ArticleJournal of anesthesia2024
Retrospective comparison of the effects of remimazolam and dexmedetomidine on postoperative delirium in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.
Article in Journal of anesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The delirium dichotomy of remimazolam: a differential risk profile for emergence delirium versus postoperative delirium in surgical patients: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Effect of remimazolam on postoperative delirium in elderly patients undergoing laparoscopic radical resection for colorectal cancer: a randomized controlled trial.BMC gastroenterology · 2026Trial
- Preoperative and early postoperative neutrophil-to-lymphocyte ratio for predicting delirium after laparoscopic gynecologic surgery in elderly women: a retrospective cohort study with an outcome-matched nested case-control analysis and internal validation.Anesthesia and pain medicine · 2026Article
- Hypotension incidence comparison between remimazolam and propofol in hypertensive patients undergoing spinal surgery.American journal of translational research · 2026Article
- Comparison of midazolam and dexmedetomidine on postoperative delirium in older patients undergoing total knee replacement under spinal anesthesia.Perioperative medicine (London, England) · 2025Article
- Comparison of remimazolam tosylate and sevoflurane for anesthesia induction with preserved spontaneous respiration during tracheal intubation: a prospective, single-center, randomized controlled trial.Perioperative medicine (London, England) · 2025Article
- Remimazolam: a comprehensive review.Anaesthesiology intensive therapy · 2025Review
- Multimodal sedation guided by processed electroencephalography and autonomic nervous system monitoring for spinal cord stimulator implantation: retrospective identification of anesthetic drug doses.Journal of anesthesia, analgesia and critical care · 2025Article
- Remimazolam-Based Anesthesia and Systemic Inflammatory Biomarkers in Relation to Postoperative Delirium in Elderly Patients: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- Safety and efficacy of remimazolam in mechanical ventilation in the ICU: a protocol for systematic evaluation and meta-analysis.BMJ open · 2024Article
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Authors and funding
11 authors.
Funding
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Abstract
purposeRemimazolam is often used for perioperative sedation due to its rapid onset and offset. However, the possible association between remimazolam and postoperative delirium (POD) remains undetermined. The present study evaluated whether remimazolam increased the incidence of POD compared with dexmedetomidine in elderly patients undergoing orthopedic surgery of the lower extremities.
methodsThis retrospective study included patients aged ≥ 65 years who had undergone orthopedic surgery of the lower extremities under spinal anesthesia from January 2020 to November 2022 and were sedated with continuous intravenous infusion of dexmedetomidine or remimazolam. The incidence of POD was assessed through a validated comprehensive review process of each patient's medical records. The effect of remimazolam on the occurrence of POD compared with dexmedetomidine was evaluated by propensity score weighted multivariable logistic models.
resultsA total of 447 patients were included in the final analysis. The crude incidence of POD within 3 days after surgery was 7.5% (17/226) in the dexmedetomidine group and 11.8% (26/221) in the remimazolam group, increasing to 9.7% (22/226) and 15.8% (35/221), respectively (p = 0.073), within 5 days. The multivariable models showed that, compared with dexmedetomidine, intraoperative sedation with remimazolam significantly increased the occurrence of POD within 3 days (odds ratio [OR] 2.21, 95% confidence interval [CI] 1.31 to 3.82, p = 0.003) and 5 days (OR 2.10, 95% CI 1.32 to 3.40, p = 0.002).
conclusionCompared with dexmedetomidine, remimazolam infusion may be associated with a higher risk of POD in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.
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