Remimazolam shows promise in procedural sedation

Procedural sedation with remimazolam delivers effective sedation without adversely affecting haemodynamics and respirations or lingering drowsiness, as reported in a study.

For the study, researchers looked at real-world use of remimazolam during procedural sedation to support the development of a nurse sedation protocol. Medical records of 292 adult patients who received remimazolam during procedural sedation across three hospitals within one institution were reviewed and analysed.

Logistic and linear regression models were used to analyse the association of remimazolam with recovery time, adverse reactions, and dose-response in expanded patient populations.

For patients receiving remimazolam alone, the median time to alert was 12 minutes (interquartile range, 10–17), which increased when additional sedation medications were used. Receipt of additional sedative medication led to a significantly increase in the odds of hypoxia (odds ratio [OR], 2.77, 95 percent confidence interval [CI], 1.30–5.91; p=0.008) after adjusting for body mass index, American Society of Anesthesiologists physical status (ASA-PS), and total remimazolam dose.

In addition, for every 5-kg/m² increase in body mass index, the odds of experiencing hypoxia associated with the use of additional sedative increased by 25 percent (OR, 1.25, 95 percent CI, 1.01–1.54; p=0.037).

The findings suggest that remimazolam is a promising option for nurse-administered procedural sedation, having minimal effect on vital signs, while being associated with quick recovery and no residual sedative effects.