Remimazolam tosilate has a lower incidence of hypotension than propofol in painless colonoscopy

Abstract

Background: Remimazolam tosilate is an ultra-short-acting sedative drug with the advantages of rapid onset, rapid recovery, and mild respiratory and circulatory inhibition. We aim to compare the incidence of hypotension of remimazolam with propofol in patients undergoing painless colonoscopy and explore the stability of remimazolam in circulation. Methods: This is a randomized, double-blind trial. 116 patients with outpatient appointment for painless colonoscopy in our hospital from December 2020 to March 2021 were randomly divided into the remimazolam group and the propofol group. The modified observer’s assessment of alert/sedative (MOAA/S) was used to evaluate the depth of the patient's sedation. The Narcotrend score was monitored throughout the whole process. Taking the incidence of hypotension as the primary outcome indicators, records the incidence of respiratory depression, nausea, vomiting and other adverse events during sedation in the two groups of patients, and record the effective time of anesthesia, awakening time, sedative success rate, etc. to evaluate the effect of remimazolam on circulation. Results：The incidence of hypotension during sedation (13.8%) in the remimazolam group was significantly lower than that in propofol (37.9%), and the success rate of remimazolam (98.3%) was slightly lower than propofol (100.0%), but the awakening time was significantly shorter (P<0.001); The incidence of respiratory inhibition, nausea, vomiting and other adverse events during colonoscopy, remimazolam was significantly lower than that of propofol (P<0.05). Conclusion：Remimazolam tosilate has higher circulatory stability in patients undergoing painless colonoscopy. Trial registration: The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2000040398), data of registration: 28/11/2020.