Remimazolam: A Retrospective Study of Initial Safety and Recovery Data in Diverse Procedural Sedation

The new ultra-short-acting benzodiazepine, remimazolam, offers a pharmacokinetic and pharmacodynamic advantage over commonly used procedural sedation medication. This retrospective study explored the real-world utilization of remimazolam during procedural sedation to support the development of a nur...

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Bibliographic Details
Published in:Clinical therapeutics 2024-02, Vol.46 (2), p.90-95
Main Authors: Johnson, Kelsey L., Meyers, Jennifer S., Mortensen, Genna N., Steege, Jenna R., Mara, Kristin C., Brinkman, Nathan J.
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Benzodiazepine
Benzodiazepines
Benzodiazepines - therapeutic use
Blood pressure
Body mass index
Body size
Consciousness
Cytochrome
Data recovery
Fentanyl
Hemodynamics
Humans
Hypnotics and Sedatives - adverse effects
Hypotension
Hypoxia
Hypoxia - chemically induced
Metabolism
Metabolites
Narcotics
Patients
Pharmacodynamics
Pharmacokinetics
Population studies
Procedural sedation
Recovery time
Regression analysis
Remimazolam
Retrospective Studies
Sedative
Sleep apnea
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Summary:The new ultra-short-acting benzodiazepine, remimazolam, offers a pharmacokinetic and pharmacodynamic advantage over commonly used procedural sedation medication. This retrospective study explored the real-world utilization of remimazolam during procedural sedation to support the development of a nurse sedation protocol. The primary outcome was to identify associations between recovery time, adverse reactions, and dose-response in expanded patient populations. This study reviewed charts of 292 adult patients from 3 hospitals within one institution who received remimazolam during procedural sedation between June 1, 2021 and December 31, 2021. Data were analyzed using logistic and linear regression. The median time to alert in patients receiving remimazolam alone was 12 minutes (interquartile range 10, 17) and increased when additional sedation medications were utilized. Receiving additional sedative medication significantly increased the odds of hypoxia (OR 2.77, 95% CI 1.30–5.91, P = 0.008) after adjusting for body mass index (BMI), American Society of Anesthesiologists physical status (ASA-PS), and total remimazolam dose. There was a 25% increase in odds of experiencing hypoxia for every 5 kg/m2 increase in BMI (95% CI 1.01–1.54, P = 0.037). Remimazolam presents as a promising option for nurse procedural sedation, offering minimal impact on hemodynamics and respirations, quick recovery, and no residual sedative effects.
ISSN:0149-2918
1879-114X
DOI:10.1016/j.clinthera.2023.11.004