{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T13:42:21Z","timestamp":1794490941834,"version":"4.9.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A novel short-acting benzodiazepine, Remimazolam, has recently been approved for general anesthesia and sedation. Hence, we investigated the feasibility and safety of remimazolam during the induction and maintenance of general anesthesia without using a neuromuscular blocking agent (NMBA) in patients undergoing hysteroscopic surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This prospective observational study included 38 patients undergoing hysteroscopic surgery. Remimazolam and remifentanil were the main anesthetic agents without an NMBA, and a supraglottic airway was inserted to protect the airway. The induction time, amount of each anesthetic agent used during anesthesia, intraoperative bispectral index (BIS) hemodynamic parameters, and recovery profiles were measured.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>General anesthesia was successfully administered to 37 patients using remimazolam and remifentanil without NMBA. The induction doses of remimazolam and remifentanil were 0.4\u00a0mg\/kg (interquartile range [IQR] 0.34\u20130.47\u00a0mg\/kg) and 1.07\u00a0\u03bcg\/kg (IQR, 0.90\u20131.29\u00a0\u03bcg\/kg), respectively. Additionally, the maintenance doses of remimazolam and remifentanil were 1.14\u00a0mg\/kg\/h (IQR, 0.88\u20131.55\u00a0mg\/kg\/h) and 0.06\u00a0\u03bcg\/kg\/min (IQR, 0.04\u20130.08\u00a0\u03bcg\/kg\/min), respectively. Intraoperative BIS values had risen temporarily\u2009&gt;\u200960 in eight patients (21.6%) despite administration of 2\u00a0mg\/kg\/h of remimazolam; thus, they were treated with supplementary midazolam. The median recovery time was 7\u00a0min (IQR, 5\u20138\u00a0min) after 40\u00a0min (IQR, 40.0\u201357.5\u00a0min) of total mean anesthesia time. There was no correlation between the infusion dose of remimazolam and recovery profiles, such as recovery time, final BIS of anesthesia, modified observer assessment of alertness\/sedation (OAA\/S) scale or post-anesthesia recovery (PAR) score when arriving at the PACU, and length of stay in the PACU (all <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Remimazolam can be combined with remifentanil without an NMBA in female patients who undergo hysteroscopic surgery, during which a supraglottic airway is a feasible method to protect the airway.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The study protocol was registered at ClinicalTrials.gov (NCT05025410) on 27\/08\/2021.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-022-01779-2","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T07:02:48Z","timestamp":1658818968000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Total intravenous anesthesia induced and maintained by a combination of remimazolam and remifentanil without a neuromuscular blocking agent: a prospective, observational pilot study"],"prefix":"10.1186","volume":"22","author":[{"given":"Insun","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mincheul","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Woo","family":"Nam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Won","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hwan","family":"Do","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Seok","family":"Na","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,26]]},"reference":[{"key":"1779_CR1","doi-asserted-by":"publisher","first-page":"95","DOI":"10.2147\/TCRM.S304556","volume":"18","author":"Y Morimoto","year":"2022","unstructured":"Morimoto Y. Efficacy and safety profile of remimazolam for sedation in adults undergoing short surgical procedures. Ther Clin Risk Manag. 2022;18:95\u2013100.","journal-title":"Ther Clin Risk Manag"},{"issue":"2","key":"1779_CR2","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1213\/ANE.0b013e31823f0c28","volume":"115","author":"LJ Antonik","year":"2012","unstructured":"Antonik LJ, et al. A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part I. Safety, efficacy, and basic pharmacokinetics. Anesth Analg. 2012;115(2):274\u201383.","journal-title":"Anesth Analg"},{"issue":"1","key":"1779_CR3","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/01.anes.0000267503.85085.c0","volume":"107","author":"GJ Kilpatrick","year":"2007","unstructured":"Kilpatrick GJ, et al. CNS 7056: a novel ultra-short-acting Benzodiazepine. 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After obtaining written informed consent, we recruited patients for the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"237"}}