# The effects of remimazolam on emergence agitation in patients undergoing nasal surgery: a clinical randomized controlled trial

## TL;DR

This study shows that remimazolam reduces emergence agitation and injection pain more effectively than propofol in nasal surgery patients.

## Contribution

The study provides new evidence that remimazolam is more effective than propofol in reducing emergence agitation after nasal surgery.

## Key findings

- Remimazolam reduced EA incidence by 27% compared to propofol.
- Patients receiving remimazolam had fewer cases of hypotension and injection pain.
- No significant differences were found in other adverse effects like bradycardia or nausea.

## Abstract

Emergence Agitation (EA) is a common postoperative complication, particularly prevalent following nasal surgeries. The occurrence of EA not only elevates the risk of self-inflicted injuries or harm to others but may also lead to a series of severe postoperative complications. This study aims to evaluate the effect of remimazolam on EA in patients undergoing nasal surgery and compare its efficacy with that of conventional anesthetic agents.

This randomized controlled trial included 100 patients undergoing elective nasal surgery under general anesthesia from June to September 2024. Patients were randomly assigned (1:1) to the R group (remimazolam) or the C group (propofol). Agitation levels were measured using Riker Sedation-Agitation Scale (SAS), recording each patient’s highest score. The primary outcome was the incidence of EA, with secondary outcomes including hemodynamic parameters, emergence time, and adverse events.

The results indicated that the incidence of EA was significantly lower in the R group compared to the C group (22% vs. 49%; Risk Difference −27% (95% CI [−50% to −0.3%]); Relative Risk 0.45 (95% CI [0.25–0.81]); P = 0.005). Patients in the remimazolam group also demonstrated more stable hemodynamics, with a lower incidence of hypotension (18% vs. 53%, P < 0.001) and significantly reduced occurrence of injection pain (2% vs. 41%, P < 0.001). However, there were no significant differences between the two groups in terms of adverse effects such as bradycardia, postoperative wound bleeding, and postoperative nausea and vomiting.

Remimazolam holds significant clinical application value and potential in surgeries with a high incidence of EA.