DOI

10.21007/con.dnp.2026.0132

Faculty Advisor

Dwayne Accardo DNP, CCRN, FAANA

Document Type

Poster

Publication Date

Spring 5-1-2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement

Abstract

Purpose/Background

Propofol is commonly used for procedural sedation during endoscopic procedures because of its rapid onset and short duration; however, its use is frequently associated with adverse effects such as hypotension, hypoxemia, respiratory depression, bradycardia, and injection site pain. As diagnostic endoscopic procedures continue to increase, particularly among older and medically complex patients, there is a growing need for sedative agents that provide effective sedation while minimizing perioperative risk. Remimazolam, a novel ultra–short-acting benzodiazepine metabolized by tissue esterases, has demonstrated favorable hemodynamic stability and a reduced adverse effect profile in recent literature. The purpose of this evidence-based quality improvement project is to evaluate the efficacy and safety of remimazolam compared with propofol for sedation in adult patients undergoing endoscopic procedures.

Methods

This project utilizes a prospective, non-randomized, comparative cohort design conducted at multiple healthcare institutions. A total of 30 adult patients undergoing elective endoscopic procedures will be included. Patients receiving remimazolam will be compared with those receiving propofol as part of standard clinical practice. Data will be abstracted from electronic medical records and entered into a standardized Excel spreadsheet. Primary outcomes include sedation success following the initial dose, number of supplemental doses required, and time to achieve adequate sedation. Secondary outcomes include incidence of injection site pain, hypoxemia, hypotension, bradycardia, post-anesthesia care unit recovery time, and other adverse events. Descriptive statistics and comparative analyses will be conducted using SPSS.

Results

This project is currently in the data collection and analysis phase. Outcomes will be compared between the remimazolam and propofol groups to identify differences in sedation efficacy, hemodynamic stability, adverse event rates, and recovery profiles.

Implications for Nursing Practice

Results from this project may support the use of remimazolam as a safer alternative to propofol for endoscopic sedation. Findings have the potential to inform evidence-based sedation protocols, improve patient safety, and guide clinical decision-making in nurse anesthesia practice.

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