Remimazolam for Sedation During Upper Gastrointestinal Endoscopy in an Adolescent

Garrett, Alexandrea; Flowers, Jessie; Ng, Vanessa; Tobias, Joseph D.

doi:10.14740/jmc4013

Cited by 11 publications

(11 citation statements)

References 17 publications

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“…33 A study of a 15-year-old child with multiple drug and food allergies who underwent oesophagogastroduodenoscopy showed that low-dose of remimazolam besylate (initial dose 0.03 mg/kg; maintenance dose 20µg/kg/min) was equally safe under spontaneous ventilation and a natural airway. 34 In addition, remimazolam significantly reduced the incidence of injection pain based on the phenol structure and improved the comfort of children undergoing gastroscopy, consistent with previous studies. 35…”

Section: Current Status Of Applications Of Remimazolamsupporting

confidence: 87%

Clinical Application and Research Progress of Remimazolam for Pediatric Patients

Bai,

Xu,

Guo

et al. 2024

DDDT

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Remimazolam is a novel ultrashort-acting benzodiazepine that allosterically modulates γ-aminobutyric acid type A (GABAA) receptors to exert sedative effects. Remimazolam has the properties of controllable sedation, rapid onset, and a short duration of action, along with minor depression of circulation and respiration. Remimazolam has been approved for clinical use since 2020 in Japan, and it has been applied for procedural sedation, general anesthesia induction and maintenance, and sedation in ICU patients, and has been proven to be safe and effective. Currently, no consensus has been reached on the clinical application of remimazolam in pediatric patients. This review introduces the clinical research progress and limitations of remimazolam in recent years, aiming to supply scientific guidance and a theoretical reference for the application of remimazolam in pediatric anaesthesia.

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Section: Current Status Of Applications Of Remimazolamsupporting

confidence: 87%

Clinical Application and Research Progress of Remimazolam for Pediatric Patients

Bai,

Xu,

Guo

et al. 2024

DDDT

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“…When used as the primary agent for the induction of general anesthesia, doses up to 0.2 mg/kg have been reported. Infusions, titrated to effect, have varied from 1 - 2 mg/kg/h, which is similar to our dosing range of 15 µg/kg/min and that reported anecdotally in pediatric patients [ 16 - 18 ]. Given its rapid onset, the clinical effect of sedation can generally be achieved within 10 - 15 minutes of starting the infusion without a bolus dose.…”

Section: Discussionsupporting

confidence: 72%

“…To date, published experience with the use of remimazolam in pediatric-aged patients remains anecdotal, primarily from individual case reports and small case series [16][17][18]. Dosing in both adults and children has included bolus administration and continuous administration.…”

Section: Discussionmentioning

confidence: 99%

Remimazolam for Sedation During Fiberoptic Intubation in an Adolescent

Hughes,

Maves,

Tobias

2023

J Med Cases

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In specific clinical scenarios, fiberoptic intubation (FOI) may be the preferred technique for airway management and endotracheal intubation. In addition to topical anesthesia of the airway, sedation is frequently necessary, especially in younger patients, to facilitate the procedure. The goal is to facilitate the procedure by providing sedation, anxiolysis, and analgesia with maintenance of spontaneous ventilation. Remimazolam is a novel benzodiazepine with a short half-life and limited context sensitive half-life that can be titrated by continuous infusion. These novel properties may make it a suitable agent for sedation during FOI of the trachea. We report the novel use of a combination of remimazolam and remifentanil infusions to provide sedation during FOI in an adolescent. The basic pharmacology of remimazolam is presented and previous reports of its use for sedation during FOI are reviewed.

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“…In addition to its use as the primary agent for procedural sedation, remimazolam has been shown to be an effective primary agent or adjunct to general anesthesia in adults [17][18][19]. To date, reports regarding the use of remimazolam in pediatric-aged patients have included only anecdotal retrospective experiences from single case reports or small case series [20][21][22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Remimazolam as an Adjunct to General Anesthesia During Spine Surgery in Adolescents

Hughes,

Cornelius,

Kadado

et al. 2023

J Curr Surg

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Background: Remimazolam is a benzodiazepine that has recently been released for clinical use. Similar to midazolam, it has sedative, anxiolytic, and amnestic properties. However, its metabolism is different as it undergoes metabolism by tissue esterases with a half-life of 5 -10 min and a limited context-sensitive half-life. Methods:We retrospectively reviewed our experience with the use of remimazolam as an adjunctive to general anesthesia during spine surgery. Results:The study cohort included 40 patients, ranging in age from 11 to 35 years and in weight from 21 to 126 kg. Remimazolam was added as an adjunct to maintenance anesthesia with propofol, desflurane, or dexmedetomidine/ketamine at a starting dose of 2.5 -10 µg/kg/min (median dose 5 µg/kg/min). Maintenance doses ranged from 1.5 to 30 µg/kg/min (median dose 8 µg/kg/min). Remimazolam was infused for an average of 5.1 h per patient or a total of 203 h of infusion in the 40 patients. With the infusion of remimazolam, the requirements for the volatile agent or propofol were decreased by approximately 40-50%. No adverse effects related to remimazolam were noted. Conclusions:Remimazolam is an effective adjunct to general anesthesia during spinal surgery, resulting in a significant decrease in requirements for propofol or volatile anesthetic agents.

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Remimazolam for Sedation During Upper Gastrointestinal Endoscopy in an Adolescent

Cited by 11 publications

References 17 publications

Clinical Application and Research Progress of Remimazolam for Pediatric Patients

Clinical Application and Research Progress of Remimazolam for Pediatric Patients

Remimazolam for Sedation During Fiberoptic Intubation in an Adolescent

Remimazolam as an Adjunct to General Anesthesia During Spine Surgery in Adolescents

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