Date of this Version

2025

Document Type

DNP Project

Rights

default

Abstract

Background: Procedural sedation in endoscopy is often performed with propofol, which offers rapid onset and recovery. However, it can lead to hemodynamic problems, especially in patients with comorbidities. Remimazolam, a newer and ultra-short-acting benzodiazepine, has demonstrated better stability and a rapid recovery. A direct comparison of remimazolam vs. propofol in patients with different health statuses (ASA II-IV) in those procedures has not been performed. This project aims to address this by conducting a systematic review of existing studies to pull together and compare the safety, efficacy, and recovery outcomes of both medications.

Method: A systematic search of the literature was conducted to identify studies comparing remimazolam and propofol sedation in endoscopic procedures. The databases utilized included PubMed, Embase, and Google Scholar. A Boolean search strategy was applied using the keywords: ("Remimazolam" OR "Propofol") AND ("Endoscopic Procedures" OR "ERCP" OR "Colonoscopy") AND ("Hemodynamic Stability" OR "Recovery Outcomes"). An online voice PowerPoint educational module will be disseminated to Anesthesia providers regarding the results of the systematic review comparing the safety and efficacy of Remimazolam compared to Propofol for Endoscopic procedures on patients with an ASA II-IV. A Qualtrics pre- and post-test will be used to assess the anesthesia providers’ knowledge and attitude toward the topic.

Results: Of 17 respondents, 10 completed the full intervention. Post-intervention scores revealed significant knowledge gains in identifying cardiovascular risks of ASA II-IV patients, remimazolam’s pharmacologic advantages, and the appropriate use of flumazenil. Notably, 100% of participants expressed a likelihood to adopt remimazolam in practice, indicating a positive shift in clinical perspective.

Conclusion: The educational module effectively improved provider knowledge and attitudes regarding remimazolam. The literature supports its use as a safe, effective alternative to propofol, particularly in high-risk patients. Implementing evidence-based sedation alternatives such as remimazolam may enhance patient safety and recovery outcomes in endoscopic anesthesia practice.

Download

Share

COinS