Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2024; 12(6): 1120-1129
Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1120
Efficacy and safety of remimazolam in bronchoscopic sedation: A meta-analysis
Ying Zhou, Cheng Zhao, Yi-Xun Tang, Ji-Tong Liu
Ying Zhou, Yi-Xun Tang, Ji-Tong Liu, Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410005, Hunan Province, China
Cheng Zhao, Department of Anesthesiology, Zhangjiajie People's Hospital, Zhangjiajie 427000, Hunan Province, China
Author contributions: Zhou Y and Liu JT conducted the systematic review and data collection and proposed an explanation that played an important role in the writing of the paper; Zhao C and Tang YX evaluated and verified the manuscript; Tang YX analyzed the data and reviewed the article; Liu JT developed the concept of reviewing papers and supervised, critically evaluated, and confirmed the manuscript; This article was written and approved by all authors.
Supported by the Fund of the Hunan Provincial Health Commission, No. D20230416797.
Conflict-of-interest statement: The authors claim that the survey did not involve any business or financial links that could be interpreted as potential conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised in accordance with this checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ji-Tong Liu, MD, Chief Doctor, Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), No. 61 Jiefang East Road, Wucheng District, Changsha 410005, Hunan Province, China.
Received: December 12, 2023
Peer-review started: December 12, 2023
First decision: January 2, 2024
Revised: January 14, 2024
Accepted: January 27, 2024
Article in press: January 27, 2024
Published online: February 26, 2024
Research background

Remimazolam is a new ultra-short-acting benzodiazepine sedative that is currently used for procedural sedation and general anesthesia. Several studies have used remimazolam for bendable bronchoscopes.

Research motivation

This is the first systematic review on the safety and efficacy of remimazolam during bronchoscopy.

Research objectives

This study aimed to assess the safety and efficacy of remimazolam for the sedation of patients undergoing bendable bronchoscopy.

Research methods

We searched databases of EMBASE, PubMed, Cochrane Library, and the Web of Science, from the original to August 2023. The search terms include "Remimazolam" or "CNS 7056", search scope was "Title and Abstract". The search was limited to human studies and literature in English.

Research results

This meta-analysis included five studies. The sedation success rate of remimazolam was similar to that of conventional sedatives (CS). However, remimazolam is associated with a lower incidence of hypotension and respiratory depression. The subgroup analysis showed a higher success rate for sedation with remimazolam than with midazolam. The incidences of hypotension, respiratory depression, hypoxemia, and injection pain were lower with remimazolam than with propofol.

Research conclusions

Remimazolam is safe and effective for bronchoscopic sedation. The success rate was similar to that of CS. However, remimazolam has a higher safety profile, with fewer inhibitory effects on respiration and circulation.

Research perspectives

Endoscopic surgery outside the operating room is currently increasing, and anesthesia provides strong support for the development of endoscopic surgery. The use of remimazolam can fulfill sedation requirements during bronchoscopic procedures while reducing the incidence of intraoperative adverse events and complications.