학술논문
Efficacy and safety of remimazolam-based sedation for intensive care unit patients undergoing upper gastrointestinal endoscopy: a cohort study
Original Article
Original Article
Document Type
Periodical
Author
Source
World Journal of Emergency Medicine. January 2023, Vol. 14 Issue 1, p31, 6 p.
Subject
Language
English
ISSN
1920-8642
Abstract
INTRODUCTION Emergency bedside endoscopic therapy, the best diagnostic and therapeutic procedure to diagnose and treat upper gastrointestinal bleeding (GIB), should be performed within 24 h under intensive monitoring in patients [...]
BACKGROUND: Remimazolam is a novel ultra-short-acting sedative, but its safety and adverse events (AEs) in high-risk patients in the intensive care unit (ICU) setting remain unknown. METHODS: This was a single-center, retrospective study that compared remimazolam to propofol and midazolam in patients undergoing upper gastrointestinal endoscopy. The primary outcome was the incidence of treatment-related AEs. The secondary outcomes were the time to extubation, the length of ICU stay, and the average cost of sedative per case. RESULTS: Of the 88 patients analyzed, 47 were treated with remimazolam (mean dose, 7.90[+ or -]4.84 mg), and 41 were treated with propofol (21.19[+ or -]17.98 mg) or midazolam (3.08[+ or -]2.17 mg). There was no statistically significant difference in the average duration of the endoscopic procedure (35.89[+ or -]13.37 min vs. 44.51[+ or -]21.68 min, P=0.133) or the time to extubation (15.00[+ or -]9.75 h vs. 20.59[+ or -]18.71 h, P=0.211) in the remimazolam group (group I) compared to the propofol or midazolam group (group II). ICU stays (5.40[+ or -]2.93 d vs. 4.63[+ or -]3.31 d, P=0.072) and treatment-related AEs (48.61% vs. 51.38%, P=0.056) were similar between groups. The average cost of sedative per case was significantly lower in the group I than in the group II (RMB 16.07[+ or -]10.58 yuan vs. RMB 24.37[+ or -]15.46 yuan, P=0.016). CONCLUSION: Remimazolam-based sedation was noninferior to the classic sedatives and had lower average cost per case, indicating that it may be used as a promising sedative for high-risk patients during endoscopic procedures in the ICU setting. KEYWORDS: Endoscopic sedation; Intensive care unit; Midazolam; Propofol; Remimazolam
BACKGROUND: Remimazolam is a novel ultra-short-acting sedative, but its safety and adverse events (AEs) in high-risk patients in the intensive care unit (ICU) setting remain unknown. METHODS: This was a single-center, retrospective study that compared remimazolam to propofol and midazolam in patients undergoing upper gastrointestinal endoscopy. The primary outcome was the incidence of treatment-related AEs. The secondary outcomes were the time to extubation, the length of ICU stay, and the average cost of sedative per case. RESULTS: Of the 88 patients analyzed, 47 were treated with remimazolam (mean dose, 7.90[+ or -]4.84 mg), and 41 were treated with propofol (21.19[+ or -]17.98 mg) or midazolam (3.08[+ or -]2.17 mg). There was no statistically significant difference in the average duration of the endoscopic procedure (35.89[+ or -]13.37 min vs. 44.51[+ or -]21.68 min, P=0.133) or the time to extubation (15.00[+ or -]9.75 h vs. 20.59[+ or -]18.71 h, P=0.211) in the remimazolam group (group I) compared to the propofol or midazolam group (group II). ICU stays (5.40[+ or -]2.93 d vs. 4.63[+ or -]3.31 d, P=0.072) and treatment-related AEs (48.61% vs. 51.38%, P=0.056) were similar between groups. The average cost of sedative per case was significantly lower in the group I than in the group II (RMB 16.07[+ or -]10.58 yuan vs. RMB 24.37[+ or -]15.46 yuan, P=0.016). CONCLUSION: Remimazolam-based sedation was noninferior to the classic sedatives and had lower average cost per case, indicating that it may be used as a promising sedative for high-risk patients during endoscopic procedures in the ICU setting. KEYWORDS: Endoscopic sedation; Intensive care unit; Midazolam; Propofol; Remimazolam