Comparison of Remimazolam and Propofol for Intubated General Anesthesia for Oral and Maxillofacial Surgery

Abstract

Objective Remimazolam is a new, ultra-short-acting benzodiazepine that can be used for induction and maintenance of general anesthesia. We compared the hemodynamic stability and depth of anesthesia during general anesthesia using remimazolam or propofol along with remifentanil for oral and maxillofacial surgery. Methods A total of 95 patients were divided into remimazolam and propofol groups and then subdivided into bispectral index (BIS) and patient state index (PSI) groups. Blood pressure, heart rate, and BIS/PSI values were compared at fixed time points perioperatively. Time to loss of consciousness and total opioid doses were also compared across groups. Other items that were compared included intraoperative arousal and postoperative nausea and vomiting. Results Propofol produced more significant hemodynamic depression than remimazolam, although both groups were stable. BIS/PSI values were similar in both groups. Time to loss of consciousness was significantly shorter in the remimazolam group. Total opioid dosing was higher in the remimazolam group, and there were no differences regarding other postoperative complications. Conclusion The perioperative hemodynamics with remimazolam were more stable that with propofol, especially during induction. Therefore, remimazolam may be a safe alternative to propofol for providing TIVA general anesthetics.