1.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
2.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
3.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
4.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
5.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
6.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
7.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
8.Comparative Evaluation of the Fluoride Releasing Ability and Microbial Attachment of Glass-Hybrid Restorative Material
MinKi CHOI ; Howon PARK ; Siyoung LEE ; Haeni KIM ; Juhyun LEE
Journal of Korean Academy of Pediatric Dentistry 2024;51(2):132-139
This study aimed to compare the fluoride-releasing ability and degree of microbial attachment of a newly developed glass-hybrid restorative material (GH) with those of a high-viscosity glass ionomer (HvGIC), resin-modified glass ionomer (RMGI), and composite resin (CR). In addition, the correlation between fluoride-releasing ability and microbial attachment between materials was evaluated. Specimens were prepared in a disc shape and divided into 4 groups according to the materials (GH, HvGIC, RMGI, and CR). The fluoride release experiments were performed in each group (n = 15). The amount of fluoride released was measured on days 1, 3, 7, 14, 28, and 42 after storage. For the microbial attachment experiment, 12 specimens were produced per group using Mutans Streptococci (S.mutans ), a cariogenic microorganism. S. mutans was cultured on the specimens for 24 hours, and the number of bacteria was measured. GH had the highest cumulative fluoride release and showed a significant difference when compared with RMGI (p = 0.001) and CR (p < 0.0001). Microbial attachment was the lowest in GH; however, no significant difference was observed between the materials (p = 0.169). There was no significant correlation between fluoride release from materials and microbial attachment (p > 0.05). From this perspective, remineralization of low-mineralized areas could be expected due to the high fluoride release of GH, and the effect of delaying the progression of dental caries could be predicted from the low cariogenic microbial attachment. Therefore, GH might be a useful restorative material for treating immature permanent teeth with hypomineralized enamel. However, further studies are needed about the degree of remineralization of hypomineralized areas after restoration and the capacity to recharge fluoride.
9.Evaluation of the Color Adjustment Potential of Single-Shade Composite Resin in Primary Teeth
Yongsoon KIM ; Howon PARK ; Juhyun LEE ; Haeni KIM
Journal of Korean Academy of Pediatric Dentistry 2023;50(1):113-120
Restoring composite resins with the optimal shades for all primary teeth is a great challenge for pediatric dentists. A newly developed single-shade composite resin can exhibit a color similar to that of the surrounding tooth structure based on the structural color phenomenon. This study aims to evaluate the color adjustment potential (CAP) of a single-shade composite resin compared to conventional multi-shade composite resins in primary teeth. A single-shade composite resin and two conventional multi-shade composite resins were included in this study. Two types of specimens, a single specimen and a dual specimen, were evaluated. For single specimens, duplications of the primary second molar denture teeth were made using experimental composite resins. For dual specimens, cavities were prepared on the buccal surfaces of extracted primary second molars and restored with experimental composite resins. The L*, a*, and b* values were measured using a colorimeter for the extracted teeth and specimens. The mean ΔEab* values for single and dual specimens and CAP were calculated. Bonferroni post-hoc analysis was performed to confirm the statistical significance between the ΔEab* and CAP values of the experimental resins. Among the single specimens, the single-shade composite resin showed significantly higher ΔESingle compared to other composite resins (p < 0.0167). There was no significant difference between ΔEDual for all experimental resins. The single-shade composite resin showed highest CAP compared to other multi-shade composite resins. A single-shade composite resin exhibited the most prominent color adaptability compared to other conventional multi-shade composite resins for primary second molars. A single-shade composite resin can simplify shade matching and provide esthetic outcomes for the restoration of primary second molars.
10.Surface Roughness and Cariogenic Microbial Adhesion after Polishing of Smart Chromatic Technology-based Composite Resin
Haesong KIM ; Juhyun LEE ; Haeni KIM ; Howon PARK
Journal of Korean Academy of Pediatric Dentistry 2023;50(1):65-74
This study compared the surface roughness and microbial adhesion characteristics of Omnichroma, a novel composite resin developed using “smart chromatic technology”, with those of two other conventional composite resins with different filler compositions. A total of 144 specimens were fabricated using 3 types of composite resins: Omnichroma (nano-spherical), Filtek Z350XT (nanofill), and Tetric N-Ceram (nanohybrid) and, divided into 3 groups of 48. Finishing was performed using tungsten carbide burs. Specimens were then divided into 3 subgroups using different polishing methods: Control, SofLex, and PoGo. Surface roughness was analyzed quantitatively and qualitatively using an atomic force microscope and a scanning electron microscope. Microbial adhesion was assessed by culturing Streptococcus mutans on the specimens for 24 hours and then measuring colony-forming units attached to the upper surface. The surface roughness (Ra) of Omnichroma was 0.123 μm after finishing, and it exhibited a smooth surface compared to the other resins. However, after polishing, there were no significant differences in the surface roughness between the three composite groups, regardless of the polishing methods. The surfaces of the Control subgroups were significantly rougher than those of the SofLex subgroups in all 3 composite groups. However, except for Tetric N-Ceram, there were no significant differences between the Control and PoGo subgroups in the other composite groups. Microbial adhesion assessment showed no significant differences between any of the 3 composite resin subgroups; however, Omnichroma exhibited higher microbial adhesion than the other two composites. No significant correlation was observed between surface roughness and microbial adhesion.

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