{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:46:30Z","timestamp":1782283590345,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastrointestinal endoscopy serves as a key tool for diagnosing and treating digestive disorders. Adequate sedation is indispensable in achieving ideal surgical outcomes and promoting patient comfort. Recently, remimazolam has been utilized more frequently because of its good safety features, brief action time and rapid onset. This study aims to systematically review and meta-analyze remimazolam\u2019s effectiveness and safety profile in sedating patients undergoing gastrointestinal endoscopies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted literature searches in Embase, PubMed, and the Cochrane Library databases, covering the period from the establishment of each database to January 31, 2026 for all relevant CCTs and RCTs that discussed remimazolam sedation for gastrointestinal endoscopy. RevMan software (version 5.4) was employed for all statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight trials involving 2,455 patients were included. In cardiovascular outcomes, remimazolam was linked to a significantly lower hypotension (RR\u202f=\u202f0.59; 95% CI: 0.43\u20130.81) and bradycardia (RR\u202f=\u202f0.42; 95% CI: 0.25\u20130.71) risks compared with midazolam and propofol. For respiratory adverse events, remimazolam demonstrated notably reduced rates of apnea (RR\u202f=\u202f0.51; 95% CI: 0.30\u20130.88), oxygen desaturation (RR\u202f=\u202f0.20; 95% CI: 0.08\u20130.52) and diminished respiratory compromise (RR\u202f=\u202f0.45; 95% CI: 0.23\u20130.87). Regarding patient comfort, remimazolam significantly reduced injection-related pain (RR\u202f=\u202f0.20; 95% CI: 0.06\u20130.66).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Remimazolam may confer a favorable safety profile for procedural sedation in adults receiving gastrointestinal endoscopies. It could serve as a reliable and effective alternative to conventional sedatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1811767","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:47:25Z","timestamp":1782280045000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of remimazolam for sedation in gastrointestinal endoscopy: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuxiao","family":"Kong","sequence":"first","affiliation":[{"name":"School of Anesthesiology, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anqi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Anesthesiology, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxia","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1097\/ALN.0000000000004851","article-title":"Remimazolam dosing for gastroscopy: a randomized noninferiority trial","volume":"140","author":"Zhu","year":"2024","journal-title":"Anesthesiology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.gie.2017.07.018","article-title":"Guidelines for sedation and anesthesia in GI endoscopy","volume":"87","author":"Early","year":"2018","journal-title":"Gastrointest 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Multicenter randomized controlled trial","volume":"14","author":"Park","year":"2026","journal-title":"United European Gastroenterol J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1016\/j.gie.2025.11.002","article-title":"Comparative safety and efficacy of remimazolam versus propofol for endoscopic retrograde cholangiopancreatography with the patient under deep sedation: a multicenter randomized controlled trial","volume":"103","author":"Han","year":"2025","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1007\/s11096-024-01774-2","article-title":"Effectiveness and safety of remimazolam tosilate versus propofol for sedation in patients undergoing gastrointestinal endoscopy: a randomized controlled trial","volume":"46","author":"Li","year":"2024","journal-title":"Int J Clin Pharm"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"76","DOI":"10.22514\/sv.2024.085","article-title":"Efficacy and safety of remimazolam besylate in patients with obesity undergoing painless colonoscopy: a prospective, double-blind, randomized controlled trial","volume":"20","author":"Deng","year":"2024","journal-title":"Signa Vitae"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.gie.2024.04.001","article-title":"Safety and efficacy of remimazolam versus propofol during EUS: a multicenter randomized controlled study","volume":"100","author":"Choe","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"900723","DOI":"10.3389\/fphar.2022.900723","article-title":"Safety and efficacy of remimazolam besylate in patients undergoing colonoscopy: a multicentre, single-blind, randomized, controlled, phase III trial","volume":"13","author":"Wang","year":"2022","journal-title":"Front 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trial","volume":"18","author":"Wei","year":"2023","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1016\/j.bja.2024.02.005","article-title":"Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis","volume":"132","author":"Barbosa","year":"2024","journal-title":"Br J Anaesth"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s40265-020-01299-8","article-title":"Remimazolam: first approval","volume":"80","author":"Keam","year":"2020","journal-title":"Drugs"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"457","DOI":"10.4097\/kja.22692","article-title":"Remimazolam: another option for induction of general anesthesia?","volume":"75","author":"Lee","year":"2022","journal-title":"Korean J 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Rep"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"938940","DOI":"10.3389\/fmed.2022.938940","article-title":"The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: a randomized trial","volume":"9","author":"Qiu","year":"2022","journal-title":"Front Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1097\/EJA.0000000000001701","article-title":"Effect of remimazolam versus propofol sedation on the quality of recovery after colonoscopy: a randomised, controlled, noninferiority trial","volume":"39","author":"Guo","year":"2022","journal-title":"Eur J Anaesthesiol"}],"container-title":["Frontiers in 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