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<p>The increasing use of minimally invasive procedures necessitates enhancing patient satisfaction and improving procedural quality. We compared dexmedetomidine and remimazolam for conscious sedation during percutaneous radiofrequency ablation (RFA). Ninety patients who underwent real-time ultrasonography with pre-acquired image fusion guidance for RFA of a hepatic mass between October 2023 and January 2024 were included. Remifentanil was administered by the anesthesiologist at the initiation of needle placement by the radiologist. Based on group allocation, either dexmedetomidine at 0.5–1.0&#xa0;µg·kg<sup>− 1</sup>·h<sup>− 1</sup> or remimazolam at 1&#xa0;mg was administered. Patient satisfaction was the primary outcome. All patients completed the procedure following the initiation of ablation. The procedure was temporarily stopped due to pain or respiratory depression in eight patients and then restarted (3/43 [7.0%] vs. 5/45 [11.1%], <i>P</i> = 0.511; dexmedetomidine vs. remimazolam groups). The patient satisfaction score (converted to a 0–100 scale) did not differ significantly between the groups (median [IQR] 89.5 [83.3, 92.3] vs. 93.0 [82.5, 97.4], <i>P</i> = 0.181). Satisfaction reported by radiologists and anesthesiologists also did not differ (<i>P</i> = 0.077 and <i>P</i> = 0.113, respectively). However, hypoxia (SpO₂ &lt;95%) was significantly more frequent in the remimazolam group (<i>P</i> = 0.002). In conclusion, remimazolam did not enhance satisfaction rates over dexmedetomidine, although dexmedetomidine was associated with more stable respiratory patterns when used with remifentanil.</p>

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Randomized trial of dexmedetomidine and remimazolam with remifentanil for sedation during hepatic radiofrequency ablation

  • 期刊论文

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  • 发表日期：

    2026年7月30日

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  • Seungwon Lee,
  • Jeayoun Kim,
  • In Sun Chung,
  • Myungsuk Kim,
  • Heejun Hyun,
  • MiHye Park

摘要

The increasing use of minimally invasive procedures necessitates enhancing patient satisfaction and improving procedural quality. We compared dexmedetomidine and remimazolam for conscious sedation during percutaneous radiofrequency ablation (RFA). Ninety patients who underwent real-time ultrasonography with pre-acquired image fusion guidance for RFA of a hepatic mass between October 2023 and January 2024 were included. Remifentanil was administered by the anesthesiologist at the initiation of needle placement by the radiologist. Based on group allocation, either dexmedetomidine at 0.5–1.0 µg·kg− 1·h− 1 or remimazolam at 1 mg was administered. Patient satisfaction was the primary outcome. All patients completed the procedure following the initiation of ablation. The procedure was temporarily stopped due to pain or respiratory depression in eight patients and then restarted (3/43 [7.0%] vs. 5/45 [11.1%], P = 0.511; dexmedetomidine vs. remimazolam groups). The patient satisfaction score (converted to a 0–100 scale) did not differ significantly between the groups (median [IQR] 89.5 [83.3, 92.3] vs. 93.0 [82.5, 97.4], P = 0.181). Satisfaction reported by radiologists and anesthesiologists also did not differ (P = 0.077 and P = 0.113, respectively). However, hypoxia (SpO₂ <95%) was significantly more frequent in the remimazolam group (P = 0.002). In conclusion, remimazolam did not enhance satisfaction rates over dexmedetomidine, although dexmedetomidine was associated with more stable respiratory patterns when used with remifentanil.