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However, the effect of remimazolam on reversal of neuromuscular blockade with sugammadex remains unclear. We hypothesized that sugammadex could reverse rocuronium-induced neuromuscular blockade even under remimazolam anesthesia, although the recovery might be delayed. In the present study, the recovery time from rocuronium-induced neuromuscular blockade after administration of sugammadex under remimazolam anesthesia was compared with that under propofol anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-six patients over 18\u00a0years old scheduled for elective gynecological laparotomy under general anesthesia combined with epidural anesthesia were prospectively randomly assigned to remimazolam and propofol groups. After induction of general anesthesia with remifentanil and remimazolam or remifentanil and propofol, followed by their continuous infusion for anesthesia maintenance, train-of-four (TOF) responses were monitored following 0.9\u00a0mg\/kg rocuronium administration. During surgery, rocuronium was infused continuously to maintain a TOF count of 1. At the end of surgery, when TOF counts of 2 were confirmed, sugammadex 2\u00a0mg\/kg was administered and time to recovery of the TOF ratio to\u2009\u2265\u200990% of the baseline TOF ratio was compared between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median (interquartile range) recovery times in the remimazolam and propofol groups were 3.0 (2.3 to 3.8) and 2.5 (2.0 to 3.3) min, respectively (P\u2009=\u20090.62).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Remimazolam anesthesia may not delay the efficacy of sugammadex in reversing rocuronium-induced neuromuscular blockade compared with propofol anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number and registry URL<\/jats:title>\n                    <jats:p>\n                      The Japan Registry of Clinical trials (jRCT1071230073). URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/jrct.niph.go.jp\/latest-detail\/jRCT1071230073\" ext-link-type=\"uri\">https:\/\/jrct.niph.go.jp\/latest-detail\/jRCT1071230073<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00540-025-03517-7","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T02:02:10Z","timestamp":1748224930000},"page":"703-709","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of reversal of rocuronium-induced neuromuscular blockade with sugammadex under remimazolam versus propofol anesthesia: a randomized clinical trial"],"prefix":"10.1007","volume":"39","author":[{"given":"Takashi","family":"Kawasaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3153-9941","authenticated-orcid":false,"given":"Masafumi","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"3517_CR1","first-page":"727","volume-title":"Miller\u2019s anesthesia","author":"SJ Brull","year":"2025","unstructured":"Brull SJ, Meistelman C, Nemes R, de Boer HD, Thilen SR, Eriksson LI. 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Kawasaki has no conflict of interest; M. Fujimoto has received speaker\u2019s fees from MSD Inc, Century Medical Inc, and Nihon Kohden Corporation. However, none of these entities provided financial support for his participation in this study; N. Hirata has received honoraria and speaker\u2019s fees from Mundipharma, Maruishi Pharmaceutical Corporation, and Nihon Kohden Corporation. However, none of these entities provided financial support for his participation in this study. He has also received speaker\u2019s fees from Asahi Kasei Corporation and Otsuka Pharmaceutical Factory.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}