Remimazolam has similar anesthetic effect and superior safety compared to propofol in elderly patients: A meta‐analysis of randomized controlled trials

Background The superiority between remimazolam and propofol for anesthesia is controversial in elderly patients (≥60 years). This meta‐analysis aimed to systematically compare anesthetic effect and safety profile between remimazolam and propofol in elderly patients under any surgery. Methods Cochrane Library, Web of Science, and PubMed were searched until December 25, 2023 for relevant randomized controlled trials. Results Ten studies with 806 patients receiving remimazolam (experimental group) and 813 patients receiving propofol (control group) were included. Time to loss of consciousness [standard mean difference (SMD) (95% confidence interval (CI): 1.347 (−0.362, 3.055), p = 0.122] and recovery time [SMD (95% CI): −0.022 (−0.300, 0.257), p = 0.879] were similar between experimental and control groups. Mean arterial pressure at baseline minus 1 min after induction [SMD (95% CI): −1.800 (−3.250, −0.349), p = 0.015], heart rate at baseline minus 1 min after induction [SMD (95% CI): −1.041 (−1.537, −0.545), p