{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T04:27:45Z","timestamp":1792988865356,"version":"4.5.0"},"reference-count":40,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:00:00Z","timestamp":1724630400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82102372"],"award-info":[{"award-number":["82102372"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"crossref","award":["No. ZR2023MH264"],"award-info":[{"award-number":["No. ZR2023MH264"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Zibo Medical and Health Research Project","award":["20231901134"],"award-info":[{"award-number":["20231901134"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>To evaluate the recovery quality between remimazolam and propofol after general anesthesia surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included eligible randomized controlled trials (RCTs) in EMBASE, PubMed, Cochrane Central, Scopus, and Web of Science up to June 26, 2024 for comparison the recovery quality of remimazolam and propofol after general anaesthesia. The primary outcomes were the total Quality of Recovery-15 (QoR-15) and five dimensions of QoR-15 on postoperative day 1 (POD1). Secondary outcomes were adverse events, the Quality of Recovery-40 (QoR-40) on POD1, and the intraoperative and postoperative time characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen RCTs with a total of 1,305 patients were included in this meta-analysis. Our statistical analysis showed that remimazolam group had higher QoR-15 score on POD1, with no significant difference (Mean Difference (MD) = 1.24; 95% confidence interval (CI), [\u22121.67\u20134.15]; I<jats:sup>2<\/jats:sup>= 75%;<jats:italic>P<\/jats:italic>\u00a0=\u00a00.41). In the five dimensions of QoR-15, remimazolam group was superior to propofol group in terms of physical independence (MD = 0.79; 95% CI [0.31\u20131.27]; I<jats:sup>2<\/jats:sup>\u00a0= 0%;<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001). Remimazolam group was lower than propofol group in incidence of hypotension (Risk Ratio (RR) = 0.48; 95% CI [0.40\u20130.59]; I<jats:sup>2<\/jats:sup>= 14%;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.00001), bradycardia (RR = 0.18; 95% CI [0.08\u20130.38]; I<jats:sup>2<\/jats:sup>= 0%;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) and injection pain (RR = 0.03; 95% CI [0.01\u20130.12]; I<jats:sup>2<\/jats:sup>= 48%;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.00001), respectively. The intraoperative and postoperative time characteristics and the QoR-40 were similar in the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our analysis showed that the recovery quality of the remimazolam group after general anaesthesia was similar to propofol group, while the incidence of adverse events was low in remimazolam group. As a potential anesthetic, remimazolam can be used in place of propofol for surgical general anesthesia.<\/jats:p><\/jats:sec>","DOI":"10.7717\/peerj.17930","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T06:43:30Z","timestamp":1724654610000},"page":"e17930","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of the recovery quality between remimazolam and propofol after general anesthesia: systematic review and a meta-analysis of randomized controlled trials"],"prefix":"10.7717","volume":"12","author":[{"given":"Caiyun","family":"Zhu","sequence":"first","affiliation":[{"name":"DepartmentofPharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"},{"name":"DepartmentofPharmacy, Zibo Integrated Traditional Chinese and Western Medicine Hospital, Zibo, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Xie","sequence":"additional","affiliation":[{"name":"DepartmentofPharmacy, Zibo Integrated Traditional Chinese and Western Medicine Hospital, Zibo, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Qin","sequence":"additional","affiliation":[{"name":"DepartmentofPharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"},{"name":"DepartmentofPharmacy, Liuzhou People\u2019s Hospital, Guangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiguo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Tang","sequence":"additional","affiliation":[{"name":"DepartmentofPharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"},{"name":"Stem Cell Clinical Institute, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"10.7717\/peerj.17930\/ref-1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/anae.13312","article-title":"Postoperative