Safety and efficacy of remimazolam in fiberoptic bronchoscopy:A Meta-analysis
Objective To systematically evaluate the differences in safety and effectiveness between remima-zolam and propofol in fiberoptic bronchoscopy.Methods A computerized search was conducted in databases including PubMed,Embase,Cochrane,Web of Science,China National Knowledge Infrastructure,Wanfang Data,China Biomedical Database and VIP Database,covering all records up to June 2023.A meta-analysis was performed using Revman 5.4 software.Results Out of 137 initially identified publications,6 studies meet-ing the criteria were included in the final analysis.The meta-analysis showed no significant difference be-tween propofol and remimazolam in terms of anesthesia induction time(MD = 0.35,95%CI:[-0.07,0.77],P = 0.1),anesthesia recovery time(MD = 1.29,95%CI:[-1.35,3.94],P = 0.34),examination duration(MD =-0.66,95%CI:[-1.58,0.26],P = 0.16)and anesthesia satisfaction(MD =-0.13,95%CI:[-0.46,0.20],P = 0.43).Compared with propofol,remimazolam showed a decrease in heart rate(MD = 3.75,95%CI:[0.57,6.92],P = 0.02),systolic blood pressure(MD = 18.21,95%CI:[6.24,30.17],P = 0.003)and diastolic pressure difference(MD = 12.13,95%CI:[6.19,18.07],P<0.000 1)before and after anesthesia induction.No signifi-cant difference was found between the two groups in the mean arterial pressure before and after anesthesia in-duction(MD =-0.91,95%CI:[-28.04,26.22],P = 0.95).Compared with propofol,the incidence of hypoten-sion in the remimazolam group was lower(OR = 0.31,95%CI:[0.21,0.47],P<0.0001).And there was no sig-nificant difference in the overall adverse reactions(OR = 0.21,95%CI:[0.04,1.12],P = 0.07),injection pain(OR = 0.10,95%CI:[0.01,1.72],P = 0.11),respiratory depression(OR = 0.50,95%CI:[0.06,3.83],P = 0.50),nausea and vomiting(OR =0.98,95%CI:[0.11,8.94],P = 0.98),bradycardia and physical movement(OR = 0.62,95%CI:[0.21,1.90],P = 0.41;OR =1.79,95%CI:[0.51,6.23],P = 0.36)between the two groups.Con-clusion In bronchoscopy,remimazolam and propofol are equally effective,with the former showing more sta-ble hemodynamics and a lower incidence of adverse reactions.
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