{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:44:54Z","timestamp":1791888294806,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82401450"],"award-info":[{"award-number":["82401450"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Remimazolam tosylate is an ultra\u2010short\u2010acting benzodiazepine sedative and anaesthetic. The related drug, midazolam, is associated with delirium but it remains unclear whether remimazolam also promotes delirium. We tested the primary hypothesis that remimazolam is non\u2010inferior to propofol for delirium in patients during the initial 3\u2009days after lung resection surgery. Secondary outcomes were the proportion of delirium\u2010positive assessments; duration of stay in the post\u2010anaesthesia care unit; and hospital and Mini\u2010mental State Examination scores at 30\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We randomly allocated patients aged \u2265\u200965 y to remimazolam or propofol anaesthesia for lung resection surgery. Delirium was assessed by trained assessors blinded to trial treatment using the Confusion Assessment Method in the post\u2010anaesthesia care unit and twice daily for 3 postoperative days. Our non\u2010inferiority margin was a 10% absolute difference in the incidence of postoperative delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The modified intent\u2010to\u2010treat population included 455 patients. Delirium occurred in 108\/227 (48%) patients allocated to the remimazolam group and 71\/228 (31%) in those allocated to the propofol group (risk ratio 1.53, 95%CI 1.21\u20131.94). The absolute risk difference was 16.5% (95%CI 7.7\u201325.3%) which considerably exceeded our non\u2010inferiority margin; therefore, non\u2010inferiority was not established. Emergence delirium was more frequent in patients allocated to remimazolam (105\/227 (46%) vs. 64\/228 (28%); risk ratio 1.65, 95%CI 1.28\u20132.12), whereas delirium after post\u2010anaesthesia care unit discharge was uncommon and similar between groups (9\/227 (4%) vs. 12\/228 (5%); risk ratio 0.75, 95%CI 0.32\u20131.75). Delirium\u2010positive assessments occurred in 129\/1377 (9%) patients allocated to the remimazolam group and 102\/1440 (7%) in those allocated to the propofol group (risk ratio 1.36, 95%CI 0.96\u20131.91).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Remimazolam was not non\u2010inferior to propofol for postoperative delirium in older patients having lung resection surgery and provoked more emergence delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70290","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:08:08Z","timestamp":1784282888000},"page":"1526-1534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Remimazolam vs. propofol anaesthesia for delirium in older patients recovering from lung resections: a randomised non\u2010inferiority trial"],"prefix":"10.1111","volume":"81","author":[{"given":"Wei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Peking University First Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ge","sequence":"additional","affiliation":[{"name":"School of Health Science and Engineering University of Shanghai for Science and Technology  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine  Shanghai 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-0530","authenticated-orcid":false,"given":"Yuwei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Outcomes Research Consortium  Houston TX 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