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Post-induction hypotension with remimazolam versus propofol in patients routinely administered angiotensin axis blockades: a randomized control trial.
- Source :
- BMC Anesthesiology; 6/22/2023, Vol. 23 Issue 1, p1-8, 8p
- Publication Year :
- 2023
-
Abstract
- Background: Certain routine medication could result in post-induction hypotension (PIH), such as angiotensin axis blockades, which are frequently administered as a first-line therapy against hypertension. Remimazolam is reportedly associated with lesser intraoperative hypotension than propofol. This study compared the overall incidence of PIH following remimazolam or propofol administration in patients managed by angiotensin axis blockades. Methods: This single-blind, parallel-group, randomized control trial was conducted in a tertiary university hospital in South Korea. Patients undergoing surgery with general anesthesia were considered for enrollment if the inclusion criteria were met: administration of an angiotensin converting enzyme inhibitor or angiotensin receptor blocker, 19 to 65 years old, American Society of Anesthesiologists physical status classification ≤ III, and no involvement in other clinical trials. The primary outcome was the overall incidence of PIH, defined as a mean blood pressure (MBP) < 65 mmHg or decrease by ≥ 30% of the baseline MBP. The time points of measurement were baseline, just before the initial intubation attempt, and 1, 5, 10, and 15 min following intubation. The heart rate, systolic and diastolic blood pressures, and bispectral index were also recorded. Groups P and R included patients administered propofol and remimazolam, respectively, as an induction agent. Results: A total of 81 patients were analyzed, of the 82 randomized patients. PIH was less frequent in group R than group P (62.5% versus 82.9%; t value 4.27, P = 0.04, adjusted odds ratio = 0.32 [95% confidence interval 0.10–0.99]). The decrease in the MBP from baseline was 9.6 mmHg lesser in group R than in group P before the initial intubation attempt (95% confidence interval 3.3–15.9). A similar trend was observed for systolic and diastolic blood pressures. No severe adverse events were observed in either group. Conclusion: Remimazolam results in less frequent PIH than propofol in patients undergoing routine administration of angiotensin axis blockades. Trial registration: This trial was retrospectively registered on Clinical Research Information Service (CRIS), Republic of Korea (KCT0007488). Registration date: 30/06/2022. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of surgical complications
PROPOFOL
DRUG efficacy
ANESTHESIA
ACADEMIC medical centers
GENERAL anesthesia
CONFIDENCE intervals
ACE inhibitors
DISEASE incidence
BENZODIAZEPINES
RANDOMIZED controlled trials
COMPARATIVE studies
BLIND experiment
DESCRIPTIVE statistics
RESEARCH funding
HYPOTENSION
ANGIOTENSIN receptors
STATISTICAL sampling
ODDS ratio
BLOOD pressure measurement
TRANQUILIZING drugs
PATIENT safety
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 164471989
- Full Text :
- https://doi.org/10.1186/s12871-023-02188-9