American journal of translational research · 2025
Feasibility and efficacy of remimazolam for anesthesia monitoring in transcatheter aortic valve implantation via femoral artery access.
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Liang Xin, Deng Xin, Lao Qiying, Chen Longqian, Liang Yanli, Yang Liu
Аннотация
OBJECTIVE: To evaluate the effect of remimazolam during anesthesia monitoring in transcatheter aortic valve implantation (TAVI) via femoral artery catheter (FAC).
METHODS: We reviewed the medical records of 50 patients who underwent TAVI via FAC from July 2022 to September 2023. Patients were divided into two groups: a control group (receiving propofol, n=25) and a remimazolam group (receiving remimazolam, n=25). Pulse oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP) and Bispectral Index (BIS) were recorded at various time points: 5 min before anesthesia (T0), 0 (T1), 5 (T2), 10 (T3), 15 (T4), and 20 min (T5) after infusion. Operation time, blood loss, awakening time, quality of recovery (QoR-15) scores before operation and 1 and 3 days after operation were recorded and compared between the two groups. Additionally, the incidence of delirium at 1-day post-operation was compared between the two groups. The incidence of adverse reactions and patient satisfaction were compared between the groups.
RESULTS: At T2, T3, T4 and T5, the remimazolam group exhibited significantly higher SpO2, HR and MAP than the control group (P<0.05); BIS values and modified observer's assessment of alertness/sedation (MOAA/S) scores showed no significant differences (P>0.05). The remimazolam group also had significantly earlier awakening times (P<0.05), without differences in operation time or blood loss (P<0.05). QoR-15 scores at 1 and 3 days post-operation were higher in the remimazolam group (P<0.05). The incidence of postoperative delirium was slightly lower in the remimazolam group (P>0.05). The control group had a higher total incidence of adverse reactions and lower satisfaction compared to the remimazolam group (P<0.05).
CONCLUSION: Remimazolam is an effective sedative for TAVI anesthesia, associated with lower postoperative adverse reactions, thus facilitating better recovery.
METHODS: We reviewed the medical records of 50 patients who underwent TAVI via FAC from July 2022 to September 2023. Patients were divided into two groups: a control group (receiving propofol, n=25) and a remimazolam group (receiving remimazolam, n=25). Pulse oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP) and Bispectral Index (BIS) were recorded at various time points: 5 min before anesthesia (T0), 0 (T1), 5 (T2), 10 (T3), 15 (T4), and 20 min (T5) after infusion. Operation time, blood loss, awakening time, quality of recovery (QoR-15) scores before operation and 1 and 3 days after operation were recorded and compared between the two groups. Additionally, the incidence of delirium at 1-day post-operation was compared between the two groups. The incidence of adverse reactions and patient satisfaction were compared between the groups.
RESULTS: At T2, T3, T4 and T5, the remimazolam group exhibited significantly higher SpO2, HR and MAP than the control group (P<0.05); BIS values and modified observer's assessment of alertness/sedation (MOAA/S) scores showed no significant differences (P>0.05). The remimazolam group also had significantly earlier awakening times (P<0.05), without differences in operation time or blood loss (P<0.05). QoR-15 scores at 1 and 3 days post-operation were higher in the remimazolam group (P<0.05). The incidence of postoperative delirium was slightly lower in the remimazolam group (P>0.05). The control group had a higher total incidence of adverse reactions and lower satisfaction compared to the remimazolam group (P<0.05).
CONCLUSION: Remimazolam is an effective sedative for TAVI anesthesia, associated with lower postoperative adverse reactions, thus facilitating better recovery.