{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:11:30Z","timestamp":1791569490350,"version":"4.3.4"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100019018","name":"Chinese Academy of Medical Sciences Initiative for Innovative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011635","name":"Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital","doi-asserted-by":"publisher","award":["2024-I2M-C&T-B-044"],"award-info":[{"award-number":["2024-I2M-C&T-B-044"]}],"id":[{"id":"10.13039\/501100011635","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011635","name":"Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital","doi-asserted-by":"publisher","award":["2023ZD0504705"],"award-info":[{"award-number":["2023ZD0504705"]}],"id":[{"id":"10.13039\/501100011635","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.surg.2025.109661","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:05:14Z","timestamp":1757001914000},"page":"109661","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial"],"prefix":"10.1016","volume":"187","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6461-9775","authenticated-orcid":false,"given":"Jingjia","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2334-5138","authenticated-orcid":false,"given":"Hong","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2025.109661_bib1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for perioperative care in cardiac surgery: Enhanced Recovery After Surgery Society recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg"},{"key":"10.1016\/j.surg.2025.109661_bib2","article-title":"Guidelines on Enhanced Recovery After Cardiac Surgery under cardiopulmonary bypass or off-pump","volume":"41","author":"Mertes","year":"2022","journal-title":"Anaesth Crit Care Pain Med"},{"key":"10.1016\/j.surg.2025.109661_bib3","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1016\/j.jtcvs.2017.05.107","article-title":"Predictors of operating room extubation in adult cardiac surgery","volume":"154","author":"Subramaniam","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.surg.2025.109661_bib4","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/00000542-200303000-00013","article-title":"Randomized assessment of resource use in fast-track cardiac surgery 1-year after hospital discharge","volume":"98","author":"Cheng","year":"2003","journal-title":"Anesthesiology"},{"issue":"6 Suppl","key":"10.1016\/j.surg.2025.109661_bib5","doi-asserted-by":"crossref","first-page":"445S","DOI":"10.1378\/chest.120.6_suppl.445S","article-title":"Trials comparing early vs late extubation following cardiovascular surgery","volume":"120","author":"Meade","year":"2001","journal-title":"Chest"},{"key":"10.1016\/j.surg.2025.109661_bib6","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2165\/00003495-198835040-00002","article-title":"Propofol. A review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anaesthetic","volume":"35","author":"Langley","year":"1988","journal-title":"Drugs"},{"key":"10.1016\/j.surg.2025.109661_bib7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1590\/S1807-59322010000200003","article-title":"Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine","volume":"65","author":"Basagan-Mogol","year":"2010","journal-title":"Clinics (Sao Paulo)"},{"key":"10.1016\/j.surg.2025.109661_bib8","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.5114\/aoms.2016.63193","article-title":"A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery","volume":"13","author":"Baradari","year":"2017","journal-title":"Arch Med Sci"},{"key":"10.1016\/j.surg.2025.109661_bib9","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s13054-023-04431-8","article-title":"Propofol and survival: an updated meta-analysis of randomized clinical trials","volume":"27","author":"Kotani","year":"2023","journal-title":"Crit Care"},{"key":"10.1016\/j.surg.2025.109661_bib10","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2021.690875","article-title":"Remimazolam: non-clinical and clinical profile of a new sedative\/anesthetic agent","volume":"12","author":"Kilpatrick","year":"2021","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.surg.2025.109661_bib11","doi-asserted-by":"crossref","first-page":"2875","DOI":"10.2147\/DDDT.S425860","article-title":"The efficacy and safety of remimazolam besylate combined with Esketamine for outpatient colonoscopy: a prospective, randomized, controlled clinical trial","volume":"17","author":"Li","year":"2023","journal-title":"Drug Des Devel Ther"},{"key":"10.1016\/j.surg.2025.109661_bib12","first-page":"6071","article-title":"Effectiveness of remimazolam besylate combined with alfentanil for fiberoptic bronchoscopy with preserved spontaneous breathing: a prospective, randomized, controlled clinical trial","volume":"27","author":"Zhang","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"10.1016\/j.surg.2025.109661_bib13","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12871-023-02249-z","article-title":"Effects of remimazolam combined with sufentanil on hemodynamics during anesthetic induction in elderly patients with mild hypertension undergoing orthopedic surgery of the lower limbs: a randomized controlled trial","volume":"23","author":"Xu","year":"2023","journal-title":"BMC Anesthesiol"},{"key":"10.1016\/j.surg.2025.109661_bib14","doi-asserted-by":"crossref","first-page":"NP357","DOI":"10.1093\/asj\/sjae033","article-title":"Randomized, single-blind, comparative study of remimazolam besylate vs propofol for facial plastic surgery","volume":"44","author":"Huang","year":"2024","journal-title":"Aesthet Surg J"},{"key":"10.1016\/j.surg.2025.109661_bib15","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00540-020-02788-6","article-title":"Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial","volume":"34","author":"Doi","year":"2020","journal-title":"J Anesth"},{"key":"10.1016\/j.surg.2025.109661_bib16","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s00540-020-02776-w","article-title":"Safety and efficacy of remimazolam in induction and maintenance of general anesthesia in high-risk surgical patients (ASA Class III): results of a multicenter, randomized, double-blind, parallel-group comparative trial","volume":"34","author":"Doi","year":"2020","journal-title":"J Anesth"},{"key":"10.1016\/j.surg.2025.109661_bib17","doi-asserted-by":"crossref","first-page":"10595","DOI":"10.12998\/wjcc.v9.i34.10595","article-title":"Remimazolam