Postoperative nausea and vomiting after artificial joint replacement surgery: comparison between remimazolam and sevoflurane, a propensity score analysis.

PURPOSE: Remimazolam, a newly synthesized ultrashort-acting benzodiazepine, has not been previously compared with sevoflurane with regard to postoperative nausea and vomiting (PONV). The aim of this study is to investigate the incidence of PONV between remimazolam and sevoflurane among patients undergoing artificial joint replacement surgery.

METHODS

We conducted a retrospective analysis of the electronic medical records of patients who underwent artificial joint replacement surgery at Kobe City Medical Center General Hospital from 2020 to 2022, with a focus on comparing the incidence of PONV among those who received sevoflurane versus remimazolam anesthesia. To control for confounding factors, we employed a propensity score-matching technique to pair patients who received sevoflurane anesthesia with those who received remimazolam anesthesia.

RESULTS

The records of 292 patients receiving general anesthesia for artificial joint replacement surgery were collected and categorized into group sevoflurane (n = 241) or group remimazolam (n = 51). Before propensity score matching, age and ASA-PS exhibited significant differences between two groups. There was no significant difference in the incidence of PONV between them (p = 0.461). After matching, there were 51 patients in each group. However, there is no significant difference in the incidence of PONV between the two matched cohorts (p = 0.243).

CONCLUSIONS

This study demonstrated that there was no difference in the prevalence of PONV between remimazolam and sevoflurane anesthesia in patients undergoing artificial joint replacement surgery.