Comparison of the recovery profiles of remimazolam-remifentanil and propofol-remifentanil in older patients undergoing laparoscopic abdominal surgeries.

BACKGROUND

We compared the quality of recovery (QoR) between total intravenous anesthesia using remimazolam and propofol in older patients undergoing laparoscopic abdominal surgeries.

METHODS

A total of 120 patients (aged ≥ 60 years) undergoing laparoscopic gastric or colorectal surgery were randomized to the remimazolam or propofol group. Continuous remimazolam/propofol infusion and target-controlled remifentanil infusion were performed. Recovery was evaluated using the Korean version of the Quality of Recovery-15 (QoR-15K) questionnaire. The primary outcome was the QoR-15K score on postoperative day (POD) 3. Secondary outcomes included the QoR-15K score on POD 1; perioperative mean arterial pressure and heart rate; times to eye opening, extubation, and full recovery; post-anesthetic care unit (PACU) adverse events; postoperative delirium; and duration of hospitalization.

RESULTS

The total QoR-15K scores over time did not make differences significantly between the groups. Total QoR-15K scores on POD 3 (112.0 [96.0, 119.0] vs. 104.0 [84.8, 120.5], P = 0.481) and POD 1 (80.0 [62.0, 97.0] vs. 78.0 [60.8, 95.3], P = 0.635) were comparable between the groups. The MAP and HR were significantly higher in the remimazolam group. The times to extubation (12.0 [11.0, 15.0] vs. 10.5 [9.0, 12.3] min, P = 0.003) and full recovery (13.0 [9.0, 16.0] vs. 11.5 [8.0, 14.0] min, P = 0.045) were notably longer in the remimazolam group. The incidence of adverse events in the PACU and postoperative delirium, and duration of hospitalization were comparable between the groups.

CONCLUSIONS

Remimazolam yielded a similar QoR as propofol in older patients undergoing laparoscopic abdominal surgeries.