The protocol describes how a recovery question will be tested; it does not report that either strategy won.
The multicenter protocol planned approximately 164 major-spine-surgery patients assigned to remimazolam followed by flumazenil or to propofol. Delayed emergence was the primary endpoint, with commands, extubation, recovery scores and adverse events among secondary measures.
No comparative outcome data were presented in this publication. Clinicians could not be fully blinded to the visibly different anesthetics. The authors identified postoperative pain and opioid exposure as potential recovery confounders. Planned sample size is not an analyzed patient count.
For literature review, label the publication as a protocol and retain its endpoint definitions. The future comparison concerns an antagonist-assisted strategy, not spontaneous remimazolam elimination alone. It cannot presently supply an observed rate of delayed emergence for either arm.
Source: Publication PMC12336592. The case-review applications above are interpretive analysis.
Related reading: Aminophylline Emergence Results Do Not Establish Specific Midazolam Reversal.