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Effects of Remimazolam vs. Sevoflurane Anesthesia on Intraoperative Hemodynamics in Patients with Gastric Cancer Undergoing Robotic Gastrectomy: A Propensity Score-Matched Analysis

Authors
 Bahn Lee  ;  Myoung Hwa Kim  ;  Hee Jung Kong  ;  Hye Jung Shin  ;  Sunmo Yang  ;  Na Young Kim  ;  Dongwoo Chae 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.11(9) : 2643, 2022-05 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2022-05
Keywords
hemodynamic stability ; remimazolam anesthesia ; robotic gastrectomy ; sevoflurane anesthesia
Abstract
Remimazolam has been suggested to improve the maintenance of hemodynamic stability when compared with other agents used for general anesthesia. This study aimed to compare the effects of remimazolam and sevoflurane anesthesia on hemodynamic stability in patients undergoing robotic gastrectomy. We retrospectively reviewed the electronic medical records of 199 patients who underwent robotic gastrectomy with sevoflurane (n = 135) or remimazolam (n = 64) anesthesia from January to November 2021. Propensity scores were used for 1:1 matching between the groups. The primary outcome was the difference in use of intraoperative vasopressors between groups. Secondary outcomes included differences in incidence and dose of vasopressors, as well as intraoperative hemodynamic variables, between groups. Remimazolam anesthesia was associated with a significantly less frequent use of ephedrine (odds ratio (OR): 0.13; 95% confidence interval (CI): 0.05-0.38, p < 0.001), phenylephrine (OR: 0.12; 95% CI: 0.04-0.40, p < 0.001), and any vasopressor (OR: 0.06; 95% CI: 0.02-0.25, p < 0.001) compared with sevoflurane anesthesia. Remimazolam anesthesia enables better maintenance of hemodynamic stability than sevoflurane anesthesia. Thus, remimazolam anesthesia may be beneficial for patients who are expected to experience hypotension due to the combined effects of CO2 pneumoperitoneum and the head-up position utilized during robotic gastrectomy.
Files in This Item:
T202201656.pdf Download
DOI
10.3390/jcm11092643
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kong, Hee Jung(공희정)
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Kim, Myoung Hwa(김명화) ORCID logo https://orcid.org/0000-0003-4723-9425
Lee, Bahn(이반)
Chae, Dong Woo(채동우) ORCID logo https://orcid.org/0000-0002-7675-3821
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188792
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