{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:41:13Z","timestamp":1790185273889,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Remimazolam, a new ultra\u2010short\u2010acting benzodiazepine, is a safe and effective option for procedural sedation. Nevertheless, to date, no study has directly compared remimazolam and midazolam in diagnostic upper gastrointestinal endoscopy. This study aimed to evaluate the efficacy and safety of remimazolam compared with those of midazolam in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, single\u2010blind, randomized, positive\u2010control, superiority, investigator\u2010initiated phase III trial enrolled patients who were scheduled to undergo diagnostic upper gastrointestinal endoscopy at seven academic teaching hospitals from April 2023 to January 2024. Participants were randomly assigned to receive remimazolam or midazolam (1:1 ratio). The primary endpoint was total procedure time, defined as the duration from the first sedative administration to discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 133 randomized patients, 132 (remimazolam group,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a066; midazolam group,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a066) underwent upper endoscopy with sedation. The total procedure time was significantly shorter in the remimazolam group (30.3 vs. 48.5\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Sedation\u2010related times (i.e.,\u00a0induction, sedation, recovery, and discharge times) were also significantly shorter in the remimazolam group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The incidence of adverse events did not significantly differ between the groups; however, the incidence rates of hypotension, bradycardia, and paradoxical reactions were lower in the remimazolam group. When compared to previous sedation experiences, patient satisfaction was higher in the remimazolam group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with midazolam, the use of remimazolam in diagnostic upper gastrointestinal endoscopy allows for faster sedation induction and recovery, more rapid discharge, and higher patient satisfaction compared with previous sedation experiences, while maintaining a safety profile similar to that of midazolam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      (NCT05836545)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70147","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:04:51Z","timestamp":1764000291000},"source":"Crossref","is-referenced-by-count":6,"title":["Remimazolam Enables Faster Sedation Induction and Recovery Compared With Midazolam in Diagnostic Upper Gastrointestinal Endoscopy: A Multicenter Randomized Controlled Trial"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8811-0631","authenticated-orcid":false,"given":"Yehyun","family":"Park","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Ewha Womans University Seoul Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2694-3598","authenticated-orcid":false,"given":"Jun Kyu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dongguk University College of Medicine Dongguk University Ilsan Hospital  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2898-6233","authenticated-orcid":false,"given":"Kwang Hyuck","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-9034","authenticated-orcid":false,"given":"Taejun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1913-4346","authenticated-orcid":false,"given":"Sun Hyung","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Chungnam National University School of Medicine  Daejeon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6641-2177","authenticated-orcid":false,"given":"Dong\u2010Won","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Boramae Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8447-2176","authenticated-orcid":false,"given":"Sung Bum","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yeungnam University 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