Comparing subjective quality of recovery between remimazolam- and propofol-based total intravenous anesthesia for surgical procedures: a meta-analysis.

Humans Propofol / administration & dosage Anesthesia Recovery Period Benzodiazepines / therapeutic use Anesthetics, Intravenous / administration & dosage Anesthesia, Intravenous / methods Randomized Controlled Trials as Topic
General anesthesia Propofol QoR Quality of recovery Remimazolam

Journal

Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575

Informations de publication

Date de publication:
17 Sep 2024
Historique:
received: 23 06 2024
accepted: 08 09 2024
medline: 18 9 2024
pubmed: 18 9 2024
entrez: 17 9 2024
Statut: epublish

Résumé

Remimazolam is a novel ultra-short-acting benzodiazepine that has been recently introduced as an alternative to propofol for general anesthesia. While both agents have been compared in terms of safety and efficacy, their relative effects on postoperative quality of recovery (QoR) remain unclear. Therefore, this meta-analysis aimed to compare the effects of remimazolam and propofol on subjective QoR in surgical patients who underwent general anesthesia. Medline, Embase, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched from inception to May 28, 2024 to identify randomized controlled trials comparing remimazolam and propofol in terms of postoperative QoR. The Cochrane risk-of-bias tool (RoB 2) was used to assess study quality. QoR score on postoperative day (POD) 1 (primary outcome), QoR scores on PODs 2-3, QoR dimensions, time to loss of consciousness, other recovery characteristics, and rescue analgesia requirement were evaluated using random-effects meta-analyses. This meta-analysis included 13 studies published between 2022 and 2024 involving 1,418 patients. QoR was evaluated using either the QoR-15 (10 studies) or QoR-40 (3 studies) questionnaire. The pooled results indicated no significant difference in the QoR scores on POD 1 (standardized mean difference: 0.02, 95% confidence interval [CI]: - 0.20, 0.23, P = 0.88, I Remimazolam is a potential alternative to propofol for general anesthesia as it offers similar QoR to the latter and has advantages in terms of consciousness recovery and immediate postoperative analgesia requirement.

Sections du résumé

BACKGROUND BACKGROUND
Remimazolam is a novel ultra-short-acting benzodiazepine that has been recently introduced as an alternative to propofol for general anesthesia. While both agents have been compared in terms of safety and efficacy, their relative effects on postoperative quality of recovery (QoR) remain unclear. Therefore, this meta-analysis aimed to compare the effects of remimazolam and propofol on subjective QoR in surgical patients who underwent general anesthesia.
METHODS METHODS
Medline, Embase, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched from inception to May 28, 2024 to identify randomized controlled trials comparing remimazolam and propofol in terms of postoperative QoR. The Cochrane risk-of-bias tool (RoB 2) was used to assess study quality. QoR score on postoperative day (POD) 1 (primary outcome), QoR scores on PODs 2-3, QoR dimensions, time to loss of consciousness, other recovery characteristics, and rescue analgesia requirement were evaluated using random-effects meta-analyses.
RESULTS RESULTS
This meta-analysis included 13 studies published between 2022 and 2024 involving 1,418 patients. QoR was evaluated using either the QoR-15 (10 studies) or QoR-40 (3 studies) questionnaire. The pooled results indicated no significant difference in the QoR scores on POD 1 (standardized mean difference: 0.02, 95% confidence interval [CI]: - 0.20, 0.23, P = 0.88, I
CONCLUSION CONCLUSIONS
Remimazolam is a potential alternative to propofol for general anesthesia as it offers similar QoR to the latter and has advantages in terms of consciousness recovery and immediate postoperative analgesia requirement.

Identifiants

DOI: 10.1186/s13643-024-02660-8 PMID: 39289773
pubmed: 39289773
doi: 10.1186/s13643-024-02660-8
pii: 10.1186/s13643-024-02660-8
doi:

Substances chimiques

remimazolam 7V4A8U16MB
Propofol YI7VU623SF
Benzodiazepines 12794-10-4
Anesthetics, Intravenous 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

235

Informations de copyright

© 2024. The Author(s).

