Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study
- 1Department of Anesthesiology, Shiga University of Medical Science, Shiga, Japan
Abstract
Context:: Remimazolam is an ultra-short-acting benzodiazepine used for general anesthesia, including cardiac surgery; however, its effect on postoperative emergence following cardiopulmonary bypass remains unclear.
Aims:: We aimed to compare postoperative emergence following remimazolam- and propofol-based total intravenous anesthesia in adult patients undergoing cardiac valve surgery.
Settings and Design:: A retrospective observational study.
Methods and Materials:: We included adult patients who underwent elective cardiac valve replacement surgery at a single center between April 2023 and September 2024. Patients received either remimazolam- or propofol-based total intravenous anesthesia according to institutional practice. The primary endpoint was postoperative emergence time. Secondary endpoints included time to extubation and early postoperative hemodynamic stability assessed using the vasoactive–inotropic score.
Statistical Analysis Used:: Baseline characteristics and perioperative variables were compared between the groups. Univariate and multivariable linear regression analyses were performed.
Results:: Sixty-three patients were included in the analysis (remimazolam group, n = 21; propofol group, n = 42). Postoperative emergence time did not differ significantly between the two groups (164 [120–253] min vs. 137 [95–188] min, P = 0.193). Time to extubation was also comparable between the groups (1,009 [914–1,070] min vs. 1,033 [906–1,057] min, P = 0.844). Early postoperative hemodynamic parameters, including vasoactive–inotropic scores, were comparable between the two groups.
Conclusions:: In adult patients undergoing cardiac valve surgery, postoperative emergence time was comparable between remimazolam- and propofol-based total intravenous anesthesia. More prospective studies are warranted to clarify the role of remimazolam in cardiac anesthesia.
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BibTeX
@article{fujii2026postoperative,
title = {{Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study}},
author = {Emi Fujii and Yasuhiko Imashuku and Motoi Inoue and Hirotoshi Kitagawa},
journal = {Annals of Cardiac Anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/aca.aca_90_26},
url = {https://doi.org/10.4103/aca.aca_90_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study
AU - Emi Fujii
AU - Yasuhiko Imashuku
AU - Motoi Inoue
AU - Hirotoshi Kitagawa
PY - 2026
DA - 2026/10/12
JO - Annals of Cardiac Anaesthesia
DO - 10.4103/aca.aca_90_26
UR - https://doi.org/10.4103/aca.aca_90_26
AB - Context:: Remimazolam is an ultra-short-acting benzodiazepine used for general anesthesia, including cardiac surgery; however, its effect on postoperative emergence following cardiopulmonary bypass remains unclear. Aims:: We aimed to compare postoperative emergence following remimazolam- and propofol-based total intravenous anesthesia in adult patients undergoing cardiac valve surgery. Settings and Design:: A retrospective observational study. Methods and Materials:: We included adult patients who underwent elective cardiac valve replacement surgery at a single center between April 2023 and September 2024. Patients received either remimazolam- or propofol-based total intravenous anesthesia according to institutional practice. The primary endpoint was postoperative emergence time. Secondary endpoints included time to extubation and early postoperative hemodynamic stability assessed using the vasoactive–inotropic score. Statistical Analysis Used:: Baseline characteristics and perioperative variables were compared between the groups. Univariate and multivariable linear regression analyses were performed. Results:: Sixty-three patients were included in the analysis (remimazolam group, n = 21; propofol group, n = 42). Postoperative emergence time did not differ significantly between the two groups (164 [120–253] min vs. 137 [95–188] min, P = 0.193). Time to extubation was also comparable between the groups (1,009 [914–1,070] min vs. 1,033 [906–1,057] min, P = 0.844). Early postoperative hemodynamic parameters, including vasoactive–inotropic scores, were comparable between the two groups. Conclusions:: In adult patients undergoing cardiac valve surgery, postoperative emergence time was comparable between remimazolam- and propofol-based total intravenous anesthesia. More prospective studies are warranted to clarify the role of remimazolam in cardiac anesthesia.
SN - 0971-9784
SN - 0974-5181
ER -