Remimazolam Versus Propofol for General Anesthesia Induction in Patients on Renin-angiotensin System Blockers Undergoing Robot-assisted Laparoscopic Prostatectomy
Summary
The investigators conduct a random assignment into either the remimazolam group or the propofol group. Depending on the group assignment, either remimazolam (0.2 mg/kg) or propofol (1.0 mg/kg) is administered. If necessary, additional doses of remimazolam (0.1 mg/kg) or propofol (0.5 mg/kg) are given. The standard anesthesia procedure of our institution is followed, and blood pressure data recorded during the surgery is analyzed (mean arterial pressure \<65mmHg is defined as hypotension).
Timeline
- Start
- 2023-11-17
- Primary completion
- 2024-10-22
- Completion
- 2024-10-22
Outcome
Missed primary endpoint
paper Induction with remimazolam did not reduce intraoperative hypotension risk compared with low-dose propofol in patients undergoing RALP who continued ARB therapy. PMID 41233396 ↗
paper The hypotension incidence did not differ significantly between groups during the entire anesthesia (87.5% vs. 89.3%, P > 0.999). PMID 41233396 ↗
Publications
- Yang ZJ, Wu Y, Zhao XY, Qi XS. Ultrasound-guided lung recruitment maneuver in pediatric acute respiratory distress syndrome. Sci Rep. 2026 Apr 6;16(1):16496. doi: 10.1038/s41598-026-43537-1.
- Kim HJ, Kim N, Kim J, Park JH, Shin HJ, Yang J, Kim SY. Intraoperative hypotension after remimazolam or propofol induction with sevoflurane maintenance in angiotensin II receptor blockers-treated patients: a randomized controlled trial. Sci Rep. 2025 Nov 13;15(1):39805. doi: 10.1038/s41598-025-23469-y.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Comparator | Propofol | Small molecule | 1 mg/kg | — |
| Subject | Remimazolam | Small molecule | 0.2 mg/kg | — |