{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:19:44Z","timestamp":1787854784311,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"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":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sedation during colonoscopy is becoming increasingly important. Remimazolam, an ultra\u2010short\u2010acting benzodiazepine, has a shorter pharmacokinetic half\u2010life than that of midazolam. This study examined whether remimazolam provides superior sedation during colonoscopy in Japanese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, multicenter, randomized, single\u2010blind, controlled trial included adults (18\u201380\u2009years) scheduled for sedated colonoscopy. Participants were randomized to the remimazolam and midazolam groups. The primary outcome was the proportion of ambulatory patients 5\u2009min after colonoscopy. Secondary outcomes were successful pre\u2010procedure sedation (Modified Observer's Assessment of Alertness\/Sedation [MOAA\/S] \u2264\u20094), recovery time, total sedative dose, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty patients were enrolled and analyzed (remimazolam,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919; midazolam,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921). At 5\u2009min post\u2010colonoscopy, ambulation was achieved in 100% (19\/19) of remimazolam patients and 19.1% (4\/21) of midazolam patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The median time [interquartile range (IQR)] from procedure end to full alertness (MOAA\/S\u2009=\u20095) was 0 [0\u20130] min for remimazolam and 10 [5\u201320] min for midazolam (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The median time [IQR] from procedure end to independent ambulation was 0 [0\u20135] min for remimazolam and 20 [10\u201330] min for midazolam (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pre\u2010procedure sedation was successful (MOAA\/S\u2009\u2264\u20094) in 100% of both groups. The median amount [IQR] of total sedative dose was 5 [4\u20136] mg for remimazolam and 3 [3] mg for midazolam. Hypoxemia occurred in 5.3% and 9.5% of patients in the remimazolam and midazolam groups, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with midazolam, remimazolam resulted in significantly faster recovery after colonoscopy in Japanese patients, with comparable achievement of target sedation and a low incidence of hypoxemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Registration<\/jats:title>\n                    <jats:p>Trial number: jRCTs071240062<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70130","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:55:45Z","timestamp":1772963745000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and Recovery of Remimazolam Versus Midazolam in Sedated Colonoscopy: A Multicenter Randomized Controlled Trial in Japan"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9782-9998","authenticated-orcid":false,"given":"Daisuke","family":"Yamaguchi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Saga University  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoji","family":"Ichijima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kawaguchi General Hospital  Kawaguchi Japan"},{"name":"Endoscopy Division National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9239-7495","authenticated-orcid":false,"given":"Hisatomo","family":"Ikehara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine Kitasato University School of Medicine  Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-9738","authenticated-orcid":false,"given":"Yosuke","family":"Minoda","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-2153","authenticated-orcid":false,"given":"Mitsuru","family":"Esaki","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical 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