Effects of remimazolam or dexmedetomidine combined with propofol on breathing and hemodynamics in patients with heart disease undergoing transesophageal echocardiography: a prospective randomized study.

Objective

To compare the analgesic and sedative effects of remimazolam-propofol versus the traditional analgesic and sedative regimen of dexmedetomidine-propofol on transesophageal echocardiography (TEE) examination.

Method

The R group received remimazolam 0.1 mg/kg loading over 10 min, followed by 0.5 mg/(kg·h) infusion. The D group received dexmedetomidine 0.5 μg/kg loading over 10 min, then 0.4 μg/(kg·h) infusion. Both groups received propofol 1 mg/kg initially and 25-75 μg/(kg·min) for maintenance. Sedation onset time, procedure duration, recovery time, hemodynamics, adverse events, patient and sonographer satisfaction were recorded. RESULT The demographic variables of the two groups were similar. Compared to the D group, the dosage of propofol in the R group was significantly lower. Compared to the baseline and the R group, the mean arterial pressure and heart rate in the D group were significantly reduced. The satisfaction of ultrasound doctors in the R group was higher than that of the D group.

Conclusion

Under TEE conditions, both patient groups were able to achieve the target level of sedation. Compared to dexmedetomidine, remimazolam had the advantage of causing fewer hemodynamic changes and receiving higher satisfaction scores from doctors.