recovery and outcomes\u2013what are we measuring and for whom?","volume":"71","author":"Bowyer","year":"2016","journal-title":"Anaesthesia"},{"key":"10.7717\/peerj.17930\/ref-2","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1007\/s40263-017-0463-7","article-title":"The role of GABA receptor agonists in anesthesia and sedation","volume":"31","author":"Brohan","year":"2017","journal-title":"CNS Drugs"},{"key":"10.7717\/peerj.17930\/ref-3","doi-asserted-by":"publisher","first-page":"e15495","DOI":"10.7717\/peerj.15495","article-title":"Remimazolam versus propofol for procedural sedation: a meta-analysis of randomized controlled trials","volume":"11","author":"Chang","year":"2023","journal-title":"PeerJ"},{"key":"10.7717\/peerj.17930\/ref-4","doi-asserted-by":"publisher","first-page":"974","DOI":"10.3760\/cma.j.cn131073.20191224.00820","article-title":"Sedative effect of remimazolam for induction of general anesthesia in elderly patients","volume":"8","author":"Chen","year":"2020","journal-title":"Chinese Journal of Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-5","doi-asserted-by":"publisher","first-page":"859","DOI":"10.12360\/CPB202401084","article-title":"Efficacy and safety of remimazolam tosylate for general anesthesia in morbidly obese patients","volume":"40","author":"Chen","year":"2024","journal-title":"Chinese Pharmacological Bulletin"},{"key":"10.7717\/peerj.17930\/ref-6","doi-asserted-by":"publisher","first-page":"110955","DOI":"10.1016\/j.jclinane.2022.110955","article-title":"Comparison of remimazolam-based and propofol-based total intravenous anesthesia on postoperative quality of recovery: a randomized non-inferiority trial","volume":"82","author":"Choi","year":"2022","journal-title":"Journal of Clinical Anesthesia"},{"key":"10.7717\/peerj.17930\/ref-7","doi-asserted-by":"publisher","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":"Journal of Anesthesia"},{"key":"10.7717\/peerj.17930\/ref-8","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/bja\/aet014","article-title":"Measurement of quality of recovery using the QoR-40: a quantitative systematic review","volume":"111","author":"Gornall","year":"2013","journal-title":"British Journal of Anaesthesia"},{"key":"10.7717\/peerj.17930\/ref-9","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1097\/eja.0000000000001701","article-title":"Effect of remimazolam versus propofol sedation on the quality of recovery after colonoscopy","volume":"39","author":"Guo","year":"2022","journal-title":"European Journal of Anaesthesiology"},{"key":"10.7717\/peerj.17930\/ref-10","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1186\/s12871-023-02364-x","article-title":"Efficacy and safety of remimazolam compared with propofol in hypertensive patients undergoing breast cancer surgery: a single-center, randomized, controlled study","volume":"23","author":"Huang","year":"2023","journal-title":"BMC Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-11","doi-asserted-by":"publisher","first-page":"534","DOI":"10.13429\/j.cnki.cjcr.2024.04.010","article-title":"Effects of remimazolam combined with mivacurium on recovery quality of patients after vocal cord polypectomy","volume":"37","author":"Jiao","year":"2024","journal-title":"Chinese Journal of Clinical Research"},{"key":"10.7717\/peerj.17930\/ref-12","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s40265-020-01299-8","article-title":"Remimazolam: first approval","volume":"80","author":"Keam","year":"2020","journal-title":"Drugs"},{"key":"10.7717\/peerj.17930\/ref-13","doi-asserted-by":"publisher","first-page":"690875","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":"Frontiers in Pharmacology"},{"key":"10.7717\/peerj.17930\/ref-14","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s12871-023-02091-3","article-title":"Comparison of postoperative nausea and vomiting between Remimazolam and Propofol in Patients undergoing oral and maxillofacial surgery: a prospective Randomized Controlled Trial","volume":"23","author":"Kim","year":"2023","journal-title":"BMC Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-15","doi-asserted-by":"publisher","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":"Frontiers in Pharmacology"},{"key":"10.7717\/peerj.17930\/ref-16","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1007\/s00540-024-03311-x","article-title":"Comparison of remimazolam-based and propofol-based total intravenous anesthesia on hemodynamics