• Yusheng Yao, Jinsheng Guan, Linwei Liu, Bingbing Fu, Lei Chen, and Xiaochun Zheng.
• From the Department of Anaesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital (YY, LL, BF, XZ), Department of Anaesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University (JG) and Department of Anaesthesiology, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China (LC).
• Eur J Anaesthesiol. 2022 Dec 1; 39 (12): 911917911-917.

BackgroundRemimazolam is an ultrashort-acting benzodiazepine that is potentially a practical option for procedural sedation in colonoscopy.ObjectiveTo test the hypothesis that remimazolam could provide a noninferior discharge time to propofol for ambulatory colonoscopy.DesignA prospective, randomised, double-blind, noninferiority clinical trial.SettingAmbulatory endoscopy centre.PatientsA total of 132 adult participants undergoing ambulatory colonoscopy were enrolled.InterventionsParticipants were randomly assigned in a 1 : 1 ratio to receive propofol or remimazolam for sedation.Main Outcome MeasuresThe primary outcome was discharge time after a colonoscopy, assessed using the Modified Postanaesthetic Discharge Scoring System scale. Secondary outcomes included induction time, emergence time, the extent of recovery upon arrival in the postanaethesia care unit, fatigue, endoscopist and patient satisfaction and adverse events.ResultsThe median discharge time was 24 min in the remimazolam group versus 21 min in the propofol group, with a difference of 2 min [95% confidence interval (CI), 0 to 4 min], meeting the criteria for noninferiority. Injection pain occurred in 11 of 66 (17%) participants receiving remimazolam versus 32 of 66 (49%) participants receiving propofol ( P  < 0.001); hypotension occurrence was 20% versus 47%, ( P  < 0.001), respectively, and bradycardia 6% versus 20%, ( P  = 0.019), respectively. Compared with propofol, the patient satisfaction score was higher in the remimazolam group ( P  < 0.001).ConclusionFor sedation in ambulatory colonoscopy, compared with propofol, remimazolam provides a noninferior discharge time. Furthermore, remimazolam is associated with less injection pain, lower risks of hypotension and bradycardia, and improved patient satisfaction.Trial RegistrationChinese Clinical Trial Registry, identifier: ChiCTR2100048678.Copyright © 2022 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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