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<p>This study aims to compare the remimazolam-bridged emergence strategy (discontinuing sevoflurane and switching to remimazolam maintenance 30&#xa0;min before the end of surgery) with the continued sevoflurane anesthesia combined with ondansetron regimen on postoperative nausea and vomiting (PONV) following breast cancer surgery. This study adopted a single-center, double-blind, randomized controlled trial design. A total of 92 patients scheduled for radical mastectomy were included. The patients were randomly divided into the remimazolam-bridged emergence group (Remimazolam group) and the continued sevoflurane + ondansetron group (Ondansetron group). Thirty minutes before the end of the surgery, sevoflurane was stopped in the R group and 1&#xa0;mg/(kg·h) remimazolam was administered. In the O group, 4&#xa0;mg ondansetron was given 30&#xa0;min before the end of the surgery while sevoflurane was continued. The incidences of postoperative 24-hour postoperative nausea and vomiting, the grading of PONV patients, the recovery time during the anesthesia awakening period, the maximum agitation score during the awakening period, and the incidence of agitation during the awakening period were compared between the two groups. No statistically significant difference was detected in the incidence of postoperative nausea and vomiting within 24&#xa0;h or in PONV severity classification between the two groups (<i>P</i> &gt; 0.05); compared with the ondansetron group, the time for tracheal tube removal, the time for spontaneous breathing recovery, the time for eye opening, and the time for orientation recovery in the remimazolam group were all shorter (all <i>P</i> &lt; 0.001); and the maximum agitation score during the recovery period in the remimazolam group was lower than that in the ondansetron group (<i>P</i> &lt; 0.001). Among patients undergoing radical mastectomy, comparing the remimazolam-bridged emergence strategy with the continued sevoflurane anesthesia combined with ondansetron regimen, no statistically significant difference in PONV incidence was detected between the two groups. This emergence strategy also significantly shortened recovery time and reduced emergence agitation scores. It must be emphasized that this study was not designed as a non-inferiority or equivalence trial, and therefore the results should not be interpreted as evidence of equivalence between the two regimens. These findings indicate that this emergence strategy does not increase the risk of PONV and can improve patient recovery during the perioperative period.</p>

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Effect of bridging intervention strategy with remimazolam on postoperative nausea and vomiting in patients undergoing breast cancer surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Shu Zhao,
  • Qingjun Wang,
  • Lin Zhang,
  • Mingqiang Zhao

摘要

This study aims to compare the remimazolam-bridged emergence strategy (discontinuing sevoflurane and switching to remimazolam maintenance 30 min before the end of surgery) with the continued sevoflurane anesthesia combined with ondansetron regimen on postoperative nausea and vomiting (PONV) following breast cancer surgery. This study adopted a single-center, double-blind, randomized controlled trial design. A total of 92 patients scheduled for radical mastectomy were included. The patients were randomly divided into the remimazolam-bridged emergence group (Remimazolam group) and the continued sevoflurane + ondansetron group (Ondansetron group). Thirty minutes before the end of the surgery, sevoflurane was stopped in the R group and 1 mg/(kg·h) remimazolam was administered. In the O group, 4 mg ondansetron was given 30 min before the end of the surgery while sevoflurane was continued. The incidences of postoperative 24-hour postoperative nausea and vomiting, the grading of PONV patients, the recovery time during the anesthesia awakening period, the maximum agitation score during the awakening period, and the incidence of agitation during the awakening period were compared between the two groups. No statistically significant difference was detected in the incidence of postoperative nausea and vomiting within 24 h or in PONV severity classification between the two groups (P > 0.05); compared with the ondansetron group, the time for tracheal tube removal, the time for spontaneous breathing recovery, the time for eye opening, and the time for orientation recovery in the remimazolam group were all shorter (all P < 0.001); and the maximum agitation score during the recovery period in the remimazolam group was lower than that in the ondansetron group (P < 0.001). Among patients undergoing radical mastectomy, comparing the remimazolam-bridged emergence strategy with the continued sevoflurane anesthesia combined with ondansetron regimen, no statistically significant difference in PONV incidence was detected between the two groups. This emergence strategy also significantly shortened recovery time and reduced emergence agitation scores. It must be emphasized that this study was not designed as a non-inferiority or equivalence trial, and therefore the results should not be interpreted as evidence of equivalence between the two regimens. These findings indicate that this emergence strategy does not increase the risk of PONV and can improve patient recovery during the perioperative period.