Comparison of Adverse Reactions Between Remimazolam and Propofol in Hysteroscopic Surgery in Mainland China: A Meta-Analysis and Systematic Review.

BACKGROUND

The purpose of this meta-analysis was to compare the adverse reactions of remimazolam and propofol in hysteroscopic anesthesia and to evaluate the efficacy of remimazolam in alleviating adverse reactions.

METHODS

We conducted a database search using China National Knowledge Infrastructure (CNKI), PubMed, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the use of remimazolam with propofol for hysteroscopy procedures. We extracted data on the occurrence of adverse reactions such as hypotension, respiratory depression, dizziness, nausea, and vomiting for meta-analysis. Literature published until July 2024 was screened from each database, and the quality of the included studies was assessed using the bias risk assessment tool recommended by Cochrane. Data analysis was performed using RevMan 5.3 software, developed by the Cochrane Collaboration in the United Kingdom.

RESULTS

The pooled results demonstrated significant differences in favor of remimazolam when compared to propofol for procedural sedation. Patients receiving remimazolam showed a lower risk of respiratory depression (RR: 0.19; 95% CI: [0.11, 0.33]; I 2 = 0%; p < 0.00001), dizziness (RR: 0.10; 95% CI: [0.04, 0.31]; I 2 = 0%; p < 0.0001), and postoperative nausea and vomiting (RR: 0.60; 95% CI: [0.15, 2.46]; I 2 = 0%; p = 0.48). No significant differences were observed in anesthesia recovery time between the remimazolam and propofol groups (MD: -0.07; 95% CI: [-0.18-1.04]; I 2 = 98%; p = 0.90).

CONCLUSION

Compared to propofol, remimazolam reduces the occurrence of hypotension, respiratory depression, dizziness, and postoperative nausea and vomiting in the anesthesia management of hysteroscopy procedures.