Evidence map›Paper›PMID 40413418›Full record

ArticleBMC anesthesiology2025

Effect of remimazolam in non-intubated video-assisted thoracic surgery: a retrospective cohort study.

Po-Yu Huang, Hui-Hsuan Ke, Hung-Wei Cheng, Po-Kuei Hsu, Wen-Kuei Chang, Chien-Kun Ting

Abstract read
In one paragraph

Article in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

6 authors.

Po-Yu HuangDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, R.O.C.
Hui-Hsuan KeDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, R.O.C.
Hung-Wei ChengDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, R.O.C.
Po-Kuei HsuDepartment of Surgery, Division of Thoracic Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Wen-Kuei ChangDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, R.O.C.
Chien-Kun TingDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, R.O.C.. ckting2@gmail.com.

Funding

Taipei Veterans General Hospital VN113-02
6 · The paper itself

Abstract

backgroundSingle-incision video-assisted thoracoscopic surgery (VATS) is safer, more efficient, and less invasive, with fewer complications and shorter hospital stays. When combined with non-intubated spontaneous breathing, it enhances recovery by reducing complications, operating time, and anesthesia duration. Remimazolam, an ultrashort-acting benzodiazepine, provides rapid onset and offset with minimal respiratory depression, making it promising for non-intubated VATS (NIVATS).

methodsThis retrospective study was conducted at Taipei Veterans General Hospital, Taiwan, and included 62 patients who underwent single-port NIVATS. Of these, 41 patients received propofol with dexmedetomidine (August 2019-December 2021), and 21 patients received remimazolam with dexmedetomidine (January 2023-December 2023). The primary outcome was the change in arterial carbon dioxide pressure (ΔPaCO2), while secondary outcomes included anesthesia duration, surgery duration, and postoperative hospital stay. Propensity score matching controlled for confounders, and subgroup analyses compared thoracic epidural anesthesia (TEA) with paravertebral block (PVB).

resultsThe patients in the remimazolam group showed a smaller PaCO2 increase (6.84 ± 6.01 mmHg vs. 14.42 ± 11.55 mmHg; p = 0.0113), shorter surgery duration (50.19 ± 26.12 min vs. 83.54 ± 24.86 min; p < 0.0001), and shorter postoperative hospital stay compared with those in the propofol group. No significant between-group differences were found with regard to anesthesia duration. Subgroup analysis showed consistent outcomes between TEA and PVB groups, supporting the flexibility of remimazolam-based sedation. None of the patients required flumazenil reversal.

conclusionsThis study demonstrated effective sedation and superior respiratory stability with the use of remimazolam-dexmedetomidine combination in NIVATS, suggesting it to be a viable alternative. Further studies are needed to confirm these findings in diverse surgical settings.

Indexed as

BenzodiazepinesHypnotics and SedativesThoracic Surgery, Video-AssistedAgedCohort StudiesDexmedetomidineFemaleHumansLength of StayMaleMiddle AgedOperative TimePropofolRetrospective StudiesTaiwanBenzodiazepinesDexmedetomidineHypnotics and SedativesPropofolremimazolamAnesthesiaBenzodiazepinesVideo-assisted thoracic surgery

Identifiers

PMID40413418
PMCPMC12103742

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Registered trials

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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.