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Observational Study
. 2025 Jan 29;25(1):41.
doi: 10.1186/s12876-025-03636-1.

Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single center observational study

Conigliaro Rita  1 , Pigò Flavia  2   3 , Caiazzo Anna  4 , Grande Giuseppe  1 , Russo Salvatore  1 , Cocca Silvia  1 , Lupo Marinella  1 , Marocchi Margherita  1 , Marsico Maria  1 , Sculli Simone  5 , Bertani Helga  1
Affiliations
Observational Study

Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single center observational study

Conigliaro Rita et al. BMC Gastroenterol. .

Abstract

Background and aim: Remimazolam has proved to be a very promising sedative drug in randomized clinical trials for usage in a wide spectrum of patients, including critically ill ones. The purpose of our study was to verify efficacy and safety of remimazolam for procedural sedation during diagnostic and first level operative endoscopy in a real-world setting.

Methods: This single centre prospective study evaluated sedation regimen with remimazolam for EGDS and fentanyl and remimazolam for colonoscopy in consecutive ASA 1-3 patients.

Results: Seventy-one patients underwent 73 procedures (25 EGDS, 48 colonoscopies) with a total amount of 13.2 ± 8.7 mg and 10.2 ± 6.2 mg of remimazolam administered respectively. In 6 EGDS, rescue sedation with propofol was needed. Transient hypotension was frequent (37%) and no cases of hypoxia occurred. One case of suspected allergy (erythema of the trunk) without anaphylaxis was reported.

Conclusions: Procedural sedation can be applied with remimazolam without the use of propofol, obtaining effective sedation in colonoscopies while in EGDS remimazolam alone guarantees the result in a percentage of around 70-75% of cases.

Keywords: Gastrointestinal endoscopy; Safety; Sedation.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the principles of the Declaration of Helsinki. the study was reviewed and approved in 2024, December 23th (protocol 432/2023/OSS*/AOUMO) by the Ethical Committee (Comitato Etico Area Vasta Emilia Nord, Modena, Italy). A signed informed consent was obtained for sedation before any clinical investigation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Pre-procedural, intra-procedural, post-procedural and recovery room registrations of patients’ blood pressure (a), oxygen saturation (b), heart rate (c), respiratory rate (d), and Ramsay scale (e) during the procedures
See this image and copyright information in PMC

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