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- Title
Comparison of Hemodynamic Parameters Based on the Administration of Remimazolam or Sevoflurane in Patients under General Anesthesia in the Beach Chair Position: A Single-Blinded Randomized Controlled Trial.
- Authors
Lee, Sangho; Seo, Jimung; Kim, Doh Yoon; Lee, YoungYun; Kang, Hee Yong; Choi, Jeong-Hyun; Kim, Youngsoon; Kim, Mi Kyeong; You, Ann Hee
- Abstract
Background: We aimed to evaluate whether the administration of remimazolam as a maintenance agent for general anesthesia affects the occurrence of hypotension compared with sevoflurane when switching to the beach chair position (BCP). Methods: We conducted a prospective randomized controlled trial from June 2023 to October 2023 in adult patients undergoing orthopedic surgery under general anesthesia in the BCP. A total of 78 participants were randomly allocated to the remimazolam (R) or sevoflurane (S) groups. The primary outcome was the incidence of hypotension that occurred immediately after switching to a BCP. The secondary outcomes included differences between the study groups in perioperative blood pressure (BP), heart rate (HR), endotracheal tube extubation time, postoperative complications, and hospital length of stay (LOS). Results: The incidence of hypotension immediately after switching to a BCP was significantly higher in the S group. The risk factors associated with hypotension included sevoflurane administration and a high baseline systolic BP. In the receiver operating characteristic curve analysis for the occurrence of hypotension after the transition to a BCP, the cutoff value for systolic BP was 142 mmHg. The perioperative BP and HR were higher in the R group at several timepoints. Postoperative endotracheal tube extubation time was shorter in the R group. There were no significant differences in the postoperative complications or hospital LOS between the two groups. Conclusions: Remimazolam should be considered as an anesthetic agent to prevent hypotension when switching to BCP, and hypotension may occur frequently in patients with high baseline BP.
- Subjects
GENERAL anesthesia; RECEIVER operating characteristic curves; HEMODYNAMICS; SEVOFLURANE; BLOOD pressure; BLOOD pressure testing machines; LENGTH of stay in hospitals
- Publication
Journal of Clinical Medicine, 2024, Vol 13, Issue 8, p2364
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm13082364