{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:10:43Z","timestamp":1790143843121,"version":"4.0.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012175","name":"Zhejiang Traditional Chinese Medicine Administration","doi-asserted-by":"publisher","award":["2025ZX042"],"award-info":[{"award-number":["2025ZX042"]}],"id":[{"id":"10.13039\/501100012175","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine the 90% effective dose (ED\n                      <jats:sub>90<\/jats:sub>\n                      ) of remimazolam in combination with sufentanil for sedation in patients undergoing gastroscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifty-six patients aged 18\u201365 years with ASA physical status I\u2013II and a BMI of 18\u201330\u2005kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      who were scheduled for gastroscopy were enrolled. All patients received 5\u2005\u03bcg of sufentanil, followed 3\u2005min later by an initial dose of 5\u2005mg remimazolam. The dose was determined using a two-stage biased-coin design up-and-down sequential method, with each patient's dose based on the response of the preceding patient. Dose adjustments were made in 2.5\u2005mg increments. For failure of sedation (negative response: coughing, body movement, or MOAA\/S\u2009&amp;gt;\u20091 during pharyngeal passage), the dose for the next patient was increased deterministically by 2.5\u2005mg; for success of sedation (positive response: MOAA\/S\u2009\u2264\u20091), the dose was decreased with 11% probability or kept unchanged with 89% probability. ED\n                      <jats:sub>90<\/jats:sub>\n                      and its 95% confidence interval (CI) were estimated using isotonic regression with bootstrap resampling. The incidence of adverse events during sedation was recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ED\n                      <jats:sub>90<\/jats:sub>\n                      of remimazolam combined with 5\u2005\u03bcg of sufentanil was 17.625\u2005mg (95% CI: 15.467\u201320.000\u2005mg). Six patients experienced coughing, and seven developed transient hypotension during sedation. No other adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The ED\n                      <jats:sub>90<\/jats:sub>\n                      of remimazolam combined with sufentanil for gastroscopy sedation was 17.625\u2005mg, with a low incidence of adverse events. These results provided a clinically relevant dosing benchmark for this promising drug combination.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1929896","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:50:11Z","timestamp":1790142611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The 90% effective dose of remimazolam in combination with sufentanil for sedation in patients undergoing gastroscopy"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Zhuji People\u2019s Hospital of Zhejiang Province","place":["Zhuji, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Zhuji People\u2019s Hospital of Zhejiang 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