Remimazolam for sedation: A protocol for a systematic review with meta-analysis, trial sequential analysis, and GRADE approach
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Remimazolam for sedation : A protocol for a systematic review with meta-analysis, trial sequential analysis, and GRADE approach. / Stehr-Pingel, Lasse; Maagaard, Mathias; Tvarnø, Casper Duevang; Andersen, Lars Peter Kloster; Andersen, Jakob Hessel; Mathiesen, Ole.
I: Acta Anaesthesiologica Scandinavica, Bind 67, Nr. 10, 11.2023, s. 1432-1438.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Remimazolam for sedation
T2 - A protocol for a systematic review with meta-analysis, trial sequential analysis, and GRADE approach
AU - Stehr-Pingel, Lasse
AU - Maagaard, Mathias
AU - Tvarnø, Casper Duevang
AU - Andersen, Lars Peter Kloster
AU - Andersen, Jakob Hessel
AU - Mathiesen, Ole
N1 - Funding Information: The Department of Anaesthesia, Zealand University Hospital has previously obtained funding for projects from Sygesikringen Denmark and The Novo Nordisk Foundation. Research under contract has been conducted for AM-Pharma. This review has not been influenced by any of these. The department provided investigator salaries and other costs. No external financial support was obtained. Publisher Copyright: © 2023 Acta Anaesthesiologica Scandinavica Foundation.
PY - 2023/11
Y1 - 2023/11
N2 - Background: Procedural sedation aims to facilitate a successful diagnostic or therapeutic procedure. The pharmacokinetic properties and pharmacodynamic effects need to be taken into consideration when choosing the ideal sedative. Midazolam and propofol are frequently employed. However, they are associated with respiratory depression with increasing dosage. Also, midazolam has a potentially unpredictable pharmacodynamic response and propofol may cause hypotension and injection site pain. Remimazolam may provide a superior alternative due to its rapid pharmacodynamic profile and insignificant circulatory effects. Methods: This protocol employs the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review aims to assess the beneficial and harmful clinical effects of remimazolam versus placebo or other sedatives in adult patients requiring sedation in relation to a diagnostic or therapeutic procedure, or due to other circumstances. Three primary outcomes are identified: Sedation success rate, respiratory complications, and hemodynamic complications. Six secondary outcomes are identified: among these are quality of recovery and serious adverse events. All randomized trials are included. The search strategy includes six major biomedical databases. Literature screening and data extraction will be performed independently by two authors. Risk of systemic error will be assessed with Risk of Bias 2 Tool. Risk of random error will be assessed with trial sequential analysis. Heterogeneity will be evaluated by appropriate statistical tests. The certainty of the evidence will be judged using Grading of Recommendations Assessment, Development, and Evaluation. Meta-analysis will be carried out with Rstudio. A “Summary of Findings” table will be presented with our primary and secondary outcome results. Discussion: The systematic review with up-to-date methodology outlined in this protocol investigates the clinical effects of remimazolam in relation to procedural sedation. The results may guide clinicians in the clinical use of remimazolam.
AB - Background: Procedural sedation aims to facilitate a successful diagnostic or therapeutic procedure. The pharmacokinetic properties and pharmacodynamic effects need to be taken into consideration when choosing the ideal sedative. Midazolam and propofol are frequently employed. However, they are associated with respiratory depression with increasing dosage. Also, midazolam has a potentially unpredictable pharmacodynamic response and propofol may cause hypotension and injection site pain. Remimazolam may provide a superior alternative due to its rapid pharmacodynamic profile and insignificant circulatory effects. Methods: This protocol employs the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review aims to assess the beneficial and harmful clinical effects of remimazolam versus placebo or other sedatives in adult patients requiring sedation in relation to a diagnostic or therapeutic procedure, or due to other circumstances. Three primary outcomes are identified: Sedation success rate, respiratory complications, and hemodynamic complications. Six secondary outcomes are identified: among these are quality of recovery and serious adverse events. All randomized trials are included. The search strategy includes six major biomedical databases. Literature screening and data extraction will be performed independently by two authors. Risk of systemic error will be assessed with Risk of Bias 2 Tool. Risk of random error will be assessed with trial sequential analysis. Heterogeneity will be evaluated by appropriate statistical tests. The certainty of the evidence will be judged using Grading of Recommendations Assessment, Development, and Evaluation. Meta-analysis will be carried out with Rstudio. A “Summary of Findings” table will be presented with our primary and secondary outcome results. Discussion: The systematic review with up-to-date methodology outlined in this protocol investigates the clinical effects of remimazolam in relation to procedural sedation. The results may guide clinicians in the clinical use of remimazolam.
KW - GRADE
KW - meta-analysis
KW - remimazolam
KW - sedation
KW - systematic review
KW - trial sequential analysis
U2 - 10.1111/aas.14316
DO - 10.1111/aas.14316
M3 - Review
C2 - 37580880
AN - SCOPUS:85168083205
VL - 67
SP - 1432
EP - 1438
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 10
ER -
ID: 373669783