Trial reportDrug design, development and therapy2025
Blood Pressure Reduction During Anesthetic Induction with Remimazolam versus Propofol in Elderly Patients: Pharmacodynamic Modeling of Remimazolam.
Trial report in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Purpose: Remimazolam, a novel hypnotic agent, has demonstrated superior hemodynamic stability compared with propofol during general anesthesia, particularly in elderly patients. However, the dose-dependent reduction in blood pressure associated with remimazolam has not been quantitatively modeled in this population. Patients and Methods: We analyzed data from 432 patients aged ≥ 65 years who underwent elective gastrectomy as part of a randomized trial comparing remimazolam with propofol. Remimazolam was administered via zero-order infusion at 6 mg/kg/h, whereas propofol was delivered using target-controlled infusion (TCI) guided by the Schnider model. Blood pressure data were transformed into fractional changes in mean arterial pressure (MBP) relative to baseline. A modified simple logistic regression model was developed to characterize the relationship between cumulative remimazolam dose and MBP reduction, with body weight evaluated as a covariate. Results: A total of 209 patients were analyzed in each group. The modified logistic model effectively described the dose-dependent MBP reduction associated with remimazolam. Body weight was identified as a significant covariate that improved model performance. Although the remimazolam group exhibited a statistically greater MBP reduction before intubation than the propofol group (28.0 ± 9.9% vs 25.8 ± 10.1% reduction from baseline, Conclusion: In elderly patients undergoing general anesthesia with remimazolam, the relationship between dose and MBP reduction during induction was well characterized using a modified logistic model, with body weight as a significant covariate. TCI may represent an effective dosing strategy for maintaining hemodynamic stability during anesthetic induction. Trial Registration: This study was registered at the Clinical Research Information Service of the Korean National Institute of Health (CRIS, http://cris.nih.go.kr), with registration number KCT0006877, on December 27, 2021.
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