Comparison of remimazolam and midazolam for sedation during colonoscopy in Japanese patients: A propensity score matching analysis.

Autor: Ogura K; Department of Medicine Nihon University School of Medicine Division of Gastroenterology and Hepatology Tokyo Japan.; Department of Gastroenterology Nagata Surgery and Gastroenterological Clinic Tokyo Japan., Ichijima R; Department of Medicine Nihon University School of Medicine Division of Gastroenterology and Hepatology Tokyo Japan.; Department of Gastroenterology Kiriyama Clinic Gunma Japan., Ikehara H; Department of Medicine Nihon University School of Medicine Division of Gastroenterology and Hepatology Tokyo Japan.; Department of Gastroenterology Internal Medicine Kitasato University School of Medicine Kanagawa Japan., Sugita T; Department of Medicine Nihon University School of Medicine Division of Gastroenterology and Hepatology Tokyo Japan., Yamaguchi D; Department of Gastroenterology National Hospital Organization Ureshino Medical Center Saga Japan., Nagata Y; Department of Gastroenterology Nagata Surgery and Gastroenterological Clinic Tokyo Japan., Esaki M; Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan., Minoda Y; Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan., Ono H; Division of Endoscopy Shizuoka Cancer Center Shizuoka Japan., Hotta K; Division of Endoscopy Shizuoka Cancer Center Shizuoka Japan., Kiriyama S; Department of Gastroenterology Kiriyama Clinic Gunma Japan., Sumiyoshi T; Department of Gastroenterology Tonan Hospital Hokkaido Japan., Kanmura Y; Department of Anesthesiology Fujimoto General Hospital Miyazaki Japan.
Jazyk: angličtina
Zdroj: DEN open 2024 Jul 23; Vol. 5 (1), pp. e412. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2025).
DOI: 10.1002/deo2.412
Abstrakt: Objectives: To compare the efficacy and safety of sedation with midazolam and remimazolam for colorectal endoscopy.
Methods: This single-center, two-arm, post-hoc analysis of the REM-IICTJP01 study investigated the efficacy and safety of remimazolam for gastrointestinal endoscopic sedation. We enrolled 40 and 208 patients who underwent colonoscopy under remimazolam and midazolam sedation, respectively, during the same period. The primary outcome was the time from the end of the colonoscopy until discharge. The secondary outcomes included the time from the end of the colonoscopy until awakening, dosage, and adverse events. Propensity score matching was employed to eliminate the effect of confounding factors.
Results: Thirty-seven patients in each group were matched. After propensity matching, the time to awakening after colonoscopy was 28.0 (13.0-37.0) min in the midazolam group and 0 (0-0) min in the remimazolam group; moreover, the time till discharge was 40.0 (35.0-46.5) min in the midazolam group and 0 (0-5.0) min in the remimazolam group, both of which were significantly shorter in the remimazolam group ( p < 0.01). The number of additional doses was 0 (0-0) and 2 (1-3) in the midazolam and remimazolam groups, respectively. The total dose was 2.0 (2.0-3.5) and 6.0 (5.0-7.0) mg in the midazolam and remimazolam groups, respectively.
Conclusions: Remimazolam yielded significantly faster times to awakening and discharge safely compared to midazolam.
Competing Interests: Author Hisatomo Ikehara received honoraria for his lectures from FUJIFILM Corporation, Mitsubishi Tanabe Pharma Corporation, and Olympus Corporation.
(© 2024 The Author(s). DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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