Remimazolam for the Prevention of Emergence Delirium in Children Following Tonsillectomy and Adenoidectomy Under Sevoflurane Anesthesia: A Randomized Controlled Study

作者：Xue Yang, Chuantao Lin, Sisi Chen, Yuezhou Huang, Qiong Cheng, Yusheng Yao · 发表于：Drug Design Development and Therapy · 年份：2022 · DOI：10.2147/dddt.s381611 · 被引用次数：84 · 研究领域：Intensive Care Unit Cognitive Disorders、Anesthesia and Sedative Agents、Obstructive Sleep Apnea Research

Purpose: To identify the effectiveness of remimazolam at the end of tonsillectomy and adenoidectomy for preventing emergence delirium in children under sevoflurane anesthesia. Patients and Methods: One hundred and four patients aged 3– 7 years scheduled for tonsillectomy and adenoidectomy under sevoflurane anesthesia were recruited. Patients were randomly assigned to receive either remimazolam 0.2 mg kg – 1 (intervention, n=52) or 0.9% normal saline (control, n=52) at the end of the procedure. The primary outcome was the incidence of emergence delirium, defined as a Pediatric Anesthesia Emergence Delirium (PAED) score ≥ 10. Secondary outcomes were peak PAED score, emergence time, postoperative pain intensity, length of postanesthesia care unit (PACU) stay, parental satisfaction, and postoperative behavior changes three days postoperatively. Results: Emergence delirium occurred in 6 of 51 (12%) patients receiving remimazolam versus 22 of 50 (44%) patients receiving saline (risk difference 32% [95% confidence interval, 16% to 49%], relative risk 0.27 [95% confidence interval, 0.12 to 0.60]; P < 0.001). The peak PAED scores (median [interquartile range]) were lower in the remimazolam group than in the saline group (7 [6– 8] versus 9 [8– 11], P < 0.001). Likewise, parental satisfaction was improved in the remimazolam group compared with the saline group (9 [8– 10] versus 8 [7– 8], P < 0.001). There was no difference between groups concerning postoperative pain scores, length of P...