our analyses, propofol demonstrated comparatively superior efficacy, however, remimazolam demonstrated comparatively superior safety. The debatable evidence generated from this meta-analysis may not currently be powerful enough to advocate for the use of remimazolam in elderly patients undergoing gastrointestinal procedures; hence, further comprehensive studies are necessary in order to arrive at a robust conclusion.
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What OpenQuestion holds
Registered trials
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.