Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority…

Randomized trialSurgery· Nov 2025

Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial.

Jingjia Shen, Lu Wang, Yue Liu … Hong Lv

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Cardiac & Thoracic AnesthesiaRandomized trialTreatmentQ3IF 0.7

Remimazolam gave higher sedation success than propofol in cardiac surgery

Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial.

Jingjia Shen … Hong Lv

Surgery · Nov 2025

Background

Remimazolam besylate, despite being widely used in various clinical settings, lacks evidence in cardiac anesthesia.

Purpose

This trial compared its efficacy with propofol in elective cardiac surgery.

Methods

A total of 320 adult patients undergoing elective cardiac surgery via cardiopulmonary bypass between December 2024 and March 2025 were randomized 1:1 to either propofol (1 mg/kg for induction and 1-1.5 mg/kg/h for maintenance) or remimazolam besylate (0.3 mg/kg for induction and 1 mg/kg/h for maintenance) groups.

n = 320 adult

Results

remimazolam achieved adequate sedation far more often than propofol

99.4%

Remimazolam besylate

82.3%

Propofol

More results

No significant differences in time from drug administration to bispectral index <60 (P = .119), bispectral index variation after drug withdrawal (P = .658), time to extubation (P = .824), and length of stay in intensive care unit (P = .898) and hospital (P = .294) were observed.

“

Conclusion

Remimazolam besylate is noninferior to propofol in terms of sedation efficacy during elective cardiac procedures.

Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial.

Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial.

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