The following is a summary of “Preliminary Experience With Remimazolam for Procedural Sedation and as an Adjunct to General Anesthesia During Diagnostic and Interventional Cardiac Procedures,” published in the February 2024 issue of Cardiology by Gillis et al.
Researchers started a retrospective study to investigate the clinical experience with remimazolam, a short-acting benzodiazepine with rapid recovery, compared to other options.
They involved patients who underwent cardiac procedures, including catheterization, MRI, and electrophysiology, following Institutional Review Board (IRB) approval. The primary goal was to evaluate the effectiveness and safety of remimazolam. Also, to specify remimazolam dosing (bolus and infusion) and assess the need for adjunctive agents to enhance sedation.
The results showed 26 patients, with a median age of 18 years, undergoing 33 anesthesia sessions. The most prevalent procedures involved endomyocardial biopsy or isolated hemodynamic assessment (right or left heart catheterization). Remimazolam served as the primary sedative in 82% of the cases. Most instances (25 sessions, 76%) involved administering a bolus dose of remimazolam before starting the infusion. The bolus doses typically ranged from 30 to 110 g/kg. Infusion rates for remimazolam ranged from 5 to 20 g/kg/min. No adverse effects on hemodynamics or respiration were observed. The most commonly used supplementary agents were midazolam, fentanyl, and dexmedetomidine. In one case, a patient required a transition to general anesthesia for a surgical intervention following cardiac catheterization findings. Effective sedation was achieved in all other patients.
Investigators concluded that remimazolam showed promising effectiveness for sedation during cardiovascular procedures, but further research is needed to refine dosing and compare it to established options.
Source: cardiologyres.org/index.php/Cardiologyres/article/view/1595