Postoperative Emergence After Remimazolam- Versus Propofol-Based Total Intravenous Anesthesia for Cardiac Valve Surgery: A Retrospective Observational Study

ABSTRACT Context: Remimazolam is an ultra-short-acting benzodiazepine used for general anesthesia, including cardiac surgery; however, its effect on postoperative emergence following cardiopulmonary bypass remains unclear.

Aims

We aimed to compare postoperative emergence following remimazolam- and propofol-based total intravenous anesthesia in adult patients undergoing cardiac valve surgery. Settings and Design: A retrospective observational study. Methods and Materials: We included adult patients who underwent elective cardiac valve replacement surgery at a single center between April 2023 and September 2024. Patients received either remimazolam- or propofol-based total intravenous anesthesia according to institutional practice. The primary endpoint was postoperative emergence time. Secondary endpoints included time to extubation and early postoperative hemodynamic stability assessed using the vasoactive–inotropic score. Statistical Analysis Used: Baseline characteristics and perioperative variables were compared between the groups. Univariate and multivariable linear regression analyses were performed.