Background: Remimazolam besylate is a newer benzodiazepine with characteristics of quick onset of effects, short maintenance and recovery times without accumulation in tissues. This trial was conducted to confirm the efficacy and safety of remimazolam besylate versus propofol during hysteroscopy.
Methods: Patients undergoing hysteroscopy were randomly assigned to either the remimazolam (Group R) or the propofol group (Group P). Group R was administered an induction dose of 0.2 mg/kg and a maintenance dosage of 1.0 mg/kg/h. In Group P, propofol was started at 1.5–2.0 mg/kg and then maintained at 3.0–6.0 mg/kg/h. After remimazolam besylate or propofol induction, remifentanil was infused using a target-controlled infusion system with a target concentration of 1.5 ng/ml and titrated during the procedure. The incidence rates of injection pain,low oxygen saturation (SpO2) and adverse effects in both groups were compared.
Results: Eighty-two patients were included in this study. The incidence of adverse events in Group R (3.7%) was significantly lower than that in Group P (36.6%) (p< 0.001). The incidence of injection pain in Group P (80.5%) was
much higher than that in Group R (2.4%) (p< 0.001). The incidence of other adverse events, such as low SpO2,bradycardia, and hypotension in Group R was lower than that in Group P (p< 0.05).
Conclusions: Remimazolam besylate proves to be a safer alternative for anesthesia during hysteroscopy. Moreover,adverse events caused by propofol, such as low SpO2and injection pain, are largely avoided.