Comparison of the recovery quality between remimazolam and propofol after general anesthesia: systematic review and a meta-analysis of randomized controlled trials

• Published in: PeerJ (San Francisco, CA) CA), 2024-08, Vol.12, p.e17930, Article e17930
• Main Authors: Zhu, Caiyun, Xie, Ran, Qin, Fang, Wang, Naiguo, Tang, Hui
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia Recovery Period; Anesthesia, General - adverse effects; Anesthesiology and Pain Management; Anesthetics, Intravenous - administration & dosage; Anesthetics, Intravenous - adverse effects; Benzodiazepines - administration & dosage; Benzodiazepines - adverse effects; Comparative analysis; Complications and side effects; Emergency and Critical Care; Evidence Based Medicine; Flumazenil; General anaesthesia; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - adverse effects; Hypnotics and Sedatives - therapeutic use; Meta-analysis; Neurology; Phenols; Propofol; Propofol - administration & dosage; Propofol - adverse effects; QoR; Quality management; Quality of recovery; Randomized Controlled Trials as Topic; Remimazolam
• ISSN: 2167-8359; 2167-8359
• DOI: 10.7717/peerj.17930

To evaluate the recovery quality between remimazolam and propofol after general anesthesia surgery. We included eligible randomized controlled trials (RCTs) in EMBASE, PubMed, Cochrane Central, Scopus, and Web of Science up to June 26, 2024 for comparison the recovery quality of remimazolam and propofol after general anaesthesia. The primary outcomes were the total Quality of Recovery-15 (QoR-15) and five dimensions of QoR-15 on postoperative day 1 (POD1). Secondary outcomes were adverse events, the Quality of Recovery-40 (QoR-40) on POD1, and the intraoperative and postoperative time characteristics. Thirteen RCTs with a total of 1,305 patients were included in this meta-analysis. Our statistical analysis showed that remimazolam group had higher QoR-15 score on POD1, with no significant difference (Mean Difference (MD) = 1.24; 95% confidence interval (CI), [-1.67-4.15]; I = 75%;  = 0.41). In the five dimensions of QoR-15, remimazolam group was superior to propofol group in terms of physical independence (MD = 0.79; 95% CI [0.31-1.27]; I  = 0%;  = 0.001). Remimazolam group was lower than propofol group in incidence of hypotension (Risk Ratio (RR) = 0.48; 95% CI [0.40-0.59]; I = 14%;