Study Summary

120 patients scheduled for upper limb surgery under brachial plexus blockade were randomized in a 1:1:1 ratio to receive intraoperative sedation with propofol, dexmedetomidine, or remimazolam. One patient in the remimazolam group was excluded due to inadequate block and conversion to general anesthesia, resulting in 119 patients included in the final analysis. The primary outcome of interest was recovery time, defined as the time from completion of sedative infusion to achievement of a Modified Observer’s Assessment of Alertness and Sedation score of 5. Secondary outcomes included sedation onset time, post-anesthesia care unit length of stay, Modified Aldrete Score, Quality of Recovery–15 score, adverse events, and patient and surgeon satisfaction. Outcomes were assessed intraoperatively and during post-anesthesia recovery. Overall, the results of the study revealed that propofol produced the fastest recovery, followed by remimazolam and dexmedetomidine, while recovery-related secondary outcomes were similar across groups.