ByFavo (remimazolam) / PAION, Cosmo Pharma, Mundipharma, Pharmascience, Eagle Pharma - LARVOL DELTA

Safety and efficacy of remimazolam versus propofol sedation in gynecological procedures: a meta-analysis of East Asian randomized trials. (PubMed, Front Med (Lausanne)) - "More studies are required to confirm these results. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024614416."

Journal • Retrospective data • Review • Anesthesia • Cardiovascular • CNS Disorders • Depression • Gynecology • Hypotension • Psychiatry

The Effect of Reversal of Remimazolam Sedation With Flumazenil on Cognitive Function in Patients Undergoing Hip Arthroplasty Under Spinal Anesthesia (clinicaltrials.gov) - P4 | N=150 | Not yet recruiting | Sponsor: Medical University of Gdansk

New P4 trial • Anesthesia • CNS Disorders • Orthopedics

Remimazolam attenuates traumatic brain injury-induced acute lung injury by suppressing pulmonary epithelial pyroptosis. (PubMed, J Neuroinflammation) - "Remimazolam mitigates TBI-ALI by suppressing post-traumatic ATF3 upregulation, thereby reducing NLRP3 inflammasome activation. This attenuates alveolar epithelial pyroptosis, preserves junctional protein integrity and BAB function, and ultimately ameliorates pulmonary pathology. These findings position remimazolam as a key therapeutic agent for neurotrauma-induced secondary organ dysfunction."

Journal • Acute Lung Injury • CNS Disorders • Respiratory Diseases • Vascular Neurology • ATF3 • CDH1 • NLRP3 • TJP1

Remimazolam-Based Anesthetic Management in a Patient with Severe Aortic Stenosis and Myelodysplastic Syndrome-Related Thrombocytopenia: A Case Report. (PubMed, J Clin Med) - "Transient systolic hypertension during surgical stimulation was controlled using remifentanil titration and esmolol. Recovery and the postoperative course were uneventful, and the patient was discharged in a stable condition. Remimazolam-based total intravenous anesthesia can provide hemodynamic stability without vasopressors in high-risk patients with severe AS, and a transfusion strategy adjusted step by step according to the patient's response can be effective for optimizing PLTs while minimizing the transfusion-related risks of MDS-associated thrombocytopenia."

Journal • Anesthesia • Cardiovascular • Hematological Disorders • Hematological Malignancies • Hypertension • Myelodysplastic Syndrome • Oncology • Thrombocytopenia

Effects of different anesthetics on remifentanil-induced postinfusion hyperalgesia in patients undergoing percutaneous endoscopic interlaminar discectomy: a randomized controlled trial. (PubMed, Front Med (Lausanne)) - "In this study, we investigated the effects of different anesthetics (remimazolam, propofol or sevoflurane) on RPH. The mechanical pain thresholds for the dominant inner forearm, postoperative pain intensity, sufentanil consumption, and side effects were similar among the three groups. Continuous infusion of Propofol or remimazolam attenuated RPH but not acute pain or analgesic consumption after PEID, potentially lowering the risk of chronic pain."

Journal • Anesthesia • Pain

Remimazolam alleviates cerebral ischemia-reperfusion injury of rats by inhibiting NF-κB/NLRP3 inflammasome pyroptosis. (PubMed, Sci Rep) - "Furthermore, remimazolam down-regulated the mRNA levels and protein expression of NF-κB, NLRP3, ASC, and Caspase-1, and reduced the release of IL-1β. Remimazolam may attenuate cortical neuronal pyroptosis by inhibiting NF-κB mediated activation of NLRP3 inflammasome after acute I/R injury."

Journal • Preclinical • Cardiovascular • Inflammation • Ischemic stroke • Reperfusion Injury • IL1B • NLRP3

Prolonged infusion of remimazolam in surgical and medical intensive care unit patients: a pilot pharmacokinetic study. (PubMed, J Intensive Care) - "In this preliminary study, both the surgical ICU group (approximately 24 h) and the medical ICU group (beyond 24 h) showed no evidence of time-dependent accumulation of plasma remimazolam, indicating a generally stable pharmacokinetic profile under the examined conditions."

