SynthesisBMC anesthesiology2026
Multidimensional clinical evaluation of remimazolam versus propofol and dexmedetomidine: two systematic reviews and meta-analyses based on differentiated endpoints.
Synthesis in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Effect of Remimazolam on Postoperative Delirium in Elderly Surgical Patients: A Critical Review of Pharmacological Mechanisms and Clinical Evidence.Drug design, development and therapy · 2026Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRemimazolam is a novel ultra-short-acting benzodiazepine sedative, but its clinical positioning, delirium risk profile, and comparative efficacy against standard-of-care sedatives remain incompletely defined. This study aimed to comprehensively evaluate its efficacy and safety compared with propofol (Analysis A) and dexmedetomidine (Analysis B) across diverse clinical settings.
methodsTwo independent meta-analyses were performed: Analysis A compared remimazolam vs. propofol in intubated surgical adults (primary endpoint: postoperative delirium incidence and recovery quality); Analysis B compared remimazolam vs. dexmedetomidine in perioperative/ICU adults with sedation (primary endpoint: time to achieve target sedation). Standard meta-analytic methods, trial sequential analysis (TSA), meta-regression, GRADE evidence grading, and heterogeneity source analysis were applied.
resultsAnalysis A (vs. Propofol): Remimazolam showed a delirium risk comparable to propofol (OR 1.06, 95% CI 0.78-1.45; Moderate certainty), a finding confirmed by TSA as robust. Quality of recovery (QoR-15) was similar between two agents (MD -1.85, 95% CI -7.01 to 3.31), though the certainty was very low due to very serious inconsistency and serious imprecision (I
conclusionsRemimazolam is a safe and effective alternative to propofol for surgical anesthesia, offering superior hemodynamic stability without increasing the risk of postoperative delirium. Compared with dexmedetomidine, remimazolam provides a faster onset of sedation, an advantage that may be especially pronounced in patients with pre-existing agitation. It is well-suited for ambulatory, high-turnover surgery and hemodynamically vulnerable populations. Its long-term neurocognitive safety in ICU sedation requires further investigation.
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