Short-term postoperative neurocognitive safety and recovery profiles of remimazolam tosilate combined with flumazenil vs. propofol in cirrhotic patients undergoing endoscopic variceal treatment: a randomized controlled trial - Scorecard - MDSpire
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Comparative Analysis of Short-term Neurocognitive Outcomes and Recovery in Cirrhotic Patients Undergoing Endoscopic Variceal Procedures: Remimazolam Tosilate with Flumazenil Versus Propofol in a Randomized Controlled Trial

  • By

  • Yanjie Chen

  • Xiangrong Du

  • Fu Shi

  • Na Zhu

  • September 4, 2026

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Clinical Scorecard: Comparative Analysis of Short-term Neurocognitive Outcomes and Recovery in Cirrhotic Patients Undergoing Endoscopic Variceal Procedures: Remimazolam Tosilate with Flumazenil Versus Propofol in a Randomized Controlled Trial

At a Glance

CategoryDetail
ConditionCirrhosis
Key MechanismsRemimazolam tosylate undergoes rapid hydrolysis by tissue non-specific esterases, while flumazenil acts as a specific antagonist to hasten emergence.
Target PopulationPatients with liver cirrhosis undergoing endoscopic variceal ligation (EVL) and/or endoscopic variceal sclerotherapy (EVS).
Care SettingEndoscopic procedures requiring anesthesia.

Key Highlights

  • Remimazolam with flumazenil resulted in faster recovery compared to propofol.
  • Early postoperative neurocognitive performance was comparable between both groups.
  • Significant differences in recovery metrics such as spontaneous respiration and extubation times were observed.

Guideline-Based Recommendations

Diagnosis

  • Utilize Number Connection Test-A (NCT-A) and Digit Symbol Test (DST) for assessing neurocognitive function.

Management

  • Consider remimazolam tosylate combined with flumazenil for anesthesia in cirrhotic patients undergoing EVL/EVS.

Monitoring & Follow-up

  • Monitor neurocognitive performance and recovery metrics postoperatively.

Risks

  • Be aware of the heightened risk of postoperative neurological adverse events in cirrhotic patients.

Patient & Prescribing Data

Cirrhotic patients undergoing endoscopic variceal procedures.

Remimazolam tosylate offers a rapidly controllable anesthetic option with reduced risk of prolonged sedation.

Clinical Best Practices

  • Employ rapid-acting anesthetics with minimal hepatic metabolism in cirrhotic patients.
  • Utilize flumazenil to counteract prolonged sedation effects of benzodiazepines.

Related Resources & Content

Original Source(s)

Short-term postoperative neurocognitive safety and recovery profiles of remimazolam tosilate combined with flumazenil vs. propofol in cirrhotic patients undergoing endoscopic variceal treatment: a randomized controlled trial

  • by Yanjie Chen, Xiangrong Du, Fu Shi, Na Zhu

  • September 4, 2026

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