Evidence map›Paper›PMID 41632411›Full record

SynthesisDigestive diseases and sciences2026

Propofol Versus Remimazolam in Gastrointestinal Endoscopy: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Ahmed L Youseif, Ziad W Elmezayen, Noha Hammad, Ahmed F Younis, Aya M Ramadan, Basma M El-Khalifa, Amr R Saleh, Karim A Khalil, Mohamed Nabil Hamouda, Belal Hamed and 8 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

18 authors.

Ahmed L YouseifFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ziad W ElmezayenFaculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt.
Noha HammadFaculty of Medicine, Port-Said University, Port-Said, Egypt.
Ahmed F YounisFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Aya M RamadanFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Basma M El-KhalifaFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Amr R SalehFaculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt.
Karim A KhalilFaculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed Nabil HamoudaFaculty of Medicine, Misr University for Science and Technology, Giza, Egypt.
Belal HamedFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Alaa Ashraf MohamedFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Youssef NarouzFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Doaa A ElmarzoukyFaculty of General Surgery and Medicine, Zagazig University, Zagazig, Egypt.
Amira A AlbawriFaculty of Medicine, University of Science and Technology, Sana'a, Yemen.
Yara M HarashFaculty of Medicine, Hama University, Hama, Syria.
Ahmed GadHennepin County Medical Center, Minnesota, USA.
Rana MegawerFaculty of Medicine, El-Minya University, El-Minya, Egypt.
Abdelaziz A AwadFaculty of Medicine, Al-Azhar University, Cairo, Egypt. awad.abdelaziz.0505@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPropofol is the most commonly used intravenous anesthetic for endoscopic surgery, although it comes with various adverse effects. Research indicates that Remimazolam, which is considered a safe general anesthetic, is being increasingly adopted as an alternative to propofol in clinical settings. Our meta-analysis sought to evaluate whether the rate of adverse reactions associated with Remimazolam in gastrointestinal endoscopic procedures is acceptable, and whether its surgical success rate is at least comparable to that of propofol.

methodsFollowing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched five electronic databases (PubMed, Scopus, Cochrane Library, Embase, and Web of Science) to identify eligible studies published up to January 2025. Using R version R.4.4, we reported outcomes as risk ratios (RRs) or mean differences (MDs) and confidence intervals (CIs). A P-value of ≤ 0.05 is considered statistically significant.

resultsOur meta-analysis included 37 studies encompassing 8533 patients. The results, analyzed using a random effects model, demonstrated no statistically significant difference in induction time between the two sedative groups, with an overall MD of 0.11 min (95% [- 0.10; 0.31], p = 0.2977). Patients in the Remimazolam group experienced longer total sedation times than those receiving Propofol, with an MD of 1.84 min (95% CI [0.61; 3.07], p = 0.0033). The pooled analysis indicated low heterogeneity (I

conclusionRemimazolam has demonstrated safety, showing a reduced incidence of hypotension, bradycardia, respiratory depression, and hypoxemia compared to propofol. However, efficacy outcomes including the induction time and total procedure time were comparable between the two groups. However, the results were heterogeneous, which could be due to variability in the perfumed procedures, co-analgesics or dosing.

Indexed as

Anesthetics, IntravenousBenzodiazepinesEndoscopy, GastrointestinalHypnotics and SedativesPropofolHumansRandomized Controlled Trials as TopicAnesthetics, IntravenousBenzodiazepinesHypnotics and SedativesPropofolremimazolamEndoscopyPropofolRemimazolam

Identifiers

PMID41632411
PMCPMC13447539

What OpenQuestion holds

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Registered trials

None linked

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.