{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:51:52Z","timestamp":1787500312457,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Se\u00f1or de Sipan\u2013Vicerrectorado de investigacion."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To compare the efficacy and safety of remimazolam with propofol in general anesthesia in adult patients. Methods: A systematic search in Pubmed, Scopus, Web of Science, and Embase was performed. Patients undergoing complex surgery who were critically ill or non-critically ill were included. The risk of bias (RoB) 2.0 tool was applied. Random-effects models using the inverse variance method were applied for all meta-analyses. Results: Nine randomized controlled trials were included (patients taking remimazolam, n = 678; propofol, n = 454). Remimazolam compared to propofol is likely to produce a large decrease in intraoperative hypotension (RR 0.62, 95% CI 0.50 to 0.76, I2 = 63%, n = 9, CoE moderate certainty), incidence of respiratory depression (RR 0.28, 95% CI 0.09 to 0. 82, I2 = 0%, n = 3; CoE moderate certainty), injection site pain (RR 0.14, 95% CI 0.02 to 0.94, I2 = 21%, n = 4; CoE moderate certainty), and may produce little or no difference in bradycardia (RR 0.61, 95% CI 0.36 to 1.06, I2 = 0%, n = 4; CoE moderate certainty). Conclusions: In patients undergoing complex surgery who are critically ill or non-critically ill, remimazolam, compared with propofol, is likely to produce a large decrease in intraoperative hypotension, incidence of respiratory depression, and injection site pain, but little or no difference in bradycardia is possible.<\/jats:p>","DOI":"10.3390\/jcm13247791","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T07:42:18Z","timestamp":1734680538000},"page":"7791","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Remimazolam Versus Propofol in General Anesthesia of Complex Surgery in Critical and Non-Critical Patients: Meta-Analysis of Randomized Trials"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-1566","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Mu\u00f1oz-Carrillo","sequence":"first","affiliation":[{"name":"Laboratorio de Inmunolog\u00eda, Centro Universitario de los Lagos, Universidad de Guadalajara, Lagos de Moreno, Jalisco 47460, PC, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6052-6972","authenticated-orcid":false,"given":"Natalie","family":"Rodr\u00edguez-Cortes","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad El Bosque, Bogot\u00e1 110121, PC, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9161-3499","authenticated-orcid":false,"given":"Sandra Trujillo","family":"L\u00e9vano","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Humana, Universidad Cient\u00edfica del Sur, Lima 15842, PC, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Moran-Mari\u00f1os","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n en Bibliometr\u00eda, Vicerrectorado de Investigaci\u00f3n, Universidad San Ignacio de Loyola, Lima 15024, PC, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2896-1407","authenticated-orcid":false,"given":"Joshuan J.","family":"Barboza","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Se\u00f1or de Sip\u00e1n, Chiclayo 14001, PC, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lee, M., Lee, C., Choi, G.J., and Kang, H. 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