during anesthesia induction in patients undergoing transcatheter aortic valve replacement: a randomized controlled trial","volume":"38","author":"Kotani","year":"2024","journal-title":"Journal of Anesthesia"},{"key":"10.7717\/peerj.17930\/ref-17","doi-asserted-by":"publisher","first-page":"382","DOI":"10.3390\/jpm14040382","article-title":"Quality of postoperative recovery in total intravenous anesthesia between remimazolam and propofol for intraoperative neurophysiological monitoring: a prospective double-blind randomized controlled trial","volume":"14","author":"Lee","year":"2024","journal-title":"Journal of Personalized Medicine"},{"key":"10.7717\/peerj.17930\/ref-18","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/eja.0000000000001951","article-title":"Comparison of recovery profiles between total intravenous anaesthesia with propofol or remimazolam reversed with flumazenil in patients undergoing breast surgery","volume":"41","author":"Lee","year":"2024","journal-title":"European Journal of Anaesthesiology"},{"key":"10.7717\/peerj.17930\/ref-19","doi-asserted-by":"publisher","first-page":"12660","DOI":"10.1038\/s41598-024-63578-8","article-title":"Remimazolam-flumazenil provides fast recovery from general anesthesia compared to propofol during radiofrequency catheter ablation of atrial fibrillation","volume":"14","author":"Lee","year":"2024","journal-title":"Scientific Reports"},{"key":"10.7717\/peerj.17930\/ref-20","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12871-023-02104-1","article-title":"Comparison of the recovery profile of remimazolam with flumazenil and propofol anesthesia for open thyroidectomy","volume":"23","author":"Lee","year":"2023","journal-title":"BMC Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-21","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1007\/s40265-021-01544-8","article-title":"Remimazolam: a review in procedural sedation","volume":"81","author":"Lee","year":"2021","journal-title":"Drugs"},{"key":"10.7717\/peerj.17930\/ref-22","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.3760\/cma.j.cn131073.20210902.01206","article-title":"Comparison of effects of remimazolam and propofol on quality of postoperative recovery in aged patients with goal-directed hemodynamic management strategies","volume":"41","author":"Li","year":"2021","journal-title":"Chinese Journal of Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-23","doi-asserted-by":"publisher","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":"Therapeutics and Clinical Risk Management Volume"},{"key":"10.7717\/peerj.17930\/ref-24","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1186\/s12871-023-02092-2","article-title":"Efficacy and safety of remimazolam tosilate versus propofol in patients undergoing day surgery: a prospective randomized controlled trial","volume":"23","author":"Luo","year":"2023","journal-title":"BMC Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-25","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.2147\/dddt.S359496","article-title":"Quality of recovery after general anesthesia with remimazolam in patients\u2019 undergoing urologic surgery: a randomized controlled trial comparing remimazolam with propofol","volume":"16","author":"Mao","year":"2022","journal-title":"Drug Design, Development and Therapy Volume"},{"key":"10.7717\/peerj.17930\/ref-26","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1097\/aco.0000000000000612","article-title":"Measuring quality of recovery in perioperative clinical trials","volume":"31","author":"Myles","year":"2018","journal-title":"Current Opinion in Anaesthesiology"},{"key":"10.7717\/peerj.17930\/ref-27","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1016\/j.bja.2022.03.009","article-title":"Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis","volume":"128","author":"Myles","year":"2022","journal-title":"British Journal of Anaesthesia"},{"key":"10.7717\/peerj.17930\/ref-28","doi-asserted-by":"crossref","first-page":"E761","DOI":"10.36076\/ppj.2023.26.E761","article-title":"Hemodynamic influences of remimazolam versus propofol during the induction period of general anesthesia: a systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"Peng","year":"2023","journal-title":"Pain Physician"},{"key":"10.7717\/peerj.17930\/ref-29","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1111\/anae.13931","article-title":"Satisfaction is not substantially affected by quality of recovery: different constructs