Journal • PK/PD data • Critical care

Remimazolam as an Adjunct to General Anesthesia During Surgery for Congenital Heart Disease in a Pediatric Patient With a Family History of Malignant Hyperthermia. (PubMed, J Med Cases) - "Remimazolam is a novel benzodiazepine which possesses sedative, anxiolytic, and amnestic properties similar to those of midazolam. We present anecdotal experience with the use of remimazolam as an adjunct to general anesthesia during the intraoperative care of a 6-month-old patient undergoing surgery for congenital heart disease with cardiopulmonary bypass. Previous reports regarding the use of remimazolam in MH-susceptible patients are reviewed, and its role in this clinical scenario is discussed."

Journal • Anesthesia • Cardiovascular • Genetic Disorders • Heart Failure • Pediatrics

Targeting brain injury in sepsis: How remimazolam modulates the TLR4/NF-κB pathway in rats. (PubMed, Folia Neuropathol) - "These findings suggest that RM can effectively alleviate blood-brain barrier and brain injury in septic rats by inhibiting the TLR4/NF-κB pathway. The therapeutic effects observed may pave the way for future clinical research into RM's use for managing sepsis-associated brain injury."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Infectious Disease • Inflammation • Septic Shock • Vascular Neurology

Remimazolam combined with propofol for intraoperative wake-up testing in scoliosis correction surgery: a prospective, blind, randomized controlled trial. (PubMed, Front Pharmacol) - P=N/A | "In this randomized trial, 54 scoliosis surgery patients were assigned to receive either propofol alone (Group P), propofol with dexmedetomidine (Group D), or propofol with remimazolam (Group R). This suggests it as a promising sedative option for spinal deformity surgeries. https://www.chictr.org.cn/bin/project/edit?pid=203900 as ChiCTR2300076802."

Clinical • Journal • Anesthesia • CNS Disorders • Movement Disorders

Anesthetic management for resection of a massive tracheal tumor via combined electronic bronchoscopy and rigid endoscopy: A case report. (PubMed, Medicine (Baltimore)) - "This case illustrates the importance of a staged anesthetic approach in complex airway management, particularly in the context of airway obstruction due to tracheal tumors. Effective anesthesia management facilitated successful tumor removal, highlighting the critical role of comprehensive patient assessment and tailored interventions in improving respiratory function and outcomes."

Journal • Anesthesia • Oncology • Pulmonary Disease

Effects of remimazolam on hemodynamics in children with congenital heart disease undergoing cardiac catheterization. (PubMed, Front Pharmacol) - "No adverse reactions such as bradycardia, hypotension, or hypertension were observed after intravenous injection of remimazolam. During sevoflurane-maintained anesthesia, co-administration of remimazolam provides good hemodynamic stability for children with left-to-right shunt congenital heart disease undergoing cardiac catheterization."

Journal • Anesthesia • Cardiovascular • CNS Disorders • Depression • Heart Failure • Hypertension • Hypotension • Psychiatry

Anesthetic induction drugs during tracheal intubation in critically ill patients: a systematic review. (PubMed, J Anesth) - "This review found limited evidence on the hemodynamic effects of anesthetic agents other than etomidate during tracheal intubation in critically ill patients. Standardized definitions and high-quality research are needed to better characterize post-induction hypotension and determine the safest anesthetic combinations."

Intubation • Journal • Anesthesia • Endocrine Disorders • Hypotension • Nephrology • Renal Disease

SERENE: Sedation During Endoscopy Using Remimazolam: Efficacy in a Novel Exploration (clinicaltrials.gov) - P3 | N=100 | Not yet recruiting | Sponsor: Massachusetts General Hospital

New P3 trial • Anesthesia

Anesthetic Management Using Remimazolam for Dental Treatment in a Pediatric Patient With Dravet Syndrome. (PubMed, Anesth Prog) - "After a slow mask induction with sevoflurane, RMZ, remifentanil, and rocuronium were administered to facilitate oral intubation, after which general anesthesia was maintained with air, oxygen, and continuous infusions of RMZ and remifentanil. Intraoperative temperature and other vital signs were stable, and no fever or convulsions were observed during the perioperative period. RMZ is an ultrashort-acting benzodiazepine that may be useful for the anesthetic management of pediatric patients with DS because of its potential to prevent seizures."

