SynthesisDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society2025
Comparison of Remimazolam and Propofol for Sedation in Endoscopic Retrograde Cholangiopancreatography: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.
Synthesis in Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative efficacy and safety of remimazolam versus propofol in bronchoscopic procedures: a GRADE-assessed systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- RemimazolamPeerJ · 2026Pooled it
- Safety and Efficacy of Remimazolam Combined with Esketamine for Anesthesia in Elderly Patients Undergoing ERCP: A Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Remimazolam-Propofol and Propofol Induction Regimens for Pediatric Bidirectional Endoscopy: A Three-Arm Randomized Trial.Children (Basel, Switzerland) · 2026Article
- Sedation in Gastrointestinal Endoscopy: From Drug-Centered Protocols to Personalized, Technology-Supported Pathways: A Narrative Review.Journal of clinical medicine · 2026Review
- Effects of dexmedetomidine nasal spray combined with propofol for deep sedation in patients undergoing endoscopic retrograde cholangiopancreatography: a prospective randomized study.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectivesSedation for endoscopic retrograde cholangiopancreatography (ERCP) is challenging owing to patient comorbidities and procedural complexity. Remimazolam, a novel benzodiazepine, has potential safety benefits. We aimed to systematically compare the efficacy and safety of remimazolam and propofol for ERCP sedation through a meta-analysis and trial sequential analysis (TSA).
methodsWe searched Ovid-MEDLINE, Ovid-Embase, Cochrane Central, and Google Scholar for randomized controlled trials (RCTs) that compared efficacy and safety of remimazolam and propofol in ERCP sedation. Sensitivity analysis and TSA were also performed.
resultsFive RCTs (965 participants) were included. In these trials, remimazolam significantly reduced hypoxia (risk ratio [RR], 0.522; 95% confidence interval [CI] 0.348-0.783; Grading of Recommendations, Assessment, Development, and Evaluation [GRADE], high), hypotension (RR, 0.507; 95% CI 0.396-0.649; GRADE, high), and bradycardia (RR, 0.475; 95% CI 0.308-0.732; GRADE, high). However, it increased tachycardia (RR, 3.363; 95% CI, 1.466-7.714; GRADE, moderate) and body movement (RR, 2.744; 95% CI, 1.216-6.193; GRADE, moderate). Delirium and agitation (RR, 0.586; 95% CI, 0.157-2.179; GRADE, moderate) and completion rate (RR, 1.009; 95% CI, 0.97-1.042; GRADE, moderate) were comparable. Recovery quality was higher in remimazolam group (mean difference, 1.541; 95% CI, 0.057-3.024; GRADE, low). Other outcomes, including induction and recovery times, were similar.
conclusionRemimazolam demonstrated superior safety profile than propofol for ERCP sedation, significantly reducing hypoxia, hypotension, and bradycardia with high certainty evidence and TSA confirmation. Despite the higher incidence of tachycardia and body movement associated with remimazolam, the completion rate and risk of delirium or agitation were similar for both sedatives.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.