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Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study

Year: 2026

Type: article

Abstract: CONTEXT: Remimazolam is an ultra-short-acting benzodiazepine used for general anesthesia, including cardiac surgery; however, its effect on postoperative emergence following cardiopulmonary bypass remains unclear. AIMS: We aimed to compare postoperative emergence following remimazolam- and propofol-based total intravenous anesthesia in adult patients undergoing cardiac valve surgery. SETTINGS AND DESIGN: A retrospective observational study. METHODS AND MATERIALS: We included adult patients who underwent elective cardiac valve replacement surgery at a single center between April 2023 and September 2024. Patients received either remimazolam- or propofol-based total intravenous anesthesia according to institutional practice. The primary endpoint was postoperative emergence time. Secondary endpoints included time to extubation and early postoperative hemodynamic stability assessed using the vasoactive-inotropic score. STATISTICAL ANALYSIS USED: Baseline characteristics and perioperative variables were compared between the groups. Univariate and multivariable linear regression analyses were performed. RESULTS: Sixty-three patients were included in the analysis (remimazolam group, n = 21; propofol group, n = 42). Postoperative emergence time did not differ significantly between the two groups (164 [120-253] min vs. 137 [95-188] min, P = 0.193). Time to extubation was also comparable between the groups (1,009 [914-1,070] min vs. 1,033 [906-1,057] min, P = 0.844). Early postoperative hemodynamic parameters, including vasoactive-inotropic scores, were comparable between the two groups. CONCLUSIONS: In adult patients undergoing cardiac valve surgery, postoperative emergence time was comparable between remimazolam- and propofol-based total intravenous anesthesia. More prospective studies are warranted to clarify the role of remimazolam in cardiac anesthesia.

Source: Annals of Cardiac Anaesthesia

DOI: 10.4103/aca.aca_90_26

Authors: Emi Fujii, Yasuhiko Imashuku, Motoi Inoue, Hirotoshi Kitagawa

Institution: Shiga University of Medical Science

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7221558245

FWCI:

Cites: 10

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Related to: 10