Remimazolam sedation for spinal anaesthesia surgery and its effect on perioperative cognitive function in elderly patients: a multicentre, placebo-controlled study
Bibliographic record
Abstract
Abstract BACKGROUND Remimazolam, a novel ultra-short-acting benzodiazepine, is a potential sedative for non-general anaesthesia surgery in the elderly. This study aimed to investigate the appropriate sedative dosage of remimazolam and its effects on perioperative cognitive function in elderly patients undergoing non-general anaesthesia surgery. METHODS This multicentre, placebo-controlled trial enrolled 330 elderly patients undergoing non-general anaesthesia procedures at eight centres in China from July 2021 to February 2022, with 238 ultimately completing the study. The primary endpoints were the dose of successful sedation with remimazolam and the changes in perioperative cognitive function. Adverse events were recorded to assess drug safety. RESULTS The induction dose of remimazolam for sedation in spinal anaesthesia in elderly patients was 5.38 mg (95% confidence interval [CI], 5.20 to 5.56), maintained at a rate of 0.223 mg·kg− 1·h− 1 (95% CI, 0.201 to 0.237) with no serious adverse effects. Compared with the saline group, there was no statistical difference in the Mini-Mental State Examination scores in the experimental group on Day2 morning (P : 0.886), Day2 afternoon (P : 0.864), and Day7 (P : 0.613), and no statistical difference in the Montreal Cognitive Assessment scores on Day2 morning (P : 0.687), Day2 afternoon (P : 0.827), and Day7 (P : 0.483). CONCLUSIONS Remimazolam besylate is an effective sedative drug during spinal anaesthesia in elderly patients, with a successful induction dose of 5.38 mg (95% CI, 5.20 to 5.56), maintained at a rate of 0.223 mg·kg− 1·h− 1 (95% CI, 0.201 to 0.237) and a good safety profile without altering the short-term postoperative cognitive function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".