| Comparison of remimazolam and desflurane in emergence agitation after general anesthesia for nasal surgery: A prospective randomized controlled study |
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Sung-Ae Cho1,2, So-min Ahn1, Woojin Kwon1, Tae-Yun Sung1,2 |
1Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
2Myunggok Medical Research Center, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea |
Corresponding author:
Tae-Yun Sung, Tel: +82-42-600-9316 ,
Email: unt1231@naver.com
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Received: 27 December 2023 • Revised: 31 March 2024 • Accepted: 14 April 2024 |
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| Abstract |
Background
Remimazolam is an ultrashort-acting benzodiazepine. Few studies have evaluated the effects of remimazolam-based total intravenous anesthesia (TIVA) on emergence agitation (EA). This study aimed to compare the incidence and severity of EA between TIVA using remimazolam and desflurane.
Methods
This prospective randomized controlled study enrolled 76 patients who underwent nasal surgery under general anesthesia. Patients were randomized into two groups of 38 each: desflurane-nitrous oxide (N2O) (DN) and remimazolam-remifentanil (RR) groups. The same protocol was used for each group from induction to emergence, except for the use of different anesthetics during maintenance of anesthesia according to the assigned group: desflurane and nitrous oxide for the DN group and remimazolam and remifentanil for the RR group. The incidence of EA as the primary outcome was evaluated using three scales: Ricker Sedation-Agitation Scale, Richmond Agitation-Sedation Scale, and Aono’s four-point agitation scale. Additionally, hemodynamic changes during emergence and postoperative sense of suffocation were compared.
Results
The incidence of EA was significantly lower in the RR group than in the DN group in all three types of EA assessment scales (all P < 0.001). During emergence, the change in heart rate differed between the two groups (P = 0.002). The sense of suffocation was lower in the RR group than in the DN group (P = 0.027).
Conclusions
RR reduced the incidence and severity of EA in patients undergoing nasal surgery under general anesthesia. In addition, RR was favorable for managing hemodynamics and postoperative sense of suffocation. |
| Key Words:
Desflurane; Emergence agitation; General anesthesia; Intravenous anesthesia; Nasal surgery; Remimazolam |
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