PDF(Pubmed)
Abstract：
BACKGROUND: Postinduction hypotension (PIHO) is a hemodynamic abnormality commonly observed during the induction of general anesthesia. Etomidate is considered a safer drug for the induction of anesthesia because it has only minor adverse effects on the cardiovascular and pulmonary systems. Recent evidence indicates that the novel benzodiazepine remimazolam has minimal inhibitory effects on the circulation and respiration. However, the efficacy and safety of remimazolam versus etomidate in the induction of anesthesia are unclear.
OBJECTIVE: To further understand the potential of remimazolam in anesthesia induction, it is necessary to design a meta-analysis to compare its effects versus the classic safe anesthetic etomidate. The aim of this study is to determine which drug has more stable hemodynamics and a lower incidence of PIHO. Our study will also yield data on sedation efficiency, time to loss of consciousness, time to awakening, incidence of injection pain, and postoperative nausea and vomiting with the two drugs.
METHODS: We plan to search the Web of Science, Cochrane Library, Embase, PubMed, China National Knowledge Infrastructure, and Wanfang databases from the date of their creation until March 31, 2025. The language is limited to English and Chinese. The search terms are \"randomized controlled trials,\" \"etomidate,\" and \"remimazolam.\" The incidence of PIHO is the primary outcome measure. Secondary outcomes include depth of anesthesia after induction, sedation success rate, time to loss of consciousness, hemodynamic profiles, recovery time, incidence of injection pain, and postoperative nausea and vomiting. Reviews, meta-analyses, case studies, abstracts from conferences, and commentaries will not be included. The heterogeneity of the results will be evaluated by sensitivity and subgroup analyses. RevMan software and Stata software will be used for data analysis. We will evaluate the quality of included studies using version 2 of the Cochrane risk-of-bias tool. The confidence of the evidence will be assessed through the Grading of Recommendations, Assessments, Developments, and Evaluations system.
RESULTS: The protocol was registered in the international PROSPERO (Prospective Register of Systematic Reviews) registry in November 2023. As of June 2024, we have performed a preliminary article search and retrieval for further review. The review and analyses are expected to be completed in March 2025. We expect to submit manuscripts for peer review by the end of June 2025.
CONCLUSIONS: By synthesizing the available evidence and comparing remimazolam and etomidate, we hope to provide valuable insights into the selection of anesthesia-inducing drugs to reduce the incidence of PIHO and improve patient prognosis.
BACKGROUND: PROSPERO CRD42023463120; https://tinyurl.com/333jb8bm.
UNASSIGNED: PRR1-10.2196/55948.
OBJECTIVE: To further understand the potential of remimazolam in anesthesia induction, it is necessary to design a meta-analysis to compare its effects versus the classic safe anesthetic etomidate. The aim of this study is to determine which drug has more stable hemodynamics and a lower incidence of PIHO. Our study will also yield data on sedation efficiency, time to loss of consciousness, time to awakening, incidence of injection pain, and postoperative nausea and vomiting with the two drugs.
METHODS: We plan to search the Web of Science, Cochrane Library, Embase, PubMed, China National Knowledge Infrastructure, and Wanfang databases from the date of their creation until March 31, 2025. The language is limited to English and Chinese. The search terms are \"randomized controlled trials,\" \"etomidate,\" and \"remimazolam.\" The incidence of PIHO is the primary outcome measure. Secondary outcomes include depth of anesthesia after induction, sedation success rate, time to loss of consciousness, hemodynamic profiles, recovery time, incidence of injection pain, and postoperative nausea and vomiting. Reviews, meta-analyses, case studies, abstracts from conferences, and commentaries will not be included. The heterogeneity of the results will be evaluated by sensitivity and subgroup analyses. RevMan software and Stata software will be used for data analysis. We will evaluate the quality of included studies using version 2 of the Cochrane risk-of-bias tool. The confidence of the evidence will be assessed through the Grading of Recommendations, Assessments, Developments, and Evaluations system.
RESULTS: The protocol was registered in the international PROSPERO (Prospective Register of Systematic Reviews) registry in November 2023. As of June 2024, we have performed a preliminary article search and retrieval for further review. The review and analyses are expected to be completed in March 2025. We expect to submit manuscripts for peer review by the end of June 2025.
CONCLUSIONS: By synthesizing the available evidence and comparing remimazolam and etomidate, we hope to provide valuable insights into the selection of anesthesia-inducing drugs to reduce the incidence of PIHO and improve patient prognosis.
