Clinical profile of a new anesthetic: remimazolam
Clinical profile of a new anesthetic: remimazolam
- 조선대학교 의학연구원
- Medical Biological Science and Engineering
- 제6권 제1호
- : KCI등재
- 2023.01
- 1 - 7 (7 pages)
Remimazolam is a novel ultrashort-acting benzodiazepine that acts on g-aminobutyric acid A receptor. It has been approved for use as a general anesthetic and sedative. This medication is recommended for inducing and maintaining anesthesia using continuous intravenous infusion; however, bolus dosing of remimazolam can also be adopted. Continuous intravenous infusion should be started at a rate of 6 or 12 mg/kg/h until loss of consciousness is achieved. Subsequently, this infusion rate should be decreased at a rate of 1 mg/kg/h as appropriate to maintain proper anesthetic depth (maximum allowable rate, 2 mg/kg/h). These recommended doses show more stable hemodynamics than those of propofol. The clinical profiles of anesthesia induction and maintenance are comparable between remimazolam and propofol. Although remimazolam has a slightly longer anesthetic induction time than propofol, the results are not inferior to each other. Recovery profiles show somewhat contradictory results, but the effects of remimazolam and propofol are comparable. Whether the bispectral index or other anesthetic depth indices are suitable for monitoring the sedative effect of remimazolam remains controversial. The appropriate ranges of electroencephalography (EEG) indices for remimazolam are unclear, but it has higher EEG indices than propofol. Thus, co-administration of opioids with a low dose of remimazolam is recommended to maintain the appropriate ranges for patients. Despite the favorable effects of remimazolam, the risk of re-sedation should always be considered after remimazolam reversal, especially when using flumazenil. Thus, remimazolam is considered comparable with propofol for inducing general anesthesia.
INTRODUCTION
CLINICAL DOSES OF REMIMAZOLAM
CLINICAL PROFILE OF REMIMAZOLAM FOR GENERAL ANESTHESIA
MONITORING OF ANESTHETIC DEPTH DURING REMIMAZOLAM INFUSION
CONSIDERABLE ADVERSE EVENTS RELATED TO REMIMAZOLAM
CONCLUSION
CONFLICT OF INTEREST
REFERENCES