Quality of recovery after arthroscopic meniscectomy with remimazolam or propofol anesthesia: A randomized controlled trial.
Eunah Cho, Ha Yan Kim, Yangjin Kim et al.
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In 30 seconds
This randomized controlled trial compared propofol-based with remimazolam-based total intravenous anesthesia in adults undergoing elective arthroscopic meniscectomy. Of 80 randomized patients, 71 completed the QoR-40 assessment and were analyzed. On postoperative day 1, global recovery scores did not differ significantly between groups (166.1 ± 16.8 vs. 170.6 ± 13.6; mean difference -4.5, 95% CI -11.8 to 2.7; P = 0.218). Remimazolam was associated with less hypotension requiring ephedrine, but slower return to full alertness and longer post-anesthesia care unit stay.
Key findings
- Postoperative day 1 global QoR-40 scores were 166.1 ± 16.8 with propofol and 170.6 ± 13.6 with remimazolam; the difference was not significant (P = 0.218).
- Hypotension requiring ephedrine occurred in 44.4% of the propofol group versus 17.1% of the remimazolam group (P = 0.013).
- Time to full alertness was longer with remimazolam than propofol: 37 [31-45] vs. 18 [15-24] min (P < 0.001).
- Post-anesthesia care unit stay was longer with remimazolam: 38 [30-50] vs. 30 [30-39] min (P = 0.008).
Why it matters
Patient-reported overall recovery was similar with the two anesthetic regimens in this minor orthopedic procedure, while their perioperative profiles differed. The findings highlight a trade-off between fewer episodes of treated intraoperative hypotension with remimazolam and slower emergence and discharge from the recovery unit. These outcomes may inform evaluation of anesthetic options, but do not establish superiority in overall recovery.
What to keep in mind
The final analysis included 71 of 80 randomized patients, and the primary QoR-40 outcome was assessed on postoperative day 1; longer-term recovery was not reported in the abstract.