{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:07:56Z","timestamp":1790028476234,"version":"4.0.1"},"reference-count":70,"publisher":"MDPI AG","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":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Remimazolam is an ultra-short-acting benzodiazepine developed according to the \u201csoft drug\u201d concept and characterized by rapid onset, predictable offset, organ-independent metabolism, and the availability of a specific antagonist. Due to these pharmacological features, this drug represents a particularly attractive option for pediatric anesthesia and sedation, a field in which traditional agents are often limited by hemodynamic instability, prolonged recovery, and adverse respiratory effects. This narrative review summarizes and discusses the current evidence regarding the use of remimazolam in pediatric patients, focusing on pharmacokinetics, pharmacodynamics, clinical applications, and safety. Available data indicate that remimazolam provides effective sedation and anesthesia in children across multiple settings, including induction of general anesthesia, non-operating room anesthesia, and intensive care unit sedation. Compared with propofol and midazolam, remimazolam is generally associated with greater hemodynamic stability, rapid recovery, reduced emergence delirium, and a favorable respiratory profile, while maintaining comparable efficacy. Intranasal administration has also shown promise as a premedication strategy for reducing preoperative anxiety, although it may occasionally be associated with pain. Even if remimazolam lacks intrinsic analgesic properties, its use appears to indirectly improve postoperative comfort by attenuating stress responses and emergence agitation. Despite encouraging results, pediatric use of remimazolam remains off-label in many countries, and evidence is still limited by small sample sizes and heterogeneous protocols. Further large-scale randomized controlled trials are needed to define optimal dosing strategies, long-term safety, and their definitive role in pediatric anesthetic and sedative practice.<\/jats:p>","DOI":"10.3390\/children13030348","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:52:38Z","timestamp":1772207558000},"page":"348","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Advantages of Remimazolam in Pediatric Anesthesia: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-3765","authenticated-orcid":false,"given":"Alessandro","family":"Vittori","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, ARCO, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Di Fabio","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences (MeSVA), University of L\u2019Aquila, Piazzale Salvatore Tommasi 1, Blocco 11, 67010 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1732-2391","authenticated-orcid":false,"given":"Elisa","family":"Francia","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, ARCO, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6484-8436","authenticated-orcid":false,"given":"Ilaria","family":"Mascilini","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, ARCO, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-635X","authenticated-orcid":false,"given":"Riccardo","family":"Tarquini","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, ARCO, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Cecchetti","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, ARCO, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6100-1371","authenticated-orcid":false,"given":"Giuliano","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Surgery Unit, Bios Medical Center, Via Domenico Chelini 39, 00197 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4931-7717","authenticated-orcid":false,"given":"Franco","family":"Marinangeli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences (MeSVA), University of L\u2019Aquila, Piazzale Salvatore Tommasi 1, Blocco 11, 67010 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5613-912X","authenticated-orcid":false,"given":"Teresa","family":"Grimaldi Capitello","sequence":"additional","affiliation":[{"name":"Clinical Psychology Unit, Department of Neuroscience, Ospedale Pediatrico Bambino Ges\u00f9 IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5236-3132","authenticated-orcid":false,"given":"Marco","family":"Cascella","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/jcph.1552","article-title":"Time-to-Event Modeling for Remimazolam for the Indication of Induction and Maintenance of General Anesthesia","volume":"60","author":"Lohmer","year":"2020","journal-title":"J. Clin. