Effect of Remimazolam vs Midazolam on Early Postoperative Cognitive Recovery in Elderly Patients Undergoing Dental Extraction: A Prospective Randomized Controlled Study
Bibliographic record
Abstract
Purpose: Elderly patients undergoing dental extraction are particularly susceptible to delayed cognitive recovery after sedation. This study aimed to compare the effects of remimazolam and midazolam on early postoperative cognitive recovery in elderly patients undergoing dental extraction. Patients and Methods: This was a single-centre randomized controlled study with elderly patients scheduled for receiving dental extraction under sedation of remimazolam (Group R) or midazolam (Group M). The primary outcome was postoperative cognitive recovery, as measured by the Montreal cognitive assessment 5-minute (MoCA 5-minute) 30 min postoperatively (T 30 ). Secondary outcomes included MoCA 5-minute score 1 h postoperatively (T 1h ), incidence of post-extraction bleeding, intraoperative adverse events, success rate of sedation, time to discharge, and complications. Results: 106 patients (53 in each group) were eligible for the study. At T 30 , MoCA 5-minute score was 25 (IQR 23.5, 27) in Group R, significantly higher than that of 23 (IQR 21, 25) in Group M (P < 0.001). This difference persisted at T 1h [27 (IQR 26, 28) vs 26 (IQR 25, 27), P = 0.003]. Group R also exhibited better hemostasis, with a lower post-extraction bleeding rate at T 1 (5.67% vs 33.96%, χ 2 = 13.36, P < 0.001). Group R showed significantly shorter times to peak sedation after the first dose of medication, awake time, and time to discharge compared to Group M (P < 0.001, P < 0.001, P < 0.001). Conclusion: Remimazolam sedation significantly improves early postoperative cognitive recovery, leading to expedited hemostasis and a shorter discharge time. Keywords: remimazolam, midazolam, elderly patients, cognitive recovery, sedation, dental extraction
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".