{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:06:38Z","timestamp":1778997998855,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"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":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Emergence delirium commonly occurs in pediatric patients after general anesthesia, causing distress and potential harm. Remimazolam, an ultra\u2010short\u2010acting benzodiazepine, has recently been introduced in pediatric anesthesia, but its preventive role against emergence delirium remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n This systematic review with meta\u2010analysis evaluated the effect of remimazolam on the incidence and severity of emergence delirium in children undergoing general anesthesia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n PubMed, EMBASE, CENTRAL, Scopus, Web of Science, and Google Scholar were searched for relevant studies. The primary outcome was the incidence of emergence delirium. Secondary outcomes included Pediatric Anesthesia Emergence Delirium score, incidence of hypotension and bradycardia, extubation time, postanesthesia care unit stay, and postoperative nausea and vomiting incidence. Relative risks (RR) or mean difference (MD) with 95% confidence intervals (CI) were calculated using a random\u2010effects model.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ten randomized controlled trials involving 1231 children were included. Remimazolam significantly reduced the incidence of emergence delirium (RR 0.38, 95% CI 0.23\u20130.63;\n p<\/jats:italic>\n \u2009=\u20090.0002) and Pediatric Anesthesia Emergence Delirium score (MD \u22121.70, 95% CI \u22122.77 to \u22120.63;\n p<\/jats:italic>\n \u2009=\u20090.0019). It also decreased bradycardia (RR 0.39, 95% CI 0.21\u20130.70;\n p<\/jats:italic>\n \u2009=\u20090.0018). Although the overall incidence of hypotension did not differ significantly (RR 0.35,\n p<\/jats:italic>\n \u2009=\u20090.0991), subgroup analysis showed a lower incidence with remimazolam than with propofol (RR 0.14,\n p<\/jats:italic>\n \u2009=\u20090.0376). Overall extubation time was comparable (MD \u22120.75,\n p<\/jats:italic>\n \u2009=\u20090.5088), but shorter with remimazolam than propofol (MD \u22123.36,\n p<\/jats:italic>\n \u2009<\u20090.0001). No significant differences were found in postanesthesia care unit stay or postoperative nausea and vomiting.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Remimazolam may reduce the incidence and severity of emergence delirium in children after general anesthesia, without affecting hemodynamic stability or recovery time.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n PROSPERO: CRD420251236789<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pan.70162","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T13:55:59Z","timestamp":1772978159000},"page":"628-640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of Remimazolam Administration on Emergence Delirium in Children After General Anesthesia: A Systematic Review With Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7723-6219","authenticated-orcid":false,"given":"Ji\u2010Na","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Bundang Hospital Seongnam Gyeonggi Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0986-3243","authenticated-orcid":false,"given":"Hyo\u2010Seok","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Bundang Hospital Seongnam Gyeonggi Republic of Korea"},{"name":"Department of Anesthesiology and Pain Medicine Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0991-7061","authenticated-orcid":false,"given":"Hyun\u2010Jung","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Bundang Hospital Seongnam Gyeonggi Republic of Korea"},{"name":"Department of Anesthesiology and Pain Medicine Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_8_2_1","article-title":"Incidence of Emergence Delirium in the Pediatric PACU: Prospective Observational Trial","volume":"9","author":"Klabusayova E.","year":"2022","journal-title":"Children (Basel)"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-024-02889-w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2017.07.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5114\/ait\/210611"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-4-38"},{"key":"e_1_2_8_10_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J.","year":"2023"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005077"},{"key":"e_1_2_8_12_1","first-page":"2728","article-title":"Comparison of the Effects of General Anesthesia Between Remimazolam and Propofol in Pediatric Patients Undergoing Binocular Strabismus Day Surgery","volume":"104","author":"Chen H. Y.","year":"2024","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_2_8_13_1","first-page":"1098","article-title":"Application of Remimazolam in Pediatric Adenoidectomy and Tonsillectomy Anesthesia and Its Effect on Emergence Agitation","volume":"56","author":"Cheng Y.","year":"2025","journal-title":"Sichuan Da Xue Xue Bao. Yi Xue Ban"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16475"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2025.2500438"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/anrp\/7780635"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2025.101423"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-03050-w"},{"key":"e_1_2_8_19_1","first-page":"362","article-title":"Effect of Remimazolam on Emergence Agitation in Children Undergoing Tooth Decay Treatment After Sevoflurane Anesthesia","volume":"43","author":"Tao M. O.","year":"2023","journal-title":"Journal of Xuzhou Medical University"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S381611"},{"key":"e_1_2_8_21_1","first-page":"73","article-title":"Emergence Agitation and Delirium: Considerations for Epidemiology and Routine Monitoring in Pediatric Patients","volume":"13","author":"Menser C.","year":"2020","journal-title":"Regional Anesthesia and Pain Medicine"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1349105"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.23953"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.52965\/001c.24514"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70162","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70162","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:07:49Z","timestamp":1778994469000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/pan.70162"],"URL":"https:\/\/doi.org\/10.1002\/pan.70162","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]},"assertion":[{"value":"2025-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}