Academic Journal
Effect of Remimazolam and Propofol on Intraoperative Blood Pressure Variability in Patients Undergoing Endovascular Embolization of Intracranial Aneurysms.
| Τίτλος: | Effect of Remimazolam and Propofol on Intraoperative Blood Pressure Variability in Patients Undergoing Endovascular Embolization of Intracranial Aneurysms. |
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| Συγγραφείς: | Duan Y; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China., He J; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China., Han C; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China., Yang W; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China., Wang Z; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China., Zhou X; Department of Anesthesiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China., Yu J; Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, People's Republic of China. |
| Πηγή: | Drug design, development and therapy [Drug Des Devel Ther] 2026 Aug 21; Vol. 20, pp. 630786. Date of Electronic Publication: 2026 Aug 21 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Dove Press Limited Country of Publication: New Zealand NLM ID: 101475745 Publication Model: eCollection Cited Medium: Internet ISSN: 1177-8881 (Electronic) Linking ISSN: 11778881 NLM ISO Abbreviation: Drug Des Devel Ther Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Auckland, N.Z.] : Dove Press Limited |
| Ιατρικοί όροι (MeSH): | Blood Pressure*/drug effects , Intracranial Aneurysm*/drug therapy , Intracranial Aneurysm*/therapy , Intracranial Aneurysm*/surgery , Intracranial Aneurysm*/physiopathology , Propofol*/pharmacology , Propofol*/administration & dosage , Benzodiazepines*/administration & dosage , Benzodiazepines*/pharmacology , Embolization, Therapeutic* , Endovascular Procedures*, Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies |
| Περίληψη: | Background: Maintaining stable arterial blood pressure during endovascular embolization of intracranial aneurysms is of great importance due to impaired cerebrovascular autoregulation and the risk of ischemic or hemorrhagic complications. Intraoperative blood pressure variability has been associated with adverse postoperative outcomes. This study aimed to compare the effects of remimazolam and propofol on intraoperative arterial blood pressure variability during endovascular embolization of intracranial aneurysms. Methods: A prospective randomized controlled trial with blinded patients and outcome assessors was conducted in 63 patients undergoing endovascular embolization of intracranial aneurysms. Patients were randomly assigned to receive either remimazolam or propofol for general anesthesia. Mean arterial pressure (MAP) was recorded at 5-minute intervals. The primary outcome was intraoperative blood pressure variability, quantified by the average real variability (ARV) of MAP. Secondary outcomes included additional indices of blood pressure variability (standard deviation [SD], coefficient of variation [CV], and MAP range), intraoperative hypotension, norepinephrine use, and postoperative clinical outcomes. Results: MAP-ARV was significantly lower in the remimazolam group than in the propofol group (P < 0.001). Similarly, MAP-SD, MAP-CV, and MAP range were all reduced in the remimazolam group (P < 0.001). The incidence of hypotension was lower in the remimazolam group (31.3% vs 71.0%, P = 0.002), with fewer hypotensive episodes, shorter duration of hypotension, and reduced norepinephrine use (P < 0.05). Surgeon satisfaction was higher in the remimazolam group (P = 0.015). No significant differences were observed in postoperative neurological outcomes, complications, or length of hospital stay. Conclusion: In patients undergoing endovascular embolization of intracranial aneurysms, remimazolam was associated with reduced intraoperative arterial blood pressure variability and improved hemodynamic stability compared with propofol. However, no significant differences were observed in postoperative neurological or functional outcomes between the two groups. (© 2026 Duan et al.) |
| Competing Interests: | The authors report no conflicts of interest in this work. |
| References: | J Hypertens. 2005 Mar;23(3):505-11. (PMID: 15716690) Int J Gen Med. 2025 Nov 19;18:7061-7073. (PMID: 41287843) Nat Rev Neurol. 2013 Mar;9(3):152-63. (PMID: 23419369) Anaesthesiol Intensive Ther. 2022;54(5):402-412. (PMID: 36734451) BMC Anesthesiol. 2024 Nov 25;24(1):424. (PMID: 39581994) Front Cardiovasc Med. 2026 Jan 07;12:1737480. (PMID: 41573509) Hypertens Res. 2012 Apr;35(4):399-403. (PMID: 22129516) Perioper Med (Lond). 2026 Feb 16;15(1):. (PMID: 41699668) Clin Exp Hypertens. 2025 Dec 31;47(1):2601054. (PMID: 41390936) Arch Clin Neuropsychol. 2022 Nov 21;37(8):1688-1698. (PMID: 35596958) Arq Neuropsiquiatr. 2021 Sep;79(9):759-765. (PMID: 34669812) J Vasc Surg. 2022 Feb;75(2):592-598.e1. (PMID: 34508798) Anesthesiology. 1997 Jan;86(1):64-72. (PMID: 9009941) Hypertension. 2021 Nov;78(5):1478-1489. (PMID: 34538105) Eur J Anaesthesiol. 2006 Nov;23(11):902-13. (PMID: 16723053) J Clin Hypertens (Greenwich). 2025 Nov;27(11):e70187. (PMID: 41292164) Hypertension. 2020 Oct;76(4):1280-1288. (PMID: 32862710) Neurology. 2022 Jul 26;99(4):150-160. (PMID: 35879090) Neurosurg Focus. 2025 Dec 1;59(6):E2. (PMID: 41343791) J Clin Anesth. 2024 May;93:111356. (PMID: 38056052) Am J Hypertens. 2009 Aug;22(8):842-7. (PMID: 19498342) Anesth Analg. 2022 Aug 1;135(2):406-413. (PMID: 35839499) J Alzheimers Dis. 2025 Nov;108(1):411-420. (PMID: 40953110) Front Neurol. 2021 Jul 23;12:688362. (PMID: 34367053) J Anesth. 2022 Apr;36(2):239-245. (PMID: 35028756) Drug Des Devel Ther. 2024 Aug 05;18:3487-3498. (PMID: 39132624) J Am Heart Assoc. 2017 Oct 19;6(10):. (PMID: 29051214) Clinics (Sao Paulo). 2018 Oct 08;73:e253. (PMID: 30304297) J Cardiothorac Vasc Anesth. 2026 Jan;40(1):347-354. (PMID: 40940247) Clin J Am Soc Nephrol. 2020 Jan 7;15(1):35-46. (PMID: 31888922) Int J Surg. 2025 Sep 1;111(9):6384-6396. (PMID: 40503766) Anaesthesia. 2024 Apr;79(4):410-422. (PMID: 38221513) Drug Des Devel Ther. 2024 Nov 15;18:5225-5237. (PMID: 39568781) Minerva Anestesiol. 2022 Dec;88(12):1035-1042. (PMID: 36326772) Drug Des Devel Ther. 2025 Apr 29;19:3425-3435. (PMID: 40322031) Br J Anaesth. 2024 Aug;133(2):264-276. (PMID: 38839472) Anaesth Crit Care Pain Med. 2024 Apr;43(2):101337. (PMID: 38061682) |
| Contributed Indexing: | Keywords: arterial blood pressure variability; endovascular embolization of intracranial aneurysms; hemodynamics; propofol; remimazolam |
| Substance Nomenclature: | YI7VU623SF (Propofol) 7V4A8U16MB (remimazolam) 12794-10-4 (Benzodiazepines) |
| Entry Date(s): | Date Created: 20260826 Date Completed: 20260826 Latest Revision: 20260909 |
| Update Code: | 20260909 |
| PubMed Central ID: | PMC13505532 |
| DOI: | 10.2147/DDDT.S630786 |
| PMID: | 42643911 |
| Βάση Δεδομένων: | MEDLINE |
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