Références

Wessels E, Perrie H, Scribante J, Jooma Z. Quality of recovery in the perioperative setting: A narrative review. J Clin Anesth. 2022;78: 110685.
pubmed: 35190342 doi: 10.1016/j.jclinane.2022.110685
Myles PS. More than just morbidity and mortality - quality of recovery and long-term functional recovery after surgery. Anaesthesia. 2020;75(Suppl 1):e143–50.
pubmed: 31903564
Myles P, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000;84:11–5.
pubmed: 10740540 doi: 10.1093/oxfordjournals.bja.a013366
Gornall B, Myles PS, Smith C, Burke J, Leslie K, Pereira M, et al. Measurement of quality of recovery using the QoR-40: a quantitative systematic review. Br J Anaesth. 2013;111:161–9.
pubmed: 23471753 doi: 10.1093/bja/aet014
Myles PS, Shulman MA, Reilly J, Kasza J, Romero L. Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis. Br J Anaesth. 2022;128:1029–39.
pubmed: 35430086 doi: 10.1016/j.bja.2022.03.009
Campfort M, Cayla C, Lasocki S, Rineau E, Léger M. Early quality of recovery according to QoR-15 score is associated with one-month postoperative complications after elective surgery. J Clin Anesth. 2022;78: 110638.
pubmed: 35033845 doi: 10.1016/j.jclinane.2021.110638
Kinugasa Y, Ida M, Nakatani S, Uyama K, Kawaguchi M. Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery. Korean J Anesthesiol. 2023;76:567–74.
pubmed: 37165623 pmcid: 10718636 doi: 10.4097/kja.23082
Niu Z, Gao X, Shi Z, Liu T, Wang M, Guo L, et al. Effect of total intravenous anesthesia or inhalation anesthesia on postoperative quality of recovery in patients undergoing total laparoscopic hysterectomy: A randomized controlled trial. J Clin Anesth. 2021;73: 110374.
pubmed: 34090183 doi: 10.1016/j.jclinane.2021.110374
Han S, Park J, Hong SH, Lim S, Park YH, Chae MS. Comparison of the impact of propofol versus sevoflurane on early postoperative recovery in living donors after laparoscopic donor nephrectomy: a prospective randomized controlled study. BMC Anesthesiol. 2020;20:273.
pubmed: 33115408 pmcid: 7592560 doi: 10.1186/s12871-020-01190-9
Xu M, Zhang G, Tang Y, Wang R, Yang J. Impact of Regional Anesthesia on Subjective Quality of Recovery in Patients Undergoing Thoracic Surgery: A Systematic Review and Meta-Analysis. J Cardiothorac Vasc Anesth. 2023;37:1744–50.
pubmed: 37301699 doi: 10.1053/j.jvca.2023.05.003
Miao M, Xu Y, Li B, Chang E, Zhang L, Zhang J. Intravenous administration of dexmedetomidine and quality of recovery after elective surgery in adult patients: A meta-analysis of randomized controlled trials. J Clin Anesth. 2020;65: 109849.
pubmed: 32403055 doi: 10.1016/j.jclinane.2020.109849
Hung KC, Kao CL, Ho CN, Hsing CH, Chang YJ, Wang LK, et al. The impact of perioperative ketamine or esketamine on the subjective quality of recovery after surgery: a meta-analysis of randomised controlled trials. Br J Anaesth. 2024;132:1293–303.
pubmed: 38614917 doi: 10.1016/j.bja.2024.03.012
Hung KC, Ko CC, Hsu CW, Pang YL, Chen JY, Sun CK. Association of peripheral nerve blocks with patient-reported quality of recovery in female patients receiving breast cancer surgery: a systematic review and meta-analysis of randomized controlled studies. Can J Anaesth. 2022;69:1288–99.
pubmed: 35882724 doi: 10.1007/s12630-022-02295-0
Hung KC, Chu CC, Hsing CH, Chang YP, Li YY, Liu WC, et al. Association between perioperative intravenous lidocaine and subjective quality of recovery: A meta-analysis of randomized controlled trials. J Clin Anesth. 2021;75: 110521.
pubmed: 34547603 doi: 10.1016/j.jclinane.2021.110521
Peng K, Liu H-Y, Wu S-R, Liu H, Zhang Z-C, Ji F-H. Does Propofol Anesthesia Lead to Less Postoperative Pain Compared With Inhalational Anesthesia?: A Systematic Review and Meta-analysis. Anesth Analg. 2016;123:846–58.
pubmed: 27636574 doi: 10.1213/ANE.0000000000001504
Schraag S, Pradelli L, Alsaleh AJO, Bellone M, Ghetti G, Chung TL, et al. Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis. BMC Anesthesiol. 2018;18:162.
pubmed: 30409186 pmcid: 6225663 doi: 10.1186/s12871-018-0632-3
