Scholarlink

Background <p>Remimazolam Tosylate (RT) is an ultrashort-acting benzodiazepine with organ-independent metabolism, suitable for patients with renal impairment. This study assessed the efficacy and safety of RT in living donor kidney transplantation.</p> Methods <p>Eighty-six patients with uremia who underwent living donor kidney transplantation from May 2024 to October 2024 were randomized into the RT group (group RT) or the propofol group (group P), with 43 patients per group. Induction in group RT was achieved with 0.2&#xa0;mg/kg RT, followed by maintenance at a constant rate of 1&#xa0;mg/kg/h. Induction in group P was achieved with 1.5&#xa0;mg/kg propofol, followed by maintenance at a constant rate of 4–10&#xa0;mg/kg/h. The primary outcomes were perioperative anesthetic efficacy and postoperative renal graft function. The secondary outcomes included perioperative electrolyte status, incidence of hypotension, and incidence of other adverse reactions.</p> Results <p>The induction success rate was 100% in each group, and neither group required remedial sedative medication. However, the time to loss of consciousness in group RT was longer than that in group P (<i>P</i> &lt; 0.05). Group RT had a longer time to eye opening and extubation compared with group P, but this difference was not significant (<i>P</i> &gt; 0.05). Furthermore, the post-anesthesia care unit stay time for group RT was longer than that for group P (<i>P</i> &lt; 0.05). No statistically significant difference was observed in postoperative renal function indicators or urine output between the two groups (<i>P</i> &gt; 0.05). In addition, no delayed graft function (DGF) was observed in either group. The incidence of hypotension during the induction period in group RT was lower than that in group P (<i>P</i> &lt; 0.05), and injection pain was also lower (<i>P</i> &lt; 0.05).</p> Conclusions <p>The sedation effect in group RT was not worse than that in group P, with fewer hemodynamic fluctuations, lower injection pain, and without adverse effects on renal function. RT may thus represent a safer and organ-independent alternative for anesthesia in renal transplant recipients.</p> Trial registration <p>The study was registered in the Chinese Clinical Trial Registry at ChiCTR.org.cn (25/04/2024, ChiCTR2400083451).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Remimazolam tosylate vs. propofol: effects on anesthetic efficacy and renal function in living donor kidney transplantation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月22日

查看全文
  • Jiaxin Wu,
  • Wendong Lin,
  • Haiying Kong

摘要

Background

Remimazolam Tosylate (RT) is an ultrashort-acting benzodiazepine with organ-independent metabolism, suitable for patients with renal impairment. This study assessed the efficacy and safety of RT in living donor kidney transplantation.

Methods

Eighty-six patients with uremia who underwent living donor kidney transplantation from May 2024 to October 2024 were randomized into the RT group (group RT) or the propofol group (group P), with 43 patients per group. Induction in group RT was achieved with 0.2 mg/kg RT, followed by maintenance at a constant rate of 1 mg/kg/h. Induction in group P was achieved with 1.5 mg/kg propofol, followed by maintenance at a constant rate of 4–10 mg/kg/h. The primary outcomes were perioperative anesthetic efficacy and postoperative renal graft function. The secondary outcomes included perioperative electrolyte status, incidence of hypotension, and incidence of other adverse reactions.

Results

The induction success rate was 100% in each group, and neither group required remedial sedative medication. However, the time to loss of consciousness in group RT was longer than that in group P (P < 0.05). Group RT had a longer time to eye opening and extubation compared with group P, but this difference was not significant (P > 0.05). Furthermore, the post-anesthesia care unit stay time for group RT was longer than that for group P (P < 0.05). No statistically significant difference was observed in postoperative renal function indicators or urine output between the two groups (P > 0.05). In addition, no delayed graft function (DGF) was observed in either group. The incidence of hypotension during the induction period in group RT was lower than that in group P (P < 0.05), and injection pain was also lower (P < 0.05).

Conclusions

The sedation effect in group RT was not worse than that in group P, with fewer hemodynamic fluctuations, lower injection pain, and without adverse effects on renal function. RT may thus represent a safer and organ-independent alternative for anesthesia in renal transplant recipients.

Trial registration

The study was registered in the Chinese Clinical Trial Registry at ChiCTR.org.cn (25/04/2024, ChiCTR2400083451).