Discussion
hypotension, pain
ADVERSE EFFECTS, RESPIRATORY DEPRESSION, ADVERSE REACTION
We designed a prospective, single-center, randomized, double-blinded, and placebo-controlled to explore the efficacy of remimazolam prior to anesthesia induction with propofol to attenuate injection pain in patients under procedural sedation. According to the findings, it was evident that remimazolam pre-administration plus propofol had a favorable effect in alleviating propofol injection pain compared to normal saline. In Group R, patients reported significantly lower incidence and intensity rates of PIP, less propofol was necessary, the recovery time was shorter, and without severe adverse effects.During the clinical application of propofol, except for hypotension and respiratory depression, the common adverse reaction is mainly the local irritating pain However, the definite patho-physiological mechanism of PIP remains unclear. Many factors have been described to be associated with PIP, such as the concentration of free propofol in the aqueous solution, type of preparation, oil and solvent, injection technology, blood buffering, pH value of propofol injection, filtration treatment, age, sex, and so onRemimazolam is a recently developed ultra-short-acting benzodiazepine agonist that has an organ-independent metabolism, similar to remifentanil, and acts on GABA receptors similar to midazolamThe possible mechanisms of reducing PIP with remimazolam may be: (1) by means of enhancing the synaptic inhibitory effects of GABAergic neurotransmission