Remimazolam for sedation in gastrointestinal endoscopy: A comprehensive review

被引:0
作者
Dahiya, Dushyant Singh [1 ]
Kumar, Ganesh [2 ]
Parsa, Syeda
Gangwani, Manesh Kumar [3 ]
Ali, Hassam [4 ,5 ]
Sohail, Amir Humza [6 ]
Alsakarneh, Saqr [7 ]
Hayat, Umar [8 ]
Malik, Sheza [9 ]
Shah, Yash R. [10 ]
Pinnam, Bhanu Siva Mohan [11 ]
Singh, Sahib [12 ]
Mohamed, Islam [13 ]
Rao, Adishwar [14 ]
Chandan, Saurabh [15 ]
Al-Haddad, Mohammad [16 ]
机构
[1] Univ Kansas, Sch Med, Div Gastroenterol Hepatol & Motil, 2000 Olathe Blvd, Kansas City, KS 66160 USA
[2] Chandka Med Coll, Dept Internal Med, Sindh 77280, Pakistan
[3] Univ Arkansas Med Sci, Dept Gastroenterol & Hepatol, Little Rock, AR 72205 USA
[4] Univ Arkansas Med Sci, Dept Gastroenterol & Hepatol, Little Rock, AR 72205 USA
[5] East Carolina Univ, Brody Sch Med, Div Gastroenterol, Hepatol & Nutr, Greenville, NC 27858 USA
[6] Univ New Mexico, Dept Surg, Sch Med, Albuquerque, NM 87106 USA
[7] Univ Missouri Kansas City, Dept Internal Med, Kansas City, MO 64108 USA
[8] Geisinger Wyoming Valley Med Ctr, Dept Internal Med, Wilkes Barre, PA 18711 USA
[9] Rochester Gen Hosp, Dept Internal Med, Rochester, NY 14621 USA
[10] Trinity Hlth Oakland Wayne State Univ, Dept Internal Med, Trinity Hlth Oakland, Pontiac, MI 48341 USA
[11] John H Stroger Hosp Cook Cty, Dept Internal Med, Chicago, IL 60612 USA
[12] Sinai Hosp, Dept Internal Med, Baltimore, MD 21215 USA
[13] Univ Missouri, Dept Nutr, Columbia, MO 65211 USA
[14] Guthrie Robert Packer Hosp, Dept Internal Med, Sayre, PA 18840 USA
[15] Creighton Univ, Sch Med, Omaha, NE 68131 USA
[16] Indiana Univ Sch Med, Div Gastroenterol & Hepatol, Indianapolis, IN 46202 USA
来源
WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY | 2024年 / 16卷 / 07期
关键词
Remimazolam; Endoscopy; Sedation; Outcomes; Efficacy; Safety; Pharmacokinetics; CNS; 7056; DOUBLE-BLIND; PROPOFOL SEDATION; GI ENDOSCOPY; SAFETY; EFFICACY; ANESTHESIA; MIDAZOLAM; COLONOSCOPY; TOSILATE;
D O I
10.4253/wjge.v16.i7.385
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Worldwide, a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort. Propofol, benzodiazepines and opioids continue to be widely used. However, in recent years, Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal (GI) endoscopy. It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation. Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase, volume of distribution, total body clearance, and negligible drug-drug interactions. It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy. Furthermore, studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol, which is currently a gold standard for procedural sedation in most parts of the world. However, the use of Propofol is associated with hemodynamic instability and respiratory depression. In contrast, Remimazolam has lower incidence of these adverse effects intra-procedurally and hence, may provide a safer alternative to Propofol in procedural sedation. In this comprehensive narrative review, highlight the pharmacologic characteristics, efficacy, and safety of Remimazolam for procedural sedation. We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.
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页数:12
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