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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2024

Open Access 01-12-2024 | Propofol | Research

Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial

Authors: Sooyoung Jeon, Jieun Kim, Myong-Hwan Karm, Jin-Tae Kim

Published in: BMC Anesthesiology | Issue 1/2024

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Abstract

Background

General anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatients. This study aimed to investigate the effect of transitioning from propofol to remimazolam with flumazenil reversal administered toward the end of surgery during propofol-based total intravenous anesthesia (TIVA) on recovery.

Methods

Adults with mental disabilities scheduled to undergo dental treatment were randomly assigned to receive either propofol-based TIVA (Group P) or propofol-remimazolam-based TIVA with flumazenil reversal (Group PR). Propofol was replaced with remimazolam 1 h before the end of surgery in Group PR; moreover, 0.5 mg of flumazenil was administered after the neuromuscular blockade reversal agent. The primary outcome was the duration of stay in the post-anesthesia care unit (PACU). The secondary outcomes included time to eye-opening, time to extubation, occurrence of PONV, and quality of recovery.

Results

Fifty-four patients were included in this study. The duration of stay in the PACU in Group PR was significantly shorter than that in Group P (mean difference, 8.7 min; confidence interval [95% CI], 3.3–14.2; P = 0.002). Group PR exhibited a shorter time to eye opening (mean difference, 5.4 min; 95% CI, 3.3–8.1; P < 0.001) and time to extubation (mean difference, 5.5 min; 95% CI, 3.6–7.9; P < 0.001) than Group P. Neither group required the administration of rescue analgesics, and the incidence of PONV was not reported.

Conclusions

Transitioning from propofol to remimazolam 1 h before the end of surgery followed by flumazenil reversal reduced the duration of stay in the PACU and the time to eye opening and extubation without affecting the incidence of PONV and quality of recovery.

Trial registration number

Clinical Research Information Service (KCT0007794), Clinical trial first registration date: 12/10/2022.
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Metadata
Title
Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial
Authors
Sooyoung Jeon
Jieun Kim
Myong-Hwan Karm
Jin-Tae Kim
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2024
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-024-02526-5

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