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Peer-reviewedCC BY 4.0PLOS One

Quality of recovery after arthroscopic meniscectomy with remimazolam or propofol anesthesia: A randomized controlled trial

  • Eunah Cho1
  • Ha Yan Kim2
  • Yangjin Kim3
  • Seokyung Shin
  1. 1Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  2. 2Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Abstract

Background: Anesthetic technique may influence postoperative quality of recovery (QoR). Remimazolam may offer hemodynamic stability and favorable early recovery characteristics, but its effect on patient-reported QoR compared with propofol remains unclear. This is particularly relevant in minor orthopedic surgery, where QoR is a principal outcome. This randomized controlled trial compared postoperative QoR between propofol-based and remimazolam-based total intravenous anesthesia (TIVA) using the QoR-40 questionnaire. Materials and methods: Eighty adult patients undergoing elective arthroscopic meniscectomy were randomly assigned to propofol-based or remimazolam-based TIVA; 71 patients completed the QoR-40 questionnaire and were included in the final analysis (36 in the Propofol group, 35 in the Remimazolam group). The primary outcome was the global QoR-40 score on postoperative day (POD) 1. Secondary outcomes included intraoperative hemodynamic variables, anesthetic and analgesic requirements, postoperative recovery profiles, pain scores, and postoperative nausea and vomiting. Results: Global QoR-40 scores on POD 1 did not differ significantly between the Propofol and Remimazolam groups (166.1 ± 16.8 vs. 170.6 ± 13.6; mean difference −4.5, 95% CI −11.8 to 2.7; P = 0.218). In an exploratory analysis, the emotional-state domain scores were higher in the Remimazolam group (37.0 ± 4.3 vs. 39.2 ± 2.5; mean difference −2.2, 95% CI −3.9 to −0.6; P = 0.009). The Remimazolam group had a longer time to full alertness (18 [15–24] vs. 37 [31–45] min; P < 0.001) and longer post-anesthesia care unit stay (30 [30–39] vs. 38 [30–50] min; P = 0.008). Intraoperative hypotension requiring ephedrine occurred more frequently in the Propofol group (44.4% vs. 17.1%; P = 0.013). Conclusions: Global QoR-40 scores on POD 1 did not differ significantly between propofol-based and remimazolam-based TIVA in adults undergoing elective arthroscopic meniscectomy, although remimazolam was associated with greater intraoperative hemodynamic stability at the cost of slower return to full alertness.

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Cite

BibTeXRIS
BibTeX
@article{cho2026quality,
  title = {{Quality of recovery after arthroscopic meniscectomy with remimazolam or propofol anesthesia: A randomized controlled trial}},
  author = {Eunah Cho and Ha Yan Kim and Yangjin Kim and Seokyung Shin},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0360759},
  url = {https://doi.org/10.1371/journal.pone.0360759},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Quality of recovery after arthroscopic meniscectomy with remimazolam or propofol anesthesia: A randomized controlled trial
AU  - Eunah Cho
AU  - Ha Yan Kim
AU  - Yangjin Kim
AU  - Seokyung Shin
PY  - 2026
DA  - 2026/10/15
JO  - PLOS One
DO  - 10.1371/journal.pone.0360759
UR  - https://doi.org/10.1371/journal.pone.0360759
AB  - Background: Anesthetic technique may influence postoperative quality of recovery (QoR). Remimazolam may offer hemodynamic stability and favorable early recovery characteristics, but its effect on patient-reported QoR compared with propofol remains unclear. This is particularly relevant in minor orthopedic surgery, where QoR is a principal outcome. This randomized controlled trial compared postoperative QoR between propofol-based and remimazolam-based total intravenous anesthesia (TIVA) using the QoR-40 questionnaire. Materials and methods: Eighty adult patients undergoing elective arthroscopic meniscectomy were randomly assigned to propofol-based or remimazolam-based TIVA; 71 patients completed the QoR-40 questionnaire and were included in the final analysis (36 in the Propofol group, 35 in the Remimazolam group). The primary outcome was the global QoR-40 score on postoperative day (POD) 1. Secondary outcomes included intraoperative hemodynamic variables, anesthetic and analgesic requirements, postoperative recovery profiles, pain scores, and postoperative nausea and vomiting. Results: Global QoR-40 scores on POD 1 did not differ significantly between the Propofol and Remimazolam groups (166.1 ± 16.8 vs. 170.6 ± 13.6; mean difference −4.5, 95% CI −11.8 to 2.7; P = 0.218). In an exploratory analysis, the emotional-state domain scores were higher in the Remimazolam group (37.0 ± 4.3 vs. 39.2 ± 2.5; mean difference −2.2, 95% CI −3.9 to −0.6; P = 0.009). The Remimazolam group had a longer time to full alertness (18 [15–24] vs. 37 [31–45] min; P < 0.001) and longer post-anesthesia care unit stay (30 [30–39] vs. 38 [30–50] min; P = 0.008). Intraoperative hypotension requiring ephedrine occurred more frequently in the Propofol group (44.4% vs. 17.1%; P = 0.013). Conclusions: Global QoR-40 scores on POD 1 did not differ significantly between propofol-based and remimazolam-based TIVA in adults undergoing elective arthroscopic meniscectomy, although remimazolam was associated with greater intraoperative hemodynamic stability at the cost of slower return to full alertness.
SN  - 1932-6203
ER  -