{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:16:54Z","timestamp":1788542214006,"version":"build-2803163510"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"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. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There is lack research about the effect of sufentanil on the effective dose of remimazolam during general anesthesia in both elderly and non-elderly patients scheduled for day surgery. This study was conducted to estimate the 95% effective dose (ED95) of remimazolam with low dose of sufentanil for BIS &amp;lt;60 during general anesthesia in both elderly and non-elderly patients scheduled for day surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients scheduled for elective gynecological day procedures were randomly allocated to one of four dosage groups receiving 0.1, 0.2, 0.3, or 0.4\u00a0mg\/kg of remimazolam, with 25 participants per group. All patients received a concurrent intravenous dose of sufentanil (0.1\u00a0\u03bcg\/kg) during anesthesia induction. Successful sedation was defined as achieving a BIS score of &amp;lt;60 within 5\u00a0minutes of remimazolam administration. The ED50 and ED95 of remimazolam for BIS &amp;lt;60 during general anesthesia induction were calculated. Secondary outcomes included the incidence of hypotension, respiratory depression, and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In elderly patients, the estimated ED50 of remimazolam was determined to be 0.156\u00a0mg\/kg, with a 95% confidence interval (CI) ranging from 0.110 to 0.190\u00a0mg\/kg. For non-elderly individuals, the corresponding ED50 was 0.218\u00a0mg\/kg (95% CI: 0.179\u20130.253\u00a0mg\/kg). Additionally, the dose required to achieve 95% efficacy (ED95) was calculated as 0.336\u00a0mg\/kg (95% CI: 0.286\u20130.437\u00a0mg\/kg) in the elderly cohort and 0.418\u00a0mg\/kg (95% CI: 0.361\u20130.528\u00a0mg\/kg) in the non-elderly cohort. Hypotension occurred significantly more often in elderly patients (<jats:italic>P<\/jats:italic> &amp;lt; 0.05), but not for the incidence of bradycardia or respiratory depression between groups (<jats:italic>P<\/jats:italic> &amp;gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Under BIS monitoring during gynecological day surgery, the estimated ED95 of remimazolam with 0.1\u00a0\u03bcg\/kg sufentanil was 0.336\u00a0mg\/kg (95% CI: 0.286\u20130.437\u00a0mg\/kg) for elderly patients and 0.418\u00a0mg\/kg (95% CI: 0.361\u20130.528\u00a0mg\/kg) for non-elderly patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>This study is registered with <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link> as ChiCTR2400091138.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1692105","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T06:16:52Z","timestamp":1759904212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effective sedative dose of remimazolam for BIS &lt;60 during general anesthesia induction between elderly and non-elderly patients-A randomized controlled trial"],"prefix":"10.3389","volume":"16","author":[{"given":"Jun-Li","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-Feng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Ren","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Long","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Dong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Feng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/S0009-9236(99)90084-X","article-title":"The effect of age on the pharmacokinetics and pharmacodynamics of midazolam","volume":"65","author":"Albrecht","year":"1999","journal-title":"Clin. 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