Kampman JM, Hermanides J, Hollmann MW, Gilhuis CN, Bloem WA, Schraag S, et al. Mortality and morbidity after total intravenous anaesthesia versus inhalational anaesthesia: a systematic review and meta-analysis. EClinicalMedicine. 2024;72: 102636.
pubmed: 38774674 pmcid: 11106536 doi: 10.1016/j.eclinm.2024.102636
Kim KM. Remimazolam: pharmacological characteristics and clinical applications in anesthesiology. Anesth Pain Med (Seoul). 2022;17:1–11.
pubmed: 35139608 doi: 10.17085/apm.21115
Wesolowski AM, Zaccagnino MP, Malapero RJ, Kaye AD, Urman RD. Remimazolam: Pharmacologic Considerations and Clinical Role in Anesthesiology. Pharmacotherapy. 2016;36:1021–7.
pubmed: 27496519 doi: 10.1002/phar.1806
Kilpatrick GJ. Remimazolam: Non-Clinical and Clinical Profile of a New Sedative/Anesthetic Agent. Front Pharmacol. 2021;12: 690875.
pubmed: 34354587 pmcid: 8329483 doi: 10.3389/fphar.2021.690875
Huang L, Liu H, Zou X, Ding J, Tao S. Adverse Drug Events Observed with the Newly Approved Remimazolam in Comparison to Propofol for General Anesthesia in Patients Undergoing Surgery: A Meta-analysis. Adv Ther. 2024;41:1896–910.
pubmed: 38480661 doi: 10.1007/s12325-024-02820-1
Barbosa EC, Espírito Santo PA, Baraldo S, Meine GC. Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis. Br J Anaesth. 2024;132:1219–29.
pubmed: 38443286 doi: 10.1016/j.bja.2024.02.005
An X, Shen T, Yin X, Xu J, Zhang Y, Wang T. The safety of remimazolam versus propofol in gastroscopic sedation: a meta-analysis. BMC Anesthesiol. 2024;24:40.
pubmed: 38287259 pmcid: 10823673 doi: 10.1186/s12871-024-02422-y
Peng X, Liu C, Zhu Y, Peng L, Zhang X, Wei W, et al. Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Physician. 2023;26:E761–73.
pubmed: 37976477
Zhao MJ, Hu HF, Li XL, Li XM, Wang DC, Kuang MJ. The safety and efficacy between remimazolam and propofol in intravenous anesthesia of endoscopy operation: a systematic review and meta-analysis. Int J Surg. 2023;109:3566–77.
pubmed: 37534687 pmcid: 10651250 doi: 10.1097/JS9.0000000000000638
Wu X, Wang C, Gao H, Bai X, Zhang Z, Chen R, et al. Comparison of remimazolam and propofol about safety outcome indicators during general anesthesia in surgical patients: a systematic review and meta-analysis. Minerva Anestesiol. 2023;89:553–64.
pubmed: 36852570 doi: 10.23736/S0375-9393.23.17034-9
Qin F, Lian Z, Huang Y, Tian D. Remimazolam as a Potential Alternative to Propofol for General Anesthesia: A Meta-Analysis of Randomized Controlled Trials. Journal of Anesthesia and Translational Medicine. 2023;2:1–10.
doi: 10.58888/2957-3912-2023-03-01
Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014;14:135.
pubmed: 25524443 pmcid: 4383202 doi: 10.1186/1471-2288-14-135
Chen H-T, Hung K-C, Huang Y-T, Wu J-Y, Hsing C-H, Lin C-M, et al. Efficacy of electroacupuncture in improving postoperative ileus in patients receiving colorectal surgery: a systematic review and meta-analysis. Int J Surg. 2024;110:1113–25.
pubmed: 37916930 doi: 10.1097/JS9.0000000000000848
Myles PS, Myles DB. An Updated Minimal Clinically Important Difference for the QoR-15 Scale. Anesthesiology. 2021;135:934–5.
pubmed: 34543410 doi: 10.1097/ALN.0000000000003977
Wu Q, Xu F, Wang J, Jiang M. Comparison of Remimazolam-Flumazenil versus Propofol for Recovery from General Anesthesia: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12:7316.
pubmed: 38068368 pmcid: 10707179 doi: 10.3390/jcm12237316
Choi JY, Lee HS, Kim JY, Han DW, Yang JY, Kim MJ, et al. Comparison of remimazolam-based and propofol-based total intravenous anesthesia on postoperative quality of recovery: A randomized non-inferiority trial. J Clin Anesth. 2022;82: 110955.
pubmed: 36029704 doi: 10.1016/j.jclinane.2022.110955
Huang Y, Yan T, Lu G, Luo H, Lai Z, Zhang L. Efficacy and safety of remimazolam compared with propofol in hypertensive patients undergoing breast cancer surgery: a single-center, randomized, controlled study. BMC Anesthesiol. 2023;23:409.
