Efficacy and safety of remimazolam besylate in patients with obesity undergoing painless colonoscopy: a prospective, double-blind, randomized controlled trial

Remimazolam besylate helps relieve mild respiratory depression and stabilizes cardiac circulation. We designed a randomized controlled trial to compare sedative potential of remimazolam besylate with propofol in obese patients undergoing painless colonoscopy. A total of 100 obese patients undergoing colonoscopy were recruited and randomly divided into group RB and group P. Anesthesia was induced by 0.15 mg/kg remimazolam besylate or 2 mg/kg propofol combined with 0.1 µg/kg sufentanil. General conditions of patients of both groups were noted. Similarly, the respiratory parameters, hemodynamic parameters, duration of colonoscopy, induction time, orientation recovery time, and post-anesthesia care unit (PACU) stay time were noted. The incidence of nausea and vomiting, dizziness, headache, lethargy, abdominal pain, and distension after the examination were recorded. The satisfaction scores of endoscopists, anesthesiologists and patients were also noted. Only 26% of patients of RB group suffered from apnea during induction which is less than 50% in group P (p = 0.003). Similarly, 32% of patients of RB group developed hypoxemia, while 66% of patients in group P developed hypoxemia (p = 0.001). The incidence of hypotension during induction in both groups was statistically different, exactly 36% in group RB and 66% in group P (p = 0.005). During induction, 8% of patients suffering from pain at the injection site in group RB, significantly less than the 34% in group P (p = 0.003). The satisfaction score of patients in group RB was significantly higher compared to group P (8.93 ± 1.08 vs. 7.97 ± 1.31, p = 0.001, p < 0.05). The remimazolam besylate-sufentanil is safer than propofol-sufentanil for painless colonoscopy in obese patients, and can reduce the incidence of hypoxemia, injection pain, and improve satisfaction of patients. Therefore, this anesthetic scheme is worth promoting in clinical practice.

Remimazolam besylate; Propofol; Patients with obesity; Painless colonoscopy

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