Both remimazolam tosylate and propofol offer effective and safe sedation and have comparable success rates for painless hysteroscopy. However, the safety of remimazolam tosylate for hysteroscopy seems to be better when compared to propofol, as per the findings of a randomized, parallel controlled, single-blind trial published in The Journal of Clinical Pharmacy and Therapeutics.

Shuoya Zhang et al. carried out this study for comparing the safety and effectiveness of remimazolam tosylate and propofol in 90 people who underwent hysteroscopy. The prospectively enrolled participants were segregated into 3 groups (30 people in each group): (i) Group A: Propofol group, (ii) Group B: Low-dose remimazolam tosylate group, and (iii) Group C: High-dose remimazolam tosylate group.

For analgesic preconditioning, 0.1ug/kg sufentanil was given intravenously. Subjects in group A were given intravenous administration of 2 mg/kg propofol and was maintained at the rate of 5 mg/kg/h. Subjects in groups B and C were intravenously administered 0.25 mg/kg remimazolam tosylate. Group B and Group C were maintained with remimazolam tosylate at a rate of 0.48 mg/kg/h and 0.6 mg/kg/h respectively.

Recording of the alterations of heart rate, mean arterial pressure and saturation of peripheral oxygen were done after hospitalization (T0), one minute after anaesthesia (T1), dilation of uterine cavity (T2), and at hysteroscopy end (T3). Recording of Observer's Assessment of Alertness/Sedation Scale (OAA/S) at one min, three min, and five min following hysteroscopy, the occurrence of noxious events, and the time from end of hysteroscopy to attain the discharge standard, was done.

The success rate of sedation in groups A, B, and C was noted to be 100%. Following administration, the occurrence of adverse events in Group A was substantially greater when compared to Groups B and C. Remimazolam tosylate did not elicit injection pain, exhibited reduced impact on haemodynamics and resulted in less respiratory depression in comparison with propofol.