or are we lost in statistics?","volume":"72","author":"Royse","year":"2017","journal-title":"Anaesthesia"},{"key":"10.7717\/peerj.17930\/ref-30","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/ALN.0b013e318289b84b","article-title":"Development and psychometric evaluation of a postoperative quality of recovery score","volume":"118","author":"Stark","year":"2013","journal-title":"Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-31","doi-asserted-by":"publisher","first-page":"100237","DOI":"10.1016\/j.bjao.2023.100237","article-title":"Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial","volume":"8","author":"Tang","year":"2023","journal-title":"BJA Open"},{"key":"10.7717\/peerj.17930\/ref-32","doi-asserted-by":"publisher","first-page":"939","DOI":"10.23736\/s0375-9393.22.16631-9","article-title":"Remimazolam versus traditional sedatives for procedural sedation: a systematic review and meta-analysis of efficacy and safety outcomes","volume":"88","author":"Tang","year":"2022","journal-title":"Minerva Anestesiologica"},{"key":"10.7717\/peerj.17930\/ref-33","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1097\/meg.0000000000002096","article-title":"Standardized versus nonstandardized pharmacologic treatment for hepatorenal syndrome","volume":"33","author":"Ustundag","year":"2021","journal-title":"European Journal of Gastroenterology & Hepatology"},{"key":"10.7717\/peerj.17930\/ref-34","doi-asserted-by":"publisher","first-page":"110685","DOI":"10.1016\/j.jclinane.2022.110685","article-title":"Quality of recovery in the perioperative setting: a narrative review","volume":"78","author":"Wessels","year":"2022","journal-title":"Journal of Clinical Anesthesia"},{"key":"10.7717\/peerj.17930\/ref-35","doi-asserted-by":"publisher","first-page":"553","DOI":"10.23736\/s0375-9393.23.17034-9","article-title":"Comparison of remimazolam and propofol about safety outcome indicators during general anesthesia in surgical patients: a systematic review and meta-analysis","volume":"89","author":"Wu","year":"2023","journal-title":"Minerva Anestesiologica"},{"key":"10.7717\/peerj.17930\/ref-36","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3760\/cma.j.cn131073.20240207.00410","article-title":"Effect of remimazolam-flumazenil regimen on emergence of patients undergoing endoscopic retrograde cholangiopancreatography","volume":"44","author":"Xiao","year":"2024","journal-title":"Chinese Journal of Anesthesiology"},{"key":"10.7717\/peerj.17930\/ref-37","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.23736\/s0375-9393.22.16817-3","article-title":"Remimazolam versus propofol for procedural sedation and anesthesia: a systemic review and meta-analysis","volume":"88","author":"Zhang","year":"2022","journal-title":"Minerva Anestesiologica"},{"key":"10.7717\/peerj.17930\/ref-38","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.2147\/dddt.S456675","article-title":"Comparison of remimazolam tosilate and propofol sedation on the early postoperative quality of recovery in patients undergoing day surgery: a prospective randomized controlled trial","volume":"18","author":"Zhang","year":"2024","journal-title":"Drug Design, Development and Therapy Volume"},{"key":"10.7717\/peerj.17930\/ref-39","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.3760\/cma.j.cn112137-20221121-02449","article-title":"Effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy","volume":"103","author":"Zhao","year":"2023","journal-title":"National Medical Journal of China"},{"key":"10.7717\/peerj.17930\/ref-40","doi-asserted-by":"publisher","first-page":"655042","DOI":"10.3389\/fmed.2021.655042","article-title":"Efficacy and safety of remimazolam in endoscopic sedation\u2014a systematic review and meta-analysis","volume":"8","author":"Zhu","year":"2021","journal-title":"Frontiers in Medicine"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/17930.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17930.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17930.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17930.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T06:25:44Z","timestamp":1732688744000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/17930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,26]]},"references-count":40,"alternative-id":["10.7717\/peerj.17930"],"URL":"https:\/\/doi.org\/10.7717\/peerj.17930","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,26]]},"article-number":"e17930"}}