{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:46:58Z","timestamp":1791985618395,"version":"4.4.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Remimazolam is an ultra-short-acting benzodiazepine used for general anesthesia, including cardiac surgery; however, its effect on postoperative emergence following cardiopulmonary bypass remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>We aimed to compare postoperative emergence following remimazolam- and propofol-based total intravenous anesthesia in adult patients undergoing cardiac valve surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>A retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Materials:<\/jats:title>\n                    <jats:p>We included adult patients who underwent elective cardiac valve replacement surgery at a single center between April 2023 and September 2024. Patients received either remimazolam- or propofol-based total intravenous anesthesia according to institutional practice. The primary endpoint was postoperative emergence time. Secondary endpoints included time to extubation and early postoperative hemodynamic stability assessed using the vasoactive\u2013inotropic score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis Used:<\/jats:title>\n                    <jats:p>Baseline characteristics and perioperative variables were compared between the groups. Univariate and multivariable linear regression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-three patients were included in the analysis (remimazolam group, n = 21; propofol group, n = 42). Postoperative emergence time did not differ significantly between the two groups (164 [120\u2013253] min vs. 137 [95\u2013188] min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.193). Time to extubation was also comparable between the groups (1,009 [914\u20131,070] min vs. 1,033 [906\u20131,057] min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.844). Early postoperative hemodynamic parameters, including vasoactive\u2013inotropic scores, were comparable between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      <jats:bold>I<\/jats:bold>\n                      n adult patients undergoing cardiac valve surgery, postoperative emergence time was comparable between remimazolam- and propofol-based total intravenous anesthesia. More prospective studies are warranted to clarify the role of remimazolam in cardiac anesthesia.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_90_26","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:00:31Z","timestamp":1791824431000},"page":"570-576","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study"],"prefix":"10.4103","volume":"29","author":[{"given":"Emi","family":"Fujii","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Shiga University of Medical Science, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Imashuku","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shiga University of Medical Science, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shiga University of Medical Science, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotoshi","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shiga University of Medical Science, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"R1-20261014","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":"R2-20261014","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s10877-021-00653-9","article-title":"Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: A prospective observational study","volume":"36","author":"Saugel","year":"2022","journal-title":"J Clin Monit Comput"},{"key":"R3-20261014","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1186\/s13063-021-05691-x","article-title":"Effect of remimazolam besylate compared with propofol on the incidence of delirium after cardiac surgery: Study protocol for a randomized trial","volume":"22","author":"Yang","year":"2021","journal-title":"Trials"},{"key":"R4-20261014","doi-asserted-by":"crossref","first-page":"e00851","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":"R5-20261014","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":"R6-20261014","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1186\/s12871-024-02614-6","article-title":"Comparison of remimazolam tosilate and propofol during induction and maintenance of general anesthesia in patients undergoing laparoscopic cholecystectomy: A prospective, single center, randomized controlled trial","volume":"24","author":"Luo","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"R7-20261014","doi-asserted-by":"crossref","first-page":"1265860","DOI":"10.3389\/fmed.2023.1265860","article-title":"Safety and efficacy of remimazolam for general anesthesia in elderly patients undergoing laparoscopic cholecystectomy: A randomized controlled trial","volume":"10","author":"So","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"R8-20261014","doi-asserted-by":"crossref","first-page":"829","DOI":"10.2147\/TCRM.S428278","article-title":"Comparative study about different doses of remimazolam in short laparoscopic surgery: A randomized controlled double-blind trial","volume":"19","author":"Luo","year":"2023","journal-title":"Ther Clin Risk Manag"},{"key":"R9-20261014","doi-asserted-by":"crossref","first-page":"1101728","DOI":"10.3389\/fphar.2023.1101728","article-title":"The use of remimazolam versus propofol for induction and maintenance of general anesthesia: A systematic review and meta-analysis","volume":"14","author":"Ko","year":"2023","journal-title":"Front Pharmacol"},{"key":"R10-20261014","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"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_90_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:02:06Z","timestamp":1791982926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_90_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_90_26","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}