Remimazolam versus Propofol for General Anesthesia in Colon Cancer Surgery: A Systematic Review and Meta-Analysis of Comparative Studies

This research project is a systematic review and meta-analysis designed to evaluate and compare the efficacy, safety, perioperative hemodynamic stability, and recovery outcomes of remimazolam versus propofol in adult patients undergoing colon or colorectal cancer surgery under general anesthesia. Propofol is widely used in this surgical setting but is frequently associated with hypotension and respiratory depression, which may negatively affect perioperative stability, particularly in elderly or hemodynamically vulnerable patients. Remimazolam, a novel ultra-short–acting benzodiazepine, has been proposed as an alternative anesthetic agent with more favorable hemodynamic properties while maintaining comparable anesthetic depth and recovery profiles. The review synthesizes evidence from randomized controlled trials and comparative cohort studies that directly compare remimazolam and propofol in colon or colorectal cancer surgery. The primary focus is on perioperative hemodynamic outcomes, specifically mean arterial pressure and heart rate at predefined intraoperative and postoperative timepoints. Secondary outcomes include recovery parameters such as post-anesthesia care unit stay and time to emergence, intraoperative variables including remifentanil consumption and anesthesia duration, and safety outcomes such as postoperative nausea and vomiting and respiratory depression. Data are systematically identified through comprehensive searches of PubMed, Scopus, and Web of Science, followed by structured study selection, data extraction, risk of bias assessment, and quantitative synthesis using random-effects meta-analysis models. The expected outcome of this project is to provide a robust, evidence-based comparison of remimazolam and propofol in the context of colon and colorectal cancer surgery, clarifying whether remimazolam offers clinically meaningful advantages in perioperative hemodynamic stability without compromising recovery or safety. The findings aim to inform anesthetic decision-making and guide future clinical research in oncologic anesthesia.