{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:02:15Z","timestamp":1773032535311,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Remimazolam is a benzodiazepine receptor agonist intravenous anesthetic. This study aimed to evaluate the efficacy and safety of remimazolam for sedation during gastrointestinal endoscopy using real\u2010world clinical data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study included 352 patients who underwent esophagogastroduodenoscopy or colonoscopy sedated with remimazolam between January and February 2024 at our institution. Outcomes included the incidence of awakening during procedures, the sedation completion rate, and the incidence and severity of adverse events. Multivariate logistic regression analyses identified factors associated with hypoxia and hypotension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median patient age was 67\u2009years (IQR: 58\u201374), and 62.2% were male. Median initial and additional doses were 3 (IQR: 2\u20133\u2009mg) and 1\u2009mg (IQR: 0\u20132\u2009mg). Awakening occurred in 19.0% of patients. The sedation completion rate was 100%. Adverse events included hypotension (7.8%), hypoxia (13.1%), and bradycardia (4.0%), and no serious adverse events were observed. The only risk factor for hypoxia was advanced age (Odds ratio 1.04, 95% confidence interval: 1.01\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and the dose of remimazolam itself was not an independent risk factor for either hypoxia or hypotension.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Remimazolam usage for gastrointestinal endoscopic sedation showed a favorable safety profile. Advanced age was associated with an increased risk of hypoxia, suggesting that careful monitoring and individualized sedation protocols are especially necessary for elderly patients. On the other hand, there are still issues regarding the duration of sedation. During long procedures, it is necessary to frequently check the depth of sedation to avoid undersedation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70351","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:40:03Z","timestamp":1771306803000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Evaluation of Remimazolam for Sedation During Gastrointestinal Endoscopy: Efficacy, Safety, and Risk Factors"],"prefix":"10.1002","volume":"10","author":[{"given":"Hinako","family":"Sakurai","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurato","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoki","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Oowada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misaki","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Kubo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Mizobe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai","family":"Katsumi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Imura","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoma","family":"Murata","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Minezaki","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"},{"name":"Department of Gastroenterology Oita University Faculty of Medicine  Oita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Iwata","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"},{"name":"Division of Gastroenterology and Hepatology Saitama City Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Tojo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teppei","family":"Masunaga","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumiko","family":"Kirita","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari","family":"Mizutani","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4259-3583","authenticated-orcid":false,"given":"Michiko","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"},{"name":"Department of Gastroenterological Oncology Hyogo Cancer Center  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusaku","family":"Takatori","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teppei","family":"Akimoto","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideomi","family":"Tomida","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"},{"name":"Endoscopy Center Ehime University Hospital  Ehime Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohisa","family":"Sujino","sequence":"additional","affiliation":[{"name":"Department of Multidimensional Analysis of Gastrointestinal Biology, Sakaguchi Laboratory Keio University School of Medicine  Tokyo Japan"},{"name":"Keio Global Research Institute Keio University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaoru","family":"Takabayashi","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanai","family":"Takanori","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohisa","family":"Yahagi","sequence":"additional","affiliation":[{"name":"Division of Research and Development for Minimally Invasive Treatment, Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motohiko","family":"Kato","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13882"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14365"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.17085\/apm.21115"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000267503.85085.c0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-020-02788-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318241f68a"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S384155"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.15030"},{"key":"e_1_2_10_10_1","article-title":"Efficacy of Remimazolam Versus Midazolam for Procedural Sedation: Post Hoc Integrated Analyses of Three Phase 3 Clinical Trials","volume":"10","author":"Dao V. A.","year":"2022","journal-title":"Endoscopy International Open"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5847\/wjem.j.1920-8642.2023.020"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.04.001"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.08.062"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000548"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.04.2351"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15188"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.655042"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2020.10.039"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v22i2.44"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000638"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14948"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-025-02519-1"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.412"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.70100"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14758"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.70057"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1159\/000540527"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70351","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.70351","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:11:00Z","timestamp":1773029460000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.70351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jgh3.70351"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.70351","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70351"}}