The Pharmaceutical Future of Remimazolam as Compared to Propofol and Midazolam: A Literature Review.

Q4 Medicine
Hannah Meyer, Sean McCann, Joel Farmer
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引用次数: 0

Abstract

Introduction: Remimazolam is an ultra-short-acting benzodiazepine with a predictable and quick recovery that was FDA approved in 2020. As a relatively new medication, it is not as mainstream as other sedatives such as propofol or midazolam. This research aims to highlight the differences, benefits, and drawbacks of remimazolam in comparison to other short-term sedatives in order to bring greater awareness, and to consolidate the current knowledge of the effects of remimazolam.

Methods: The PubMed database was used to search for current relevant research to review. The search terms used were: "remimazolam", "midazolam", "propofol", and procedural sedation. The search also used qualifiers using only publications in English and published within the last five years. This query yielded 26 articles which were reviewed for content and relevance.

Results: Sixteen of the reviewed studies resulted in common themes suggesting remimazolam to be an effective alternative for procedural sedation with fewer adverse effects. Primarily, remimazolam is observed to have decreased procedural hypotension, bradycardia, and injection site pain. With no studies demonstrating an increased frequency of bradycardia, remimazolam is theorized to be superior to propofol in respect to sedation-associated bradycardia. One specific study notes a 14% decrease in frequency of bradycardia compared to propofol. Further benefits of remimazolam over propofol include the availability of an effective and reliable antidote, flumazenil.

Conclusion: In being that remimazolam has primarily been used and studied in short-term sedation, we can only confidently conclude remimazolam's safety in these settings. There is little research being done in the way of ICU sedation or general anesthesia, but with the relatively similar, or decreased rates of adverse events with remimazolam, we suspect an increase in clinical research of remimazolam in these settings. With continued robust research, remimazolam could become more widely accepted as a safe alternative to current sedatives.

雷马唑仑与丙泊酚和咪达唑仑相比的制药前景:文献综述。
简介雷马唑仑是一种超短效苯二氮卓类药物,具有可预测和快速恢复的特点,于 2020 年获得 FDA 批准。作为一种相对较新的药物,它不像异丙酚或咪达唑仑等其他镇静剂那样成为主流。本研究旨在强调雷马唑仑与其他短期镇静剂相比的差异、益处和缺点,以提高人们对雷马唑仑的认识,并巩固目前对雷马唑仑作用的了解:方法:使用 PubMed 数据库搜索当前相关的研究综述。使用的搜索关键词有"雷马唑仑"、"咪达唑仑"、"异丙酚 "和手术镇静。搜索还使用了限定词,即只搜索过去五年内发表的英文出版物。这一查询结果产生了 26 篇文章,并对这些文章的内容和相关性进行了审查:结果:经审查的 16 项研究得出了共同的主题,表明雷马唑仑是手术镇静的有效替代药物,且不良反应较少。据观察,雷马唑仑主要能减少手术过程中的低血压、心动过缓和注射部位疼痛。由于没有研究表明心动过缓的频率会增加,因此在镇静相关的心动过缓方面,雷马唑仑被认为优于异丙酚。一项特定研究指出,与异丙酚相比,心动过缓的频率降低了 14%。与异丙酚相比,瑞马唑仑的其他优点还包括可以使用有效、可靠的解毒剂--氟马西尼:考虑到瑞马唑仑主要用于短期镇静和研究,我们只能对瑞马唑仑在这些情况下的安全性做出肯定的结论。在重症监护室镇静或全身麻醉方面的研究很少,但由于雷马唑仑的不良反应发生率相对相似或较低,我们怀疑在这些情况下雷马唑仑的临床研究会增加。随着研究的不断深入,雷马唑仑作为目前镇静剂的安全替代品可能会被更多人接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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