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1213\/ANE.0b013e31823f0c28","article-title":"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","volume":"115","author":"Antonik","year":"2012","journal-title":"Anesth. Analg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tomuli\u0107 Brusich, K., \u0160estan, M., Jurilj, Z., and \u010cipak Ga\u0161parovi\u0107, A. (2025). Remimazolam and Esketamine for CT-Guided Aortic Graft Infection Drainage in a Patient with Severe Systematic Comorbidities: A Case Report. Anesth. Res., 2.","DOI":"10.3390\/anesthres2020013"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Goudra, B., and Mason, K.P. (2021). Emerging Approaches in Intravenous Moderate and Deep Sedation. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081735"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.4097\/kja.22297","article-title":"Remimazolam\u2014Current Knowledge on a New Intravenous Benzodiazepine Anesthetic Agent","volume":"75","author":"Kim","year":"2022","journal-title":"Korean J. Anesthesiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"110","DOI":"10.3390\/anesthres1020011","article-title":"C-MAC Video Stylet Assisted Endotracheal Intubation in Sedated but Spontaneously Breathing Patients Using Remimazolam and Trachospray Device: A Report of Two Cases","volume":"1","author":"Witkam","year":"2024","journal-title":"Anesth. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.29271\/jcpsp.2022.11.1381","article-title":"Comparative Sedation with Sevoflurane and Thiopental in Children Undergoing MR Imaging","volume":"32","author":"Kurt","year":"2022","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/j.1399-6576.2008.01584.x","article-title":"Addition of Ketamine to Propofol for Initiation of Procedural Anesthesia in Children Reduces Propofol Consumption and Preserves Hemodynamic Stability","volume":"52","author":"Aouad","year":"2008","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jclinane.2017.01.014","article-title":"The Sedative Effects of the Intranasal Administration of Dexmedetomidine in Children Undergoing Surgeries Compared to Other Sedation Methods: A Systematic Review and Meta-Analysis","volume":"38","author":"Kim","year":"2017","journal-title":"J. Clin. Anesth."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1097\/EJA.0000000000001270","article-title":"Intranasal Dexmedetomidine versus Oral Midazolam Premedication to Prevent Emergence Delirium in Children Undergoing Strabismus Surgery: A Randomised Controlled Trial","volume":"37","author":"Yao","year":"2020","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kilpatrick, G.J. (2021). Remimazolam: Non-Clinical and Clinical Profile of a New Sedative\/Anesthetic Agent. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.690875"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Long, X., Wen, L.-X., Yang, H., Zhu, G.-H., Zhang, Q.-Y., Jiang, J.-J., and Gong, Y. (2023). ED95 of Remimazolam in Nasal Administration for Attenuating Preoperative Anxiety in Children. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1253738"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101423","DOI":"10.1016\/j.jped.2025.101423","article-title":"Remimazolam for Preventing Sevoflurane-Induced Emergence Delirium after Pediatric Laparoscopic Inguinal Hernia Repair: A Placebo-Controlled Randomized Clinical Trial","volume":"101","author":"Lu","year":"2025","journal-title":"J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Wan, M., Yu, X., Yan, R., and Guo, X. (2025). Comparing the Effect of Remimazolam and Propofol Anesthesia on Extubation Time, Hospital Stay and Psychological Wellbeing Post Pediatric Tonsillectomy and Adenoidectomy. BMC Pediatr., 25.","DOI":"10.1186\/s12887-025-06244-w"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.2147\/DDDT.S461122","article-title":"Preoperative Anxiolytic and Sedative Effects of Intranasal Remimazolam and Dexmedetomidine: A Randomized Controlled Clinical Study in Children Undergoing General Surgeries","volume":"18","author":"Cai","year":"2024","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s00540-022-03079-y","article-title":"A Population Pharmacokinetic Model of Remimazolam for General Anesthesia and Consideration of Remimazolam Dose in Clinical Practice","volume":"36","author":"Masui","year":"2022","journal-title":"J. Anesth."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jsps.2013.04.004","article-title":"Chemical Delivery Systems and Soft Drugs: Retrometabolic Approaches of Drug Design","volume":"22","author":"Bhardwaj","year":"2014","journal-title":"Saudi Pharm. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"388","DOI":"10.4103\/1658-354X.136627","article-title":"Remimazolam: The Future of Its Sedative Potential","volume":"8","author":"Goudra","year":"2014","journal-title":"Saudi J. Anaesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/ALN.0b013e3181ae8460","article-title":"Is Anesthesiology Going Soft?: Trends in Fragile Pharmacology","volume":"111","author":"Egan","year":"2009","journal-title":"Anesthesiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/01.anes.0000267503.85085.c0","article-title":"CNS 7056: A Novel Ultra-Short-Acting Benzodiazepine","volume":"107","author":"Kilpatrick","year":"2007","journal-title":"Anesthesiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.bja.2023.08.019","article-title":"Pharmacokinetics of Remimazolam after Intravenous Infusion in Anaesthetised Children","volume":"131","author":"Gao","year":"2023","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ALN.0000000000003102","article-title":"Pharmacokinetics and Pharmacodynamics of Remimazolam (CNS 7056) after Continuous Infusion in Healthy Male Volunteers: Part I. Pharmacokinetics and Clinical Pharmacodynamics","volume":"132","author":"Eisenried","year":"2020","journal-title":"Anesthesiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jpba.2017.01.016","article-title":"Metabolite Characterization of a Novel Sedative Drug, Remimazolam in Human Plasma and Urine Using Ultra High-Performance Liquid Chromatography Coupled with Synapt High-Definition Mass Spectrometry","volume":"137","author":"Zhou","year":"2017","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"257","DOI":"10.5114\/ait\/210611","article-title":"Remimazolam: A Comprehensive Review","volume":"57","author":"Kapica","year":"2025","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1007\/s00228-020-02984-z","article-title":"Pharmacokinetics and Pharmacodynamics of Intranasal Remimazolam-a Randomized Controlled Clinical Trial","volume":"76","author":"Pesic","year":"2020","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e15495","DOI":"10.7717\/peerj.15495","article-title":"Remimazolam versus Propofol for Procedural Sedation: A Meta-Analysis of Randomized Controlled Trials","volume":"11","author":"Chang","year":"2023","journal-title":"PeerJ"},{"key":"ref_27","first-page":"929","article-title":"Remimazolam, a Short-Acting GABAA Receptor Agonist for Intravenous Sedation and\/or Anesthesia in Day-Case Surgical and Non-Surgical Procedures","volume":"13","author":"Rogers","year":"2010","journal-title":"IDrugs"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1097\/CM9.0000000000002243","article-title":"Remimazolam Besylate for Sedation of Postoperative Patients in Intensive Care Units: A Phase I, Open Label, Dose-Finding Study","volume":"135","author":"Tang","year":"2022","journal-title":"Chin. Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wu, Y., Wang, F., Zhu, K., Ling, L., and Zhang, W. (2025). A Randomized Controlled Study of Remimazolam in Preschool Children Undergoing Adenotonsillectomy. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1678650"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhu, X., Wang, H., Yuan, S., Li, Y., Jia, Y., Zhang, Z., Yan, F., and Wang, Z. (2021). Efficacy and Safety of Remimazolam in Endoscopic Sedation-A Systematic Review and Meta-Analysis. Front. Med., 8.","DOI":"10.3389\/fmed.2021.655042"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1177\/1747493018778713","article-title":"Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke","volume":"13","author":"Sacks","year":"2018","journal-title":"Int. J. Stroke"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"295","DOI":"10.23736\/S0375-9393.19.14126-0","article-title":"Pediatric Anesthesia Practice in Italy: A Multicenter National Prospective Observational Study Derived from the APRICOT Trial","volume":"86","author":"Wolfler","year":"2020","journal-title":"Minerva Anestesiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"100023","DOI":"10.1124\/dmd.124.001916","article-title":"Impact of Genetic Polymorphisms and Drug-Drug Interactions Mediated by Carboxylesterase 1 on Remimazolam Deactivation","volume":"53","author":"Wang","year":"2025","journal-title":"Drug Metab. Dispos."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.17085\/apm.21115","article-title":"Remimazolam: Pharmacological Characteristics and Clinical Applications in Anesthesiology","volume":"17","author":"Kim","year":"2022","journal-title":"Anesth. Pain Med."