American journal of translational research · 2026
Application value and safety advantages of remimazolam tosilate in sedation for emergency rescue endotracheal intubation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Yang Dengcai, Chen Jiguan, Lin Xiaoyin, Wang Jie, Huang Zhen, Huang Zhenzhen, Fang Xueliu, Zhang Fujia
Аннотация
OBJECTIVES: Emergency tracheal intubation is a high-risk, life-support procedure that requires rapid and safe sedation. This study aimed to evaluate the clinical effectiveness and safety of remimazolam tosilate compared to propofol for sedation during emergency resuscitation intubation.
METHODS: This retrospective cohort study included adult patients who underwent sedation-assisted emergency intubation between June 2022 and June 2025. Patients were grouped according to the primary sedative administered: propofol or remimazolam. Sedation depth was assessed using the Ramsay score, and intubation success rates were recorded. Hemodynamic indices and respiratory rates were documented pre- and post-intubation. The incidence of adverse events and cognitive function at postoperative 72 hours were also evaluated.
RESULTS: A total of 216 patients were included (104 in the propofol group and 112 in the remimazolam group). Propofol demonstrated a faster onset of sedation (42.12 ± 6.63 vs. 95.12 ± 10.17 seconds, P < 0.001), whereas remimazolam achieved a significantly higher first-attempt intubation success rate (87.50% vs. 66.35%, P < 0.001). After intubation, patients in the remimazolam group maintained higher systolic blood pressure (122.20 ± 9.77 vs. 116.42 ± 17.38 mmHg, P=0.003) and mean arterial pressure, as well as a lower rate-pressure product (10395.81 ± 928.89 vs. 10754.15 ± 1168.58 mmHg/min, P=0.014). The remimazolam group also exhibited lower incidences of hypotension (9.82% vs. 20.19%, P=0.032) and respiratory depression (5.36% vs. 17.31%, P=0.005), and experienced less injection pain (5.36% vs. 27.88%, P < 0.001).
CONCLUSIONS: In emergency intubation, compared to propofol, remimazolam tosilate demonstrated a slower onset of sedation but offers better hemodynamic stability, higher first-attempt success rates, more favorable respiratory profiles, and improved early cognitive recovery, making it a valuable alternative sedative.
METHODS: This retrospective cohort study included adult patients who underwent sedation-assisted emergency intubation between June 2022 and June 2025. Patients were grouped according to the primary sedative administered: propofol or remimazolam. Sedation depth was assessed using the Ramsay score, and intubation success rates were recorded. Hemodynamic indices and respiratory rates were documented pre- and post-intubation. The incidence of adverse events and cognitive function at postoperative 72 hours were also evaluated.
RESULTS: A total of 216 patients were included (104 in the propofol group and 112 in the remimazolam group). Propofol demonstrated a faster onset of sedation (42.12 ± 6.63 vs. 95.12 ± 10.17 seconds, P < 0.001), whereas remimazolam achieved a significantly higher first-attempt intubation success rate (87.50% vs. 66.35%, P < 0.001). After intubation, patients in the remimazolam group maintained higher systolic blood pressure (122.20 ± 9.77 vs. 116.42 ± 17.38 mmHg, P=0.003) and mean arterial pressure, as well as a lower rate-pressure product (10395.81 ± 928.89 vs. 10754.15 ± 1168.58 mmHg/min, P=0.014). The remimazolam group also exhibited lower incidences of hypotension (9.82% vs. 20.19%, P=0.032) and respiratory depression (5.36% vs. 17.31%, P=0.005), and experienced less injection pain (5.36% vs. 27.88%, P < 0.001).
CONCLUSIONS: In emergency intubation, compared to propofol, remimazolam tosilate demonstrated a slower onset of sedation but offers better hemodynamic stability, higher first-attempt success rates, more favorable respiratory profiles, and improved early cognitive recovery, making it a valuable alternative sedative.