A Randomized Trial of Remimazolam vs Propofol for Sedation in Elderly Patients

Wong M, Johnson S, Kim D
Anesthesiology, Mayo Clinic

Abstract

Background: Remimazolam may offer advantages over propofol for sedation in elderly patients. Methods: 120 patients (age >=65) undergoing colonoscopy were randomized. Results: Recovery time shorter with remimazolam (8.2 vs 12.7 min, p=0.003). Hypotension less frequent (8% vs 22%, p=0.01). Conclusion: Remimazolam provides faster recovery and fewer hemodynamic events.

1. Introduction

Sedation in elderly is challenging. Propofol has narrow therapeutic window and hemodynamic effects. Remimazolam is a novel ultra-short-acting benzodiazepine.

2. Methods

Single-center double-blind RCT. Inclusion: age >=65, ASA I-III, colonoscopy.

Table 1. Baseline

Table 2. Events

3. Results

All 120 patients completed. Primary outcome: recovery time shorter with remimazolam (8.2+/-2.1 vs 12.7+/-3.4 min; p=0.003). Patient satisfaction favored remimazolam.

4. Discussion

Remimazolam provides faster recovery and fewer complications vs propofol in elderly.
