Hemodynamic Effects of Remimazolam vs Propofol During Robot-assisted Gynecologic Surgery

A Randomized, Parallel, Open-label With Blinded Assessment Study Comparing Hemodynamic Profiles Between Remimazolam- and Propofol-based Total Intravenous Anesthesia in Patients Undergoing Robot-assisted Gynecologic Surgery

This single-center study at CHA Ilsan Medical Center compares intraoperative hemodynamics between remimazolam- and propofol-based total intravenous anesthesia (TIVA) in patients undergoing robot-assisted gynecologic surgery requiring pneumoperitoneum and steep Trendelenburg positioning.

This study aims to compare intraoperative hemodynamic characteristics between remimazolam- and propofol-based total intravenous anesthesia (TIVA) in patients undergoing robot-assisted gynecologic surgery. Continuous invasive blood pressure will be analyzed to evaluate time-weighted average (TWA) and area-under-the-curve (AUC) differences between groups. The study is designed as a randomized, parallel, open-label with blinded assessment trial.

Inclusion Criteria:

• Female patients <65 years of age
• American Society of Anesthesiologists (ASA) physical status I-II
• Scheduled to undergo robotic hysterectomy under general anesthesia

Exclusion Criteria:

• Body mass index (BMI) > 35 kg/m²
• Baseline hypotension (systolic blood pressure <100 mmHg) or bradycardia (heart rate <60 bpm)
• History of ischemic heart disease or cardiac conduction block
• Significant cardiopulmonary disease, including hypoxemia (SpO₂ <90%), uncontrolled asthma, or chronic obstructive pulmonary disease (COPD)
• Use of inhalational anesthetics during anesthesia
• Conversion from robotic/laparoscopic surgery to open laparotomy