Remimazolam versus propofol in combination with esketamine for surgical abortion: A double-blind randomized controlled trial

• Published in: Clinical and translational science 2023-09, Vol.16 (9), p.1606-1616
• Main Authors: Yue, Linli, Ma, Xiaoling, Li, Na, Chen, Jing, Wang, Jun, Wan, Zhenzhen, Yang, Lin
• Format: Article
• Language: English
• Subjects: Abortion; Adverse events; Analgesics; Anesthesia; Benzodiazepines; Bradycardia; Cardiovascular disease; Childrens health; Clinical medicine; Clinical trials; Double-blind studies; Drug dosages; Endoscopy; General anesthesia; Hemodynamics; Ketamine; Maternal & child health; Oxygen saturation; Pain; Patients; Pregnancy; Propofol; Recovery (Medical); Safety; Surgery
• ISSN: 1752-8054; 1752-8062; 1752-8062
• DOI: 10.1111/cts.13572

Remimazolam is a new benzodiazepine with a short half-life, good efficacy, and safety profiles in general anesthesia. Combining esketamine with propofol (P + E) could reduce propofol consumption and injection pain. It is, however, unclear if a low dose of remimazolam co-administrated with esketamine (R + E) is comparable to the increasingly used P + E for surgical abortion with general anesthetic. We conducted a double-blind randomized controlled trial to compare the efficacy and safety of R + E and P + E. Two hundred patients scheduled for a surgical abortion were randomized to receive remimazolam 0.3 mg/kg plus esketamine 0.3 mg/kg (R + E), and propofol 2 mg/kg plus esketamine 0.3 mg/kg (P + E). Sedative effectiveness was evaluated by measuring the time to lose consciousness (LOC), recovery time, and successful sedation rate. Safety was assessed by hemodynamics and adverse events during and postoperation. The time to LOC and recovery time in R + E was 5 s shorter and 1 min longer than that in P + E, respectively (both p