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Recall of extubation after remimazolam anesthesia with flumazenil antagonism during emergence: a retrospective clinical study

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Abstract

Purpose

This study was performed to examine and compare the incidence of extubation recall in surgical patients who underwent remimazolam anesthesia with flumazenil antagonism during emergence and in those who underwent propofol anesthesia.

Methods

One hundred sixty-three patients who underwent surgery using general endotracheal or supraglottic airway anesthesia with propofol (n = 97) or remimazolam (n = 66) were retrospectively analyzed. Remimazolam was antagonized by flumazenil after discontinuation of remimazolam at the end of surgery. The endotracheal tube or supraglottic airway was removed after surgery was complete, and consciousness and adequate spontaneous breathing were confirmed. The incidence of extubation recall was compared between the remimazolam and propofol anesthesia groups using propensity score matching.

Results

Extubation recall was observed in 28 patients (17%). After propensity score matching, the incidence of extubation recall did not significantly differ between the remimazolam and propofol anesthesia groups (15.6% vs. 18.8%; p = 1.000).

Conclusion

The incidence of extubation recall after remimazolam anesthesia with flumazenil antagonism during emergence did not significantly differ from that after propofol anesthesia.

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Acknowledgements

We thank T. Ojima (Hamamatsu University School of Medicine) for his statistical assistance. We thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Anesthesiology, Suzukake Central Hospital, Hamamatsu, Japan

    Tsunehisa Sato

  2. Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan

    Soichiro Mimuro, Tadayoshi Kurita, Mayumi Kobayashi, Matsuyuki Doi, Takasumi Katoh & Yoshiki Nakajima

Authors
  1. Tsunehisa Sato
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  2. Soichiro Mimuro
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  3. Tadayoshi Kurita
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  4. Mayumi Kobayashi
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  5. Matsuyuki Doi
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  6. Takasumi Katoh
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  7. Yoshiki Nakajima
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by TS. The first draft of the manuscript was written by TS. All authors commented on the revised versions and read and approved the final manuscript

Corresponding author

Correspondence to Soichiro Mimuro.

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Prior presentation

Part of this article was presented at the 68th Annual Meeting of the Japanese Society of Anesthesiologists (June 3–4, 2021, online, Japan).

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Cite this article

Sato, T., Mimuro, S., Kurita, T. et al. Recall of extubation after remimazolam anesthesia with flumazenil antagonism during emergence: a retrospective clinical study. J Anesth 36, 688–692 (2022). https://doi.org/10.1007/s00540-022-03093-0

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  • DOI: https://doi.org/10.1007/s00540-022-03093-0

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