pubmed: 38087245 pmcid: 10714447 doi: 10.1186/s12871-023-02364-x
Jiao Z, Wang P, Meng R, Wang K, Xiao R, Yuan M. Effects of remimazolam combined with mivacurium on recovery quality of patients after vocal cord polypectomy. Chin J Clin Res. 2024;37(4):534–9.
Kim EJ, Kim CH, Yoon JY, Byeon GJ, Kim HY, Choi EJ. Comparison of postoperative nausea and vomiting between Remimazolam and Propofol in Patients undergoing oral and maxillofacial surgery: a prospective Randomized Controlled Trial. BMC Anesthesiol. 2023;23:132.
pubmed: 37085760 pmcid: 10122311 doi: 10.1186/s12871-023-02091-3
Kotani T, Ida M, Naito Y, Kawaguchi M. Comparison of remimazolam-based and propofol-based total intravenous anesthesia on hemodynamics during anesthesia induction in patients undergoing transcatheter aortic valve replacement: a randomized controlled trial. J Anesthesia. 2024:1–9.
Lee H-J, Lee HB, Kim YJ, Cho H-Y, Kim WH, Seo J-H. Comparison of the recovery profile of remimazolam with flumazenil and propofol anesthesia for open thyroidectomy. BMC Anesthesiol. 2023;23:147.
pubmed: 37131126 pmcid: 10152604 doi: 10.1186/s12871-023-02104-1
Lee J, Han DW, Song Y, Lee J, Jeon S, Kim MH. Quality of Postoperative Recovery in Total Intravenous Anesthesia between Remimazolam and Propofol for Intraoperative Neurophysiological Monitoring: A Prospective Double-Blind Randomized Controlled Trial. J Pers Med. 2024;14(4):382.
pubmed: 38673009 pmcid: 11051443 doi: 10.3390/jpm14040382
Luo L, Jiang J, Zhang M, Guo Z, Zhang X, Wang F, et al. Comparative Study About Different Doses of Remimazolam in Short Laparoscopic Surgery: A Randomized Controlled Double-Blind Trial. Ther Clin Risk Manag. 2023:829–37.
Mao Y, Guo J, Yuan J, Zhao E, Yang J. Quality of Recovery After General Anesthesia with Remimazolam in Patients’ Undergoing Urologic Surgery: A Randomized Controlled Trial Comparing Remimazolam with Propofol. Drug Des Devel Ther. 2022;16:1199–209.
pubmed: 35509490 pmcid: 9058002 doi: 10.2147/DDDT.S359496
Tang L, Sun Y, Hao X, Sun X, Xie C, Wang T, et al. Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: a randomised clinical trial. BJA Open. 2023;8: 100237.
pubmed: 37942055 pmcid: 10630608 doi: 10.1016/j.bjao.2023.100237
Zhao S, Lu X, Lyu S, Shan Y, Miao C. Effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy [Chinese]. Natl Med J Chin. 2023;103(17):1303–9.
Chen H, Wang H, Wang Y, Su S, Wang G. Remimazolam versus propofol on quality of recovery after general anesthesia in elders undergoing ocular fundus daytime surgery. J Pract Med. 2024;40:1052–7.
Lee J, Kim DH, Ju JW, Nam K, Cho YJ, Jeon Y, et al. Comparison of recovery profiles between total intravenous anaesthesia with propofol or remimazolam reversed with flumazenil in patients undergoing breast surgery: A randomised controlled trial. Eur J Anaesthesiol. 2024;41:199–207.
pubmed: 38205822 doi: 10.1097/EJA.0000000000001951
Li FZ, Zhao C, Tang YX, Liu JT. Safety and efficacy comparison of remimazolam and propofol for intravenous anesthesia during gastroenteroscopic surgery of older patients: A meta-analysis. World J Clin Cases. 2024;12:1272–83.
pubmed: 38524507 pmcid: 10955534 doi: 10.12998/wjcc.v12.i7.1272
Terres MT, Assis ML, CB DAS, Amaral S. Remimazolam versus propofol for endoscopy sedation in elderly patients: a systematic review, meta-analysis and trial sequential analysis. Minerva Anestesiol. 2024. Online ahead of print.
Collins J, O’Sullivan EP. Rapid sequence induction and intubation. BJA Educ. 2022;22:484–90.
pubmed: 36406036 pmcid: 9669739 doi: 10.1016/j.bjae.2022.09.001
de Carvalho CC, da Silva DM, de Athayde Regueira SLP, de Souza ABS, Rego CO, Ramos IB, et al. Comparison between rocuronium and succinylcholine for rapid sequence induction: A systematic review and network meta-analysis of randomized clinical trials. J Clin Anesth. 2021;72: 110265.
pubmed: 33819827 doi: 10.1016/j.jclinane.2021.110265
Sokal SM, Craft DL, Chang Y, Sandberg WS, Berger DL. Maximizing operating room and recovery room capacity in an era of constrained resources. Arch Surg. 2006;141:389–95.