},{"key":"ref_35","first-page":"e86354","article-title":"Remimazolam as a Novel Anesthetic in Pediatric Procedural Sedation and Anesthesia: A Narrative Review","volume":"17","author":"Zhu","year":"2025","journal-title":"Cureus"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1213\/ANE.0b013e3182a705ae","article-title":"A Phase Ib, Dose-Finding Study of Multiple Doses of Remimazolam (CNS 7056) in Volunteers Undergoing Colonoscopy","volume":"117","author":"Worthington","year":"2013","journal-title":"Anesth. Analg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40981-021-00485-1","article-title":"Three Cases of Difficulty in Achieving Definitive Loss of Consciousness with Remimazolam","volume":"8","author":"Miyanishi","year":"2022","journal-title":"JA Clin. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Hirano, T., Kimoto, Y., Kuratani, N., Cavanaugh, D., and Mason, K.P. (2023). Remimazolam for Pediatric Procedural Sedation: Results of an Institutional Pilot Program. J. Clin. Med., 12.","DOI":"10.3390\/jcm12185937"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/ALN.0000000000005560","article-title":"Pharmacokinetics and Pharmacodynamics of Remimazolam for Procedural Sedation in Children and Adolescents","volume":"143","author":"Colin","year":"2025","journal-title":"Anesthesiology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13741-023-00342-y","article-title":"Unplanned Admissions after Day-Case Surgery in an Italian Third-Level Pediatric Hospital: A Retrospective Study","volume":"12","author":"Vittori","year":"2023","journal-title":"Perioper. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/pan.15093","article-title":"Last-Minute Cancellations in Pediatric Ambulatory and Day Surgeries in Italy: Prevalence and Risk Factors","volume":"35","author":"Vittori","year":"2025","journal-title":"Paediatr. Anaesth."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1001\/jama.283.11.1451","article-title":"Sedation in the Intensive Care Unit: A Systematic Review","volume":"283","author":"Ostermann","year":"2000","journal-title":"JAMA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"R169","DOI":"10.1186\/cc8145","article-title":"Incidence of Propofol-Related Infusion Syndrome in Critically Ill Adults: A Prospective, Multicenter Study","volume":"13","author":"Roberts","year":"2009","journal-title":"Crit. Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jcrc.2021.04.001","article-title":"A Systematic Review and Meta-Analysis of Propofol versus Midazolam Sedation in Adult Intensive Care (ICU) Patients","volume":"64","author":"Garcia","year":"2021","journal-title":"J. Crit. Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation\/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU","volume":"46","author":"Devlin","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3957","DOI":"10.2147\/DDDT.S384155","article-title":"Remimazolam: An Updated Review of a New Sedative and Anaesthetic","volume":"16","author":"Hu","year":"2022","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3215","DOI":"10.1016\/S0960-894X(02)00512-7","article-title":"Identification and Structure-Activity Studies of Novel Ultrashort-Acting Benzodiazepine Receptor Agonists","volume":"12","author":"Stafford","year":"2002","journal-title":"Bioorganic Med. Chem. Lett."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1038\/nrn2370","article-title":"GABA(A) Receptor Trafficking and Its Role in the Dynamic Modulation of Neuronal Inhibition","volume":"9","author":"Jacob","year":"2008","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3487","DOI":"10.2147\/DDDT.S474854","article-title":"Remimazolam in General Anesthesia: A Comprehensive Review of Its Applications and Clinical Efficacy","volume":"18","author":"Zhang","year":"2024","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2174\/0113892002308233240801104910","article-title":"Carboxylesterase 1-Based Drug-Drug Interaction Potential of Remimazolam: In-Vitro Studies and Literature Review","volume":"25","author":"Petersen","year":"2024","journal-title":"Curr. Drug Metab."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Yang, X., Tang, Y., Du, R., Yu, Y., Xu, J., Zhang, J., Liu, H., Zou, X., Ren, L., and Yuan, S. (2023). Long-Term Sedation with Remimazolam Besylate versus Propofol in Critically Ill Patients during Invasive Mechanical Ventilation: A Study Protocol for a Multicenter Randomized Non-Inferior Trial. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1139872"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1186\/s40001-023-01440-9","article-title":"Remimazolam Tosylate\u2019s Long-Term Sedative Properties in ICU Patients on Mechanical Ventilation: Effectiveness and Safety","volume":"28","author":"Yao","year":"2023","journal-title":"Eur. J. Med. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"R467","DOI":"10.1186\/cc2976","article-title":"Discomfort and Factual Recollection in Intensive Care Unit Patients","volume":"8","author":"Loef","year":"2004","journal-title":"Crit. Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1046\/j.1365-2044.2001.01842.x","article-title":"Risk Factors for Postoperative Anxiety in Adults","volume":"56","author":"Caumo","year":"2001","journal-title":"Anaesthesia"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1007\/s40265-021-01544-8","article-title":"Remimazolam: A Review in Procedural Sedation","volume":"81","author":"Lee","year":"2021","journal-title":"Drugs"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40560-025-00840-9","article-title":"Prolonged Infusion of Remimazolam in Surgical and Medical Intensive Care Unit Patients: A Pilot Pharmacokinetic Study","volume":"14","author":"Suzuki","year":"2025","journal-title":"J. Intensive Care"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1111\/aas.14439","article-title":"Remimazolam for Sedation and Anesthesia in Children: A Scoping Review","volume":"68","author":"Kuklin","year":"2024","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Kimoto, Y., Hirano, T., Kuratani, N., Cavanaugh, D., and Mason, K.P. (2023). Remimazolam as an Adjunct to General Anesthesia in Children: Adverse Events and Outcomes in a Large Cohort of 418 Cases. J. Clin. Med., 12.","DOI":"10.3390\/jcm12123930"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"495","DOI":"10.14740\/jmc4013","article-title":"Remimazolam for Sedation During Upper Gastrointestinal Endoscopy in an Adolescent","volume":"13","author":"Garrett","year":"2022","journal-title":"J. Med. Cases"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"289","DOI":"10.14740\/jmc4137","article-title":"Remimazolam for Sedation During Fiberoptic Intubation in an Adolescent","volume":"14","author":"Hughes","year":"2023","journal-title":"J. Med. Cases"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"174","DOI":"10.14740\/jocmr4870","article-title":"Remimazolam as a Primary Agent for Brief Invasive and Noninvasive Procedures: A Case Series","volume":"15","author":"Yeh","year":"2023","journal-title":"J. Clin. Med. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"273","DOI":"10.17245\/jdapm.2024.24.4.273","article-title":"Effect of Remimazolam and Propofol Anesthesia on Autonomic Nerve Activities during Le Fort I Osteotomy under General Anesthesia: Blinded Randomized Clinical Trial","volume":"24","author":"Tsuji","year":"2024","journal-title":"J. Dent. Anesth. Pain Med."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Frelich, M., Sklienka, P., Romanov\u00e1, T., N\u011bmcov\u00e1, S., B\u00edlen\u00e1, M., Strakov\u00e1, H., Le\u010dbychov\u00e1, K., Jor, O., Form\u00e1nek, M., and Bur\u0161a, F. (2024). The Effect of BIS-Guided Anaesthesia on the Incidence of Postoperative Nausea and Vomiting in Children: A Prospective Randomized Double-Blind Study. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02610-w"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/anae.16205","article-title":"Anaesthetic Efficacy and Postinduction Hypotension with Remimazolam Compared with Propofol: A Multicentre Randomised Controlled Trial","volume":"79","author":"Fechner","year":"2024","journal-title":"Anaesthesia"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1097\/EJA.0000000000002042","article-title":"Remimazolam vs. Propofol for General Anaesthesia in Elderly Patients: A Meta-Analysis with Trial Sequential Analysis","volume":"41","author":"Pereira","year":"2024","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"An, X., Shen, T., Yin, X., Xu, J., Zhang, Y., and Wang, T. (2024). The Safety of Remimazolam versus Propofol in Gastroscopic Sedation: A Meta-Analysis. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02422-y"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1097\/EJA.0000000000001902","article-title":"Remimazolam and Serious Adverse Events: A Scoping Review","volume":"40","author":"Kempenaers","year":"2023","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s40001-025-02383-z","article-title":"Effectiveness of Perioperative Remimazolam in Preventing Postoperative Delirium: A Systematic Review and Meta-Analysis","volume":"30","author":"Wang","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Ye, G., Ding, L., and Zhou, Q. (2025). Remimazolam\u2019s Clinical Application and Safety: A Signal Detection Analysis Based on FAERS Data and Literature Support. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0330769"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"4605","DOI":"10.2147\/DDDT.S515924","article-title":"The Influence of Age on the Effective Dosage of Intravenous Remimazolam for the Relief of Preoperative Anxiety in Pediatric Patients at Median and 95% Effective Doses: A Prospective Study","volume":"19","author":"Chen","year":"2025","journal-title":"Drug Des. Dev. 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