benzenesulfonate anesthesia effectiveness in cardiac surgery patients under general anesthesia","volume":"9","author":"Tang","year":"2021","journal-title":"World J Clin Cases"},{"key":"10.1016\/j.surg.2025.109661_bib18","doi-asserted-by":"crossref","first-page":"381","DOI":"10.2147\/DDDT.S401969","article-title":"Comparison of remimazolam tosilate and etomidate on hemodynamics in cardiac surgery: a randomised controlled trial","volume":"17","author":"Hu","year":"2023","journal-title":"Drug Des Devel Ther"},{"key":"10.1016\/j.surg.2025.109661_bib19","article-title":"Safety and efficacy of remimazolam besylate in patients undergoing colonoscopy: a multicentre, single-blind, randomized, controlled, phase \u2162 trial","volume":"13","author":"Wang","year":"2022","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.surg.2025.109661_bib20","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/bcpt.13761","article-title":"Comparison of ciprofol (HSK3486) versus propofol for the induction of deep sedation during gastroscopy and colonoscopy procedures: a multi-centre, non-inferiority, randomized, controlled phase 3 clinical trial","volume":"131","author":"Li","year":"2022","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"10.1016\/j.surg.2025.109661_bib21","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/j.1399-6576.2006.01206.x","article-title":"Propofol causes more hypotension than etomidate in patients with severe aortic stenosis: a double-blind, randomized study comparing propofol and etomidate","volume":"51","author":"Bendel","year":"2007","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.surg.2025.109661_bib22","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d1110","article-title":"Prevention of pain on injection of propofol: systematic review and meta-analysis","volume":"342","author":"Jalota","year":"2011","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2025.109661_bib23","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1002\/phar.1806","article-title":"Remimazolam: pharmacologic considerations and clinical role in anesthesiology","volume":"36","author":"Wesolowski","year":"2016","journal-title":"Pharmacotherapy"},{"key":"10.1016\/j.surg.2025.109661_bib24","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1213\/ANE.0b013e31823f0c28","article-title":"A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): part I. Safety, efficacy, and basic pharmacokinetics","volume":"115","author":"Antonik","year":"2012","journal-title":"Anesth Analg"},{"key":"10.1016\/j.surg.2025.109661_bib25","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.23736\/S0375-9393.21.15517-8","article-title":"Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia","volume":"87","author":"Dai","year":"2021","journal-title":"Minerva Anestesiol"},{"key":"10.1016\/j.surg.2025.109661_bib26","article-title":"Pharmacokinetics and pharmacodynamics of analgesic and anesthetic drugs in patients during cardiac surgery with cardiopulmonary bypass: a narrative review","author":"Beukers","year":"2025","journal-title":"Anesth Analg"},{"key":"10.1016\/j.surg.2025.109661_bib27","doi-asserted-by":"crossref","first-page":"741.e9-18","DOI":"10.1016\/j.jcrc.2012.02.013","article-title":"Pharmacokinetic changes in patients receiving extracorporeal membrane oxygenation","volume":"27","author":"Shekar","year":"2012","journal-title":"J Crit Care"},{"key":"10.1016\/j.surg.2025.109661_bib28","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13054-015-0772-5","article-title":"Propofol, midazolam, vancomycin and cyclosporine therapeutic drug monitoring in extracorporeal membrane oxygenation circuits primed with whole human blood","volume":"19","author":"Lemaitre","year":"2015","journal-title":"Crit Care"},{"key":"10.1016\/j.surg.2025.109661_bib29","doi-asserted-by":"crossref","DOI":"10.6061\/clinics\/2018\/e178","article-title":"Application of a pharmacokinetics-pharmacodynamics approach to the free propofol plasma levels during coronary artery bypass grafting surgery with hypothermic cardiopulmonary bypass","volume":"73","author":"Silva-Filho","year":"2018","journal-title":"Clinics (Sao Paulo)"},{"key":"10.1016\/j.surg.2025.109661_bib30","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2020.109899","article-title":"Population pharmacokinetic\/pharmacodynamic modeling for remimazolam in the induction and maintenance of general anesthesia in healthy subjects and in surgical subjects","volume":"66","author":"Zhou","year":"2020","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.surg.2025.109661_bib31","doi-asserted-by":"crossref","DOI":"10.1002\/prp2.851","article-title":"Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: a randomized, double-blind, controlled trial","volume":"9","author":"Liu","year":"2021","journal-title":"Pharmacol Res Perspect"},{"key":"10.1016\/j.surg.2025.109661_bib32","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1213\/ANE.0000000000006861","article-title":"Efficacy of single-bolus administration of remimazolam during induction of anesthesia in patients undergoing cardiac surgery: a prospective, single-center, randomized controlled study","volume":"139","author":"Lee","year":"2024","journal-title":"Anesth Analg"},{"key":"10.1016\/j.surg.2025.109661_bib33","first-page":"682","article-title":"Remimazolam for anesthesia and sedation in cardiac surgery and for cardiac patients undergoing non-cardiac surgery: a systematic-narrative hybrid review","volume":"90","author":"D'Andria Ursoleo","year":"2024","journal-title":"Minerva Anestesiol"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606025005136?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606025005136?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:38:09Z","timestamp":1779770289000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606025005136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":33,"alternative-id":["S0039606025005136"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2025.109661","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Remimazolam besylate versus propofol as sedative agents in cardiac surgery: A randomized noninferiority clinical trial","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2025.109661","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"109661"}}