pubmed: 16618898 doi: 10.1001/archsurg.141.4.389
Fields A, Huang J, Schroeder D, Sprung J, Weingarten T. Agitation in adults in the post-anaesthesia care unit after general anaesthesia. Br J Anaesth. 2018;121:1052–8.
pubmed: 30336849 doi: 10.1016/j.bja.2018.07.017
Royse CF, Chung F, Newman S, Stygall J, Wilkinson DJ. Predictors of patient satisfaction with anaesthesia and surgery care: a cohort study using the Postoperative Quality of Recovery Scale. Eur J Anaesthesiol. 2013;30:106–10.
pubmed: 22907610 doi: 10.1097/EJA.0b013e328357e584
Wu L, Huang X, Sun L. The efficacy of N-methyl-D-aspartate receptor antagonists on improving the postoperative pain intensity and satisfaction after remifentanil-based anesthesia in adults: a meta-analysis. J Clin Anesth. 2015;27:311–24.
pubmed: 25824051 doi: 10.1016/j.jclinane.2015.03.020
Fletcher D, Martinez V. Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis. Br J Anaesth. 2014;112:991–1004.
pubmed: 24829420 doi: 10.1093/bja/aeu137
Ren YL, Yuan JJ, Xing F, Zhu LN, Zhang W. Effects of Different Doses of Esketamine on Pain Sensitivity of Patients Undergoing Thyroidectomy: A Randomized Controlled Trial. Pain Ther. 2023;12:739–50.
pubmed: 36933139 pmcid: 10199971 doi: 10.1007/s40122-023-00488-z
Wu Z, Yu J, Lin Q, Li H, Zhang T, Tan H, et al. Effects of an Intraoperative Intravenous Bolus Dose of Dexmedetomidine on Remifentanil-Induced Postinfusion Hyperalgesia in Patients Undergoing Thyroidectomy: A Double-Blind Randomized Controlled Trial. Anesth Analg. 2021;132:320–8.
pubmed: 32639389 doi: 10.1213/ANE.0000000000005003
Lee C, Lim J, Hong H, Yu H, Lee H. Effect of Remimazolam on Pain Perception and Opioid-Induced Hyperalgesia in Patients Undergoing Laparoscopic Urologic Surgery-A Prospective, Randomized, Controlled Study. Medicina (Kaunas). 2024;60(1):123.
pubmed: 38256384 pmcid: 10818426 doi: 10.3390/medicina60010123
Hoshino R, Ohashi N, Uta D, Ohashi M, Deguchi H, Baba H. Actions of remimazolam on inhibitory transmission of rat spinal dorsal horn neurons. J Pharmacol Sci. 2024;155:63–73.
pubmed: 38677787 doi: 10.1016/j.jphs.2024.04.002
Xie H, Lu F, Liu W, Wang E, Wang L, Zhong M. Remimazolam alleviates neuropathic pain via regulating bradykinin receptor B1 and autophagy. J Pharm Pharmacol. 2021;73:1643–51.
pubmed: 34061162 doi: 10.1093/jpp/rgab080

Auteurs

Kuo-Chuan Hung (KC)

Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.

Wei-Ting Wang (WT)

Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.

Wei-Cheng Liu (WC)

Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
The Department of Occupational Therapy, Shu-Zen junior College of Medicine and Management, Kaohsiung City, Taiwan.

Chih-Wei Hsu (CW)

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.

Yen-Ta Huang (YT)

Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.

Jheng-Yan Wu (JY)

Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan.

I-Wen Chen (IW)

Department of Anesthesiology, Chi Mei Medical Center, No.201, Taikang Taikang Vil., Liouying Dist., Liouying, Tainan City, 73657, Taiwan. cheniwena60912@gmail.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparing subjective quality of recovery...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénols › Propofol › Comparing subjective quality of recovery...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Période périopératoire › Période postopératoire › Réveil anesthésique › Comparing subjective quality of recovery...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Benzazépines › Benzodiazépines › Comparing subjective quality of recovery...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Anesthésiques › Anesthésiques généraux › Anesthésiques intraveineux › Comparing subjective quality of recovery...
questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Anesthésie intraveineuse › Comparing subjective quality of recovery...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Comparing subjective quality of recovery...