BACKGROUND: PROSPERO CRD42023463120; https://tinyurl.com/333jb8bm.
UNASSIGNED: PRR1-10.2196/55948.
摘要：
背景：诱导后低血压（PIHO）是全身麻醉诱导过程中常见的血流动力学异常。依托咪酯被认为是麻醉诱导的更安全的药物，因为它对心血管和肺系统只有轻微的副作用。最近的证据表明，新型的苯并二氮杂列瑞米唑仑对循环和呼吸的抑制作用最小。然而,瑞咪唑安定与依托咪酯在麻醉诱导中的有效性和安全性尚不清楚.
目的：为了进一步了解瑞马唑仑在麻醉诱导中的潜力，有必要设计一项荟萃分析,以比较其与经典安全麻醉剂依托咪酯的效果.这项研究的目的是确定哪种药物具有更稳定的血流动力学和更低的PIHO发生率。我们的研究还将产生镇静效率的数据，失去意识的时间，觉醒的时间，注射疼痛的发生率，和术后恶心呕吐两种药物。
方法：我们计划搜索科学网，科克伦图书馆,Embase,PubMed,中国国家知识基础设施，和万方数据库自创建之日起至2025年3月31日。语言仅限于英语和汉语。搜索词是“随机对照试验，\"\"依托咪酯,\"和\"雷米唑仑。“PIHO的发病率是主要结果指标。次要结果包括诱导后的麻醉深度，镇静成功率,失去意识的时间，血液动力学曲线,恢复时间,注射疼痛的发生率，术后恶心呕吐。评论,荟萃分析，案例研究,会议摘要，和评论将不包括在内。结果的异质性将通过敏感性和亚组分析进行评估。将使用RevMan软件和Stata软件进行数据分析。我们将使用Cochrane偏见风险工具的第2版评估纳入研究的质量。将通过建议分级来评估证据的可信度，评估，事态发展,和评估系统。
结果：该协议于2023年11月在国际PROSPERO（前瞻性系统审查登记册）注册表中注册。截至2024年6月，我们已经进行了初步的文章搜索和检索，以便进一步审查。审查和分析预计将于2025年3月完成。我们预计在2025年6月底之前提交手稿供同行评审。
结论：通过综合现有证据并比较雷米咪唑安定和依托咪酯，我们希望为麻醉诱导药物的选择提供有价值的见解,以降低PIHO的发生率并改善患者预后.
背景：PROSPEROCRD42023463120;https://tinyurl.com/333jb8bm.
■PRR1-10.2196/55948。
目的：为了进一步了解瑞马唑仑在麻醉诱导中的潜力，有必要设计一项荟萃分析,以比较其与经典安全麻醉剂依托咪酯的效果.这项研究的目的是确定哪种药物具有更稳定的血流动力学和更低的PIHO发生率。我们的研究还将产生镇静效率的数据，失去意识的时间，觉醒的时间，注射疼痛的发生率，和术后恶心呕吐两种药物。
方法：我们计划搜索科学网，科克伦图书馆,Embase,PubMed,中国国家知识基础设施，和万方数据库自创建之日起至2025年3月31日。语言仅限于英语和汉语。搜索词是“随机对照试验，\"\"依托咪酯,\"和\"雷米唑仑。“PIHO的发病率是主要结果指标。次要结果包括诱导后的麻醉深度，镇静成功率,失去意识的时间，血液动力学曲线,恢复时间,注射疼痛的发生率，术后恶心呕吐。评论,荟萃分析，案例研究,会议摘要，和评论将不包括在内。结果的异质性将通过敏感性和亚组分析进行评估。将使用RevMan软件和Stata软件进行数据分析。我们将使用Cochrane偏见风险工具的第2版评估纳入研究的质量。将通过建议分级来评估证据的可信度，评估，事态发展,和评估系统。
结果：该协议于2023年11月在国际PROSPERO（前瞻性系统审查登记册）注册表中注册。截至2024年6月，我们已经进行了初步的文章搜索和检索，以便进一步审查。审查和分析预计将于2025年3月完成。我们预计在2025年6月底之前提交手稿供同行评审。
结论：通过综合现有证据并比较雷米咪唑安定和依托咪酯，我们希望为麻醉诱导药物的选择提供有价值的见解,以降低PIHO的发生率并改善患者预后.
背景：PROSPEROCRD42023463120;https://tinyurl.com/333jb8bm.
■PRR1-10.2196/55948。
