SynthesisBMC anesthesiology2025
The effects of remimazolam and propofol on delirium following anesthesia and sedation in elderly patients: a systematic review and meta-analysis.
Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of remimazolam on postoperative neurocognitive disorder in elderly surgical patients: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Repeated remimazolam sedation for interstitial brachytherapy in cervical cancer: a randomized controlled trial.Annals of medicine · 2026Trial
- Remimazolam for Zephyr Endobronchial Valve Placement in a Severe Chronic Obstructive Pulmonary Disease Patient: A Case Report.Clinical case reports · 2026Article
- Safety and efficacy of remimazolam in critical illness.Journal of intensive care · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundDelirium is a prevalent and serious postoperative complication in elderly patients, with an incidence reaching up to 70%, particularly in intensive care settings. It is associated with prolonged recovery, increased healthcare costs, and heightened mortality risk. While multifactorial etiologies involving neurotransmitter dysregulation and inflammatory cascades underline its pathogenesis, anesthetic agent selection has emerged as a modifiable risk factor requiring rigorous evaluation.
objectiveThis meta-analysis aims to compare the effects of remimazolam and propofol on the incidence of delirium in elderly patients.
methodsA systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and Web of Science. Eight studies comparing remimazolam and propofol were included, encompassing a total of 1,641 patients aged ≥ 65 years patients. The primary outcome was the incidence of delirium. Secondary outcomes included the incidence of hypotension, hypoxemia, sleep disturbances, postoperative nausea and vomiting, extubation time, postoperative pain scores, and length of hospital stay.
resultsThe pooled analysis revealed no significant difference in delirium incidence between the remimazolam and propofol groups [relative risk (RR) = 0.86, 95% confidence interval (CI): 0.66–1.12, P = 0.26, I² = 39%]. However, remimazolam was associated with a significantly lower incidence of hypotension (RR = 0.52, 95% CI: 0.28–0.96, P = 0.04) and sleep disturbances (RR = 0.56, 95% CI: 0.37–0.85, P = 0.007) compared to propofol. No significant differences were observed in other secondary outcomes.
conclusionThis meta-analysis suggests that remimazolam and propofol exhibit comparable efficacy in preventing postoperative delirium in elderly patients. However, remimazolam demonstrates superior hemodynamic stability and a reduced incidence of sleep disturbances, potentially enhancing overall patient outcomes. These findings support the preferential use of remimazolam in high-risk populations, though further large-scale randomized controlled trials are warranted to confirm these benefits and refine clinical recommendations.
trial registrationThe study protocol has been registered in PROSPERO (CRD42024600708).
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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.