Comparison of remimazolam and dexmedetomidine for conscious sedation in elderly patients undergoing dental implant surgery: a prospective randomized controlled trial

作者：Pengfei Gao, Jing Wang, Yang Ji, Qiang Luo · 发表于：BMC Geriatrics · 年份：2025 · DOI：10.1186/s12877-025-06589-y · 被引用次数：3 · 研究领域：Anesthesia and Sedative Agents、Intensive Care Unit Cognitive Disorders、Anesthesia and Neurotoxicity Research

BACKGROUND: The objective of this study was to compare the efficacy and safety of remimazolam and dexmedetomidine in elderly patients undergoing dental implant surgery. METHODS: Seventy-four elderly patients aged 65-80 years and scheduled for dental implant surgery were randomly divided into two groups. Patients in Group R received a 0.05 mg/kg loading dose of remimazolam over 1 min and followed by an infusion rate 0.1-0.3 mg/kg/h. In Group D, a 0.5 µg/kg bolus of dexmedetomidine was given over 10 min and followed by an infusion rate 0.2-1.0 µg/kg/h. The primary outcome of the study was the incidence of hypotension between the two groups. Secondary outcomes were perioperative complications, hemodynamic and respiratory variables, sedation and recovery profiles. RESULTS: The incidence of hypotension in Group R was significantly lower than that in Group D (5.4% vs. 24.3%, RR: 0.22, 95% CI: 0.05-0.96, P = 0.022). The difference of bradycardia was not significant between Group R and Group D (2.6% vs. 13.5%, RR: 0.20, 95% CI: 0.02-1.63, P = 0.088). Only one patient in Group D experienced transient hypoxemia lasting less than 10 s. The onset of sedation was much faster in Group R than Group D (105 ± 21 s vs. 599 ± 172 s, P < 0.01). Two patients in Group D did not reach the target sedative level in 15 min after sedative infusion. All patients reached a MOAA/S score of 5 upon completion of the dental implant surgery. However, patients in Group D had a higher incidence of delayed disch...