Journal • Anesthesia • CNS Disorders • Epilepsy • Pediatrics

Does Propofol-based or Remimazolam-based Anesthesia Impact the Incidence of Postoperative Nausea and Vomiting When Used In Combination With Prophylactic Dexamethasone and Ondansetron? (PubMed, Anesth Prog) - "The incidence of PONV during 24 hours after orthognathic surgery was not significantly different when using remimazolam-based anesthesia vs propofol-based anesthesia in combination with dexamethasone and ondansetron. There were also no significant differences in the severity of PONV or the quality of recovery between the 2 groups."

Clinical • Journal • Anesthesia • Orthopedics

Efficacy and Safety of Remimazolam versus Dexmedetomidine and Midazolam in Awake Endotracheal Intubation for Difficult Airway Patients: A Randomized Controlled Study. (PubMed, Drug Des Devel Ther) - "All patients first received 0.1μg/kg of sufentanil intravenously for basic analgesia. Remimazolam provides effective sedation for awake tracheal intubation in patients with difficult airways. It exerts minimal impact on respiratory and circulatory function, is associated with fewer adverse events, and yields a higher intubation success rate, making it a favorable option for this patient population."

Clinical • Intubation • Journal • Anesthesia • Pain

Remimazolam compared to dexmedetomidine on the incidence of hypotension in middle aged and elderly patients undergoing general anesthesia: a systematic review and meta-analysis. (PubMed, BMC Anesthesiol) - "Remimazolam and dexmedetomidine did not differ significantly in intraoperative hypotension, intraoperative hypertension, or postoperative nausea and vomiting in middle-aged and elderly patients. Remimazolam reduced the incidence of bradycardia. In contrast, dexmedetomidine had an advantage in reducing intraoperative tachycardia. These findings support individualized anesthetic selection based on patients' specific cardiovascular risk profiles."

Journal • Retrospective data • Review • Anesthesia • Cardiovascular • Hypertension • Hypotension

Comparison of Emergence Agitation Between Remimazolam With Flumazenil and Propofol-based Total Intravenous Anesthesia in Patients Undergoing Nasal Surgery (clinicaltrials.gov) - P=N/A | N=204 | Not yet recruiting | Sponsor: Seoul National University Hospital

New trial • Anesthesia • Otorhinolaryngology

Effects of penehyclidine hydrochloride or droperidol combined with dexamethasone on preventing postoperative nausea and vomiting after remimazolam-alfentanil general anesthesia for gynecological day surgery. (PubMed, BMC Anesthesiol) - No abstract available

Journal • Anesthesia

Remimazolam vs Midazolam to Reduce Delirium in Adults ≥65 Undergoing CPB Valve Surgery (clinicaltrials.gov) - P4 | N=300 | Not yet recruiting | Sponsor: Yonsei University

New P4 trial • Cardiovascular • CNS Disorders

Effective remimazolam induction dose in paediatric same-day bidirectional endoscopy: A biased coin up and down sequential trial. (PubMed, Br J Clin Pharmacol) - P=N/A | "In the induction of anaesthesia for same-day BDE, combined with 0.5 μg/kg of remifentanil, the younger the age, the higher the dose of sedative medication required. The ED90 of remimazolam was 0.67 mg/kg [90% confidence interval (CI), 0.66-0.76] in preschool children and 0.45 mg/kg (90% CI, 0.42-0.59) in school children."

Journal • Anesthesia • Pain • Pediatrics

Association between a remimazolam-propofol combination for maintenance of anesthesia and extubation time: a propensity score analysis. (PubMed, JA Clin Rep) - "Extubation time with combined remimazolam and propofol was comparable to that with remimazolam alone, and both were shorter than that with propofol alone."

Journal • Anesthesia • Cardiovascular • Hypotension

Remimazolam in elderly patients undergoing EBUS-TBNA: protocol for a randomized clinical trial. (PubMed, Int J Surg Protoc) - "Remimazolam demonstrated accelerated Steward recovery and enhanced hemodynamic stability, whereas propofol exhibited risks of adipose tissue deposition and hypotension. These pharmacodynamic profiles inform anesthetic optimization in geriatric cohorts, necessitating multicenter validation of age-adjusted protocols."

Clinical • Journal • Anesthesia • Geriatric Disorders • Hypotension

ED90 of Remimazolam Anesthesia Induction in Painless Bidirectional Endoscopy in Children (clinicaltrials.gov) - P=N/A | N=165 | Completed | Sponsor: Tongji Hospital | N=114 ➔ 165

Enrollment change • Anesthesia • Pain