Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Anesthesia
  • Anesthesia News
  • Benzodiazepine...

Benzodiazepine Breakthrough: Enhancing Anesthesia for TAVI with Remimazolam, finds study

Dr  Monish  RautWritten by Dr Monish Raut Published On 2025-07-08T22:15:07+05:30  |  Updated On 8 July 2025 10:15 PM IST
  • Benzodiazepine Breakthrough: Enhancing Anesthesia for TAVI with Remimazolam, finds study
  • Benzodiazepine Breakthrough: Enhancing Anesthesia for TAVI with Remimazolam, finds study
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Recent study investigates the perioperative management of patients undergoing transcatheter aortic valve implantation (TAVI) using remimazolam, a short-acting benzodiazepine, in combination with flumazenil, contrasting it with sevoflurane. The hypothesis posited that this combination could significantly reduce emergence time when compared to traditional sevoflurane anesthesia.

Methodology

A prospective, randomized, open-label trial was conducted, enrolling 60 patients with severe aortic stenosis aged 18 or older. Participants were divided into two groups: one receiving remimazolam with flumazenil and the other receiving sevoflurane. The primary outcome focused on the time taken for extubation post-anesthesia discontinuation, while secondary outcomes included hemodynamic variables, vasopressor usage, complication rates, and muscle recovery metrics. Results indicated that the median time to extubation was significantly shorter in the remimazolam group (6.5 minutes) compared to the sevoflurane group (14.2 minutes), showcasing a notable difference of 6.9 minutes with a confidence interval of -8.7 to -5.0 (P < 0.001). The remimazolam group also required fewer boluses of ephedrine for hemodynamic support, suggesting improved cardiovascular stability; however, mean arterial pressure (MAP), heart rate (HR), and overall vasopressor requirements did not differ significantly between groups.

Intraoperative Findings

Intraoperatively, parameters such as perfusion index (PI) and regional cerebral oxygen saturation (rSO2) showed statistically significant differences; the remimazolam group had lower values than those receiving sevoflurane, hinting at variations in hemodynamic responses although the clinical significance remains debatable. No significant intraoperative complications were reported in either group.

Flumazenil Considerations

The use of flumazenil to reverse the sedative effects of remimazolam is acknowledged, although potential risks including resedation are noted. Statistical analysis was conducted utilizing mixed models to assess intraoperative variables, reinforcing the findings of reduced emergence time without compromising intraoperative hemodynamics.

Conclusions and Implications

Despite limitations including a lack of blinding and a single-center study design, the data generally supports the conclusion that a combination of remimazolam and flumazenil results in more efficient emergence from anesthesia compared to sevoflurane in high-risk patients undergoing TAVI. These findings suggest that remimazolam could be a viable anesthetic option for these procedures, addressing safety and recovery time effectively within the perioperative context.

Key Points

- A prospective, randomized, open-label trial with 60 patients assessed the efficacy of remimazolam combined with flumazenil against sevoflurane for perioperative management in transcatheter aortic valve implantation (TAVI), focusing on emergence time as the primary endpoint.

- The median extubation time post-anesthesia was significantly shorter in the remimazolam group (6.5 minutes) compared to the sevoflurane group (14.2 minutes), indicating a notable reduction of 6.9 minutes (P < 0.001).

- Hemodynamic support requirements were lower in the remimazolam group, with fewer doses of ephedrine administered, signifying greater cardiovascular stability; however, other hemodynamic metrics such as mean arterial pressure and heart rate did not differ notably between the groups.

- Intraoperative measurements, including perfusion index and regional cerebral oxygen saturation, presented statistically lower values in the remimazolam cohort, suggesting altered hemodynamic responses, although the clinical relevance of these differences is questionable.

- The administration of flumazenil to counteract remimazolam's sedative effects was acknowledged, alongside the consideration of risks such as potential resedation; mixed models were employed for statistical analysis of intraoperative variables.

- The study concludes that remimazolam and flumazenil offer a more efficient emergence from anesthesia compared to sevoflurane for high-risk TAVI patients, with implications for enhanced safety and reduced recovery times, despite inherent limitations including a lack of blinding and a single-center study design.

Reference –

Harimochi, S., Godai, K., Nakahara, M. et al. Comparison of remimazolam and sevoflurane for general anesthesia during transcatheter aortic valve implantation: a randomized trial. Can J Anesth/J Can Anesth 72, 397–408 (2025). https://doi.org/10.1007/s12630-024-02900-4




aortic stenosisgeneral anesthesiaremimazolamsevofluranetranscatheter aortic valve implantation
Dr  Monish  Raut
Dr Monish Raut

    MBBS, MD (Anaesthesiology), FNB (Cardiac Anaesthesiology)

    Dr Monish Raut is a practicing Cardiac Anesthesiologist. He completed his MBBS at Government Medical College, Nagpur, and pursued his MD in Anesthesiology at BJ Medical College, Pune. Further specializing in Cardiac Anesthesiology, Dr Raut earned his FNB in Cardiac Anesthesiology from Sir Ganga Ram Hospital, Delhi.

    Show Full Article
    Next Story

    Editorial

    Featured image representing orthopaedic care

    Modern Orthopaedic Care: How Is Technology Improving Movement and Recovery? - Dr Abhijit Lonari

    Aspirin in Primary Prevention of Stroke-Review of Evidence Through the Needs of Indian Clinical Settings

    Aspirin in Primary Prevention of Stroke-Review of Evidence Through the Needs of Indian Clinical...

    Dapagliflozin Shines in Post-TAVI Patients:DAPA-TAVI Trial Findings

    Dapagliflozin Shines in Post-TAVI Patients:DAPA-TAVI Trial Findings

    Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension, Dyslipidemia, and Familial ASCVD Risk

    Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension,...

    Featured image representing thinking

    Is Pharma Marketing Going Through "Thinking Recession"?

    View All

    Journal Club Today

    Is Your Brain Aging Too Fast? New Study Can Tell from One Brain Scan

    Is Your Brain Aging Too Fast? New Study Can Tell from One Brain Scan

    View All

    Health News Today

    Health Bulletin 8/July/ 2025

    Health Bulletin 8/July/ 2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok