Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial

Abstract Background The stability of hemodynamics during anesthesia induction in patients undergoing valve replacement surgery is particularly important. Remimazolam is a new type of benzodiazepine drug, with supposed advantages of rapid induction, rapid recovery, stable hemodynamics, and mild respi...

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Autores principales:	Tianxiao Liu, Ting Lai, Jing Chen, Yizhi Lu, Fang He, Yanhua Chen, Yubo Xie
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	anesthesia induction cardiovascular events hemodynamics propofol remimazolam valve replacement surgery Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/7eb0743a6e214afda586807bebcce8c3
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spelling	oai:doaj.org-article:7eb0743a6e214afda586807bebcce8c32021-11-16T13:45:54ZEffect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial2052-170710.1002/prp2.851https://doaj.org/article/7eb0743a6e214afda586807bebcce8c32021-10-01T00:00:00Zhttps://doi.org/10.1002/prp2.851https://doaj.org/toc/2052-1707Abstract Background The stability of hemodynamics during anesthesia induction in patients undergoing valve replacement surgery is particularly important. Remimazolam is a new type of benzodiazepine drug, with supposed advantages of rapid induction, rapid recovery, stable hemodynamics, and mild respiratory inhibition. Aim To evaluate the effect of remimazolam anesthesia induction on hemodynamics in patients undergoing valve replacement surgery. Methods This randomized, double‐blind, controlled trial enrolled consecutive patients undergoing mitral valve replacement (MVR)/aortic valve replacement (AVR)/double‐valve replacement (DVR) surgery on cardiopulmonary bypass (CPB). The study was conducted according to the Consolidated Standards of Reporting Trials statement. Participants were randomly assigned to receive either remimazolam or propofol induction of 30 patients each. All patients, data collectors, and data analyzers were blinded to the group allocation. The primary outcomes were the fluctuations in hemodynamic parameters (the difference of maximum or minimum heart rate to baseline, ▲HR, the difference of maximum or minimum mean arterial pressure to baseline, ▲MAP), the occurrence of cardiovascular events (hypotension, severe bradycardia), and the cumulative norepinephrine doses used per patient, averaged per group during induction. The secondary outcomes were hemodynamic parameters (heart rate, HR, mean arterial pressure, MAP, bispectral index, BIS, plasma lactic acid, Lac, and blood glucose, Glu values). Results A total of 60 patients with heart valve replacement were included in the final analysis, with 30 patients in each group. The ▲MAP was significantly lower in the remimazolam group than in the propofol group during induction (p < .05). The incidences of hypotension and the cumulative norepinephrine doses used per patient, averaged per group during induction were significantly lower in the remimazolam group than in the propofol group (p < .05). Conclusion Remimazolam may be safe and effective for induction and may as an alternative to propofol during anesthesia induction in patients undergoing valve replacement surgery.Tianxiao LiuTing LaiJing ChenYizhi LuFang HeYanhua ChenYubo XieWileyarticleanesthesia inductioncardiovascular eventshemodynamicspropofolremimazolamvalve replacement surgeryTherapeutics. PharmacologyRM1-950ENPharmacology Research & Perspectives, Vol 9, Iss 5, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anesthesia induction cardiovascular events hemodynamics propofol remimazolam valve replacement surgery Therapeutics. Pharmacology RM1-950
spellingShingle	anesthesia induction cardiovascular events hemodynamics propofol remimazolam valve replacement surgery Therapeutics. Pharmacology RM1-950 Tianxiao Liu Ting Lai Jing Chen Yizhi Lu Fang He Yanhua Chen Yubo Xie Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
description	Abstract Background The stability of hemodynamics during anesthesia induction in patients undergoing valve replacement surgery is particularly important. Remimazolam is a new type of benzodiazepine drug, with supposed advantages of rapid induction, rapid recovery, stable hemodynamics, and mild respiratory inhibition. Aim To evaluate the effect of remimazolam anesthesia induction on hemodynamics in patients undergoing valve replacement surgery. Methods This randomized, double‐blind, controlled trial enrolled consecutive patients undergoing mitral valve replacement (MVR)/aortic valve replacement (AVR)/double‐valve replacement (DVR) surgery on cardiopulmonary bypass (CPB). The study was conducted according to the Consolidated Standards of Reporting Trials statement. Participants were randomly assigned to receive either remimazolam or propofol induction of 30 patients each. All patients, data collectors, and data analyzers were blinded to the group allocation. The primary outcomes were the fluctuations in hemodynamic parameters (the difference of maximum or minimum heart rate to baseline, ▲HR, the difference of maximum or minimum mean arterial pressure to baseline, ▲MAP), the occurrence of cardiovascular events (hypotension, severe bradycardia), and the cumulative norepinephrine doses used per patient, averaged per group during induction. The secondary outcomes were hemodynamic parameters (heart rate, HR, mean arterial pressure, MAP, bispectral index, BIS, plasma lactic acid, Lac, and blood glucose, Glu values). Results A total of 60 patients with heart valve replacement were included in the final analysis, with 30 patients in each group. The ▲MAP was significantly lower in the remimazolam group than in the propofol group during induction (p < .05). The incidences of hypotension and the cumulative norepinephrine doses used per patient, averaged per group during induction were significantly lower in the remimazolam group than in the propofol group (p < .05). Conclusion Remimazolam may be safe and effective for induction and may as an alternative to propofol during anesthesia induction in patients undergoing valve replacement surgery.
format	article
author	Tianxiao Liu Ting Lai Jing Chen Yizhi Lu Fang He Yanhua Chen Yubo Xie
author_facet	Tianxiao Liu Ting Lai Jing Chen Yizhi Lu Fang He Yanhua Chen Yubo Xie
author_sort	Tianxiao Liu
title	Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
title_short	Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
title_full	Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
title_fullStr	Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
title_full_unstemmed	Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial
title_sort	effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: a randomized, double‐blind, controlled trial
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/7eb0743a6e214afda586807bebcce8c3
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Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: A randomized, double‐blind, controlled trial

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