{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:47:00Z","timestamp":1791474420160,"version":"4.3.4"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Gastrointestinal (GI) endoscopy requires safe and effective sedation. Remimazolam, an ultra-short-acting benzodiazepine, may offer advantages over traditional sedatives like midazolam and propofol, including rapid onset, short half-life, and a favorable safety profile. This study evaluates the feasibility, safety, and patient satisfaction of continuous remimazolam infusion administered by trained gastroenterologists for GI endoscopy. Materials and Methods: This prospective registry included patients with ASA physical status I and II undergoing standard endoscopic procedures. Continuous remimazolam sedation was administered, with boluses given as needed. Vital signs were monitored, and patient satisfaction was assessed before and after the procedure using standardized questionnaires. Results: A total of 159 procedures were performed in 141 patients. Sedation was successful in all patients, with a mean induction dose of 7.1 mg and total infusion of 15.1 mg. Recovery time averaged 3.3 min. Adverse events, including transient hypotension and hypoxia, occurred in 11.3% of patients but were easily managed. Most patients (97%) reported sufficient comfort, with an average satisfaction score of 8.1\/10. Conclusions: Continuous remimazolam infusion administered by trained gastroenterologists is a safe and effective alternative to traditional propofol sedation for GI endoscopy. It offers stable sedation, rapid recovery and high patient satisfaction, potentially reducing anesthesiology workload and improving procedural efficiency. Further studies are needed to confirm these findings in broader patient populations.<\/jats:p>","DOI":"10.3390\/medicina62040723","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:08:12Z","timestamp":1775812092000},"page":"723","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Continuous Remimazolam Administration by Gastroenterologists for Endoscopic Sedation"],"prefix":"10.3390","volume":"62","author":[{"given":"Tanya M.","family":"Bisseling","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela van","family":"Zuuk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Vaneker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5586-6246","authenticated-orcid":false,"given":"Hennie","family":"Hukker","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cariline","family":"Roosen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9532-2091","authenticated-orcid":false,"given":"Jasmijn","family":"Olde","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4814-9376","authenticated-orcid":false,"given":"Marjolijn","family":"Duijvestein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert J.","family":"Bulte","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4141-3701","authenticated-orcid":false,"given":"Lucas T.","family":"van Eijk","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rgen","family":"Bruhn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/ALN.0000000000004811","article-title":"Target-controlled infusion of remimazolam in healthy volunteers shows some acute tolerance","volume":"140","author":"Vellinga","year":"2024","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"636","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_3","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00540-020-02788-6","article-title":"Efficacy and safety of remimazolam versus propofol for general anesthesia: A multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial","volume":"34","author":"Doi","year":"2020","journal-title":"J. Anesth."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lee, C., Lee, C., Lee, J., Jang, G., Kim, B., and Park, S. (2022). Comparison of core body temperatures in patients administered remimazolam or propofol during robotic-assisted and laparoscopic radical prostatectomy. Medicina, 58.","DOI":"10.3390\/medicina58050690"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Qiu, Y., Gu, W., Zhao, M., Zhang, Y., and Wu, J. (2022). The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: A randomized trial. Front. Med., 9.","DOI":"10.3389\/fmed.2022.938940"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S221","DOI":"10.1097\/SAP.0000000000003377","article-title":"Use of remimazolam combined with alfentanil for plastic surgery anesthesia cases: A clinical trial","volume":"90","author":"Xu","year":"2023","journal-title":"Ann. Plast. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Oue, K., Oda, A., Shimizu, Y., Takahashi, T., Kamio, H., Sasaki, U., Imamura, S., Imado, E., Mukai, A., and Doi, M. (2023). Efficacy and safety of remimazolam besilate for sedation in outpatients undergoing impacted third molar extraction: A prospective exploratory study. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03538-2"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Sekiguchi, R., Kinoshita, M., Kawanishi, R., Kakuta, N., Saka, Y., and Tanaka, K. (2023). Comparison of hemodynamics during induction of general anesthesia with remimazolam and target-controlled propofol in middle-aged and elderly patients: A single-center, randomized, controlled trial. BMC Anesthesiol., 23.","DOI":"10.1186\/s12871-023-01974-9"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"111223","DOI":"10.1016\/j.jclinane.2023.111223","article-title":"Comparison of propofol vs remimazolam on emergence profiles after general anesthesia: A randomized clinical trial","volume":"90","author":"Oh","year":"2023","journal-title":"J. Clin. Anesth."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"C100237","DOI":"10.1016\/j.bjao.2023.100237","article-title":"Effect of general anaesthesia with remimazolam versus propofol on postoperative quality of recovery in patients undergoing ambulatory arthroscopic meniscus repair: A randomised clinical trial","volume":"8","author":"Tang","year":"2023","journal-title":"BJA Open"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Furuta, M., Ito, H., and Yamazaki, M. (2021). Anaesthetic management using remimazolam in a patient with severe aortic stenosis: A case report. BMC Anesthesiol., 21.","DOI":"10.1186\/s12871-021-01422-6"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40981-021-00413-3","article-title":"Anesthetic management for a patient with myotonic dystrophy with remimazolam","volume":"7","author":"Morimoto","year":"2021","journal-title":"Clin. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s40981-022-00514-7","article-title":"Remimazolam enabled safe anesthetic management during tracheostomy in a patient with amyotrophic lateral sclerosis: A case report","volume":"8","author":"Nishihara","year":"2022","journal-title":"JA Clin. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e01599","DOI":"10.1213\/XAA.0000000000001599","article-title":"Total intravenous anesthesia using remimazolam and continuous cardiac output monitoring for dental anesthesia in a patient with Takayasu\u2019s arteritis: A case report","volume":"16","author":"Takaishi","year":"2022","journal-title":"AA Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s40981-022-00556-x","article-title":"Use of remimazolam in living donor liver transplantation: A case report","volume":"8","author":"Matsumoto","year":"2022","journal-title":"Clin. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1080\/03007995.2023.2196198","article-title":"Economic benefits of remimazolam compared to midazolam and propofol for procedural sedation in colonoscopies and bronchoscopies","volume":"39","author":"Pedersen","year":"2023","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.3748\/wjg.v19.i15.2355","article-title":"Patient comfort and quality in colonoscopy","volume":"19","author":"Ekkelenkamp","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_18","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. Devel. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.bja.2021.05.027","article-title":"Pharmacokinetic properties of remimazolam in subjects with hepatic or renal impairment","volume":"127","author":"Colin","year":"2021","journal-title":"Br. J. Anaesth."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jatmed.2025.05.001","article-title":"Efficacy and safety of continuous infusion of remimazolam for sedation in elderly patients undergoing colonoscopic polypectomy: A non-inferiority prospective controlled clinical trial","volume":"4","author":"Tian","year":"2025","journal-title":"J. Anesth. Transl. Med."},{"key":"ref_21","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_22","doi-asserted-by":"crossref","first-page":"106604","DOI":"10.4253\/wjge.v17.i6.106604","article-title":"Sedation in endoscopy: Current practices and future innovations","volume":"17","author":"Bruni","year":"2025","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.23736\/S0375-9393.22.16817-3","article-title":"Remimazolam versus propofol for procedural sedation and anesthesia: A systemic review and meta-analysis","volume":"88","author":"Zhang","year":"2022","journal-title":"Minerva Anestesiol."},{"key":"ref_24","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."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/4\/723\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:56:55Z","timestamp":1775815015000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/4\/723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["medicina62040723"],"URL":"https:\/\/doi.org\/10.3390\/medicina62040723","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]}}}