Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, People's Republic of China.
Drug Des Devel Ther. 2024 Aug 5;18:3487-3498. doi: 10.2147/DDDT.S474854. eCollection 2024.
Remimazolam is a novel ultra-short-acting benzodiazepine with a unique pharmacokinetic profile that makes it an attractive option for use in general anesthesia. This review paper provides an in-depth analysis of remimazolam's applications in the field of general anesthesia, focusing on its pharmacological properties, clinical efficacy, safety profile, and potential advantages compared to other anesthetic agents. Remimazolam acts on GABAa receptors, offering rapid onset and recovery times due to its unique metabolic pathway involving tissue esterases. Clinical trials have demonstrated its efficacy in procedural sedation and general anesthesia, showing a favorable safety profile with minimal cardiovascular and respiratory depression. Compared to traditional anesthetics such as propofol, remimazolam presents distinct advantages, including predictable pharmacokinetics, reduced risk of prolonged sedation, and a reliable safety margin. These attributes position remimazolam as a promising agent in various clinical settings. The purpose of this review is to synthesize current evidence on remimazolam and discuss its potential to improve clinical outcomes in anesthesia practice.
瑞马唑仑是一种新型超短效苯二氮䓬类药物，具有独特的药代动力学特征，使其成为全身麻醉应用的理想选择。本文深入分析了瑞马唑仑在全身麻醉领域的应用，重点讨论了其药理学特性、临床疗效、安全性以及与其他麻醉剂相比的潜在优势。瑞马唑仑通过作用于 GABAa 受体，由于其独特的代谢途径涉及组织酯酶，因此具有快速起效和恢复的特点。临床试验表明，瑞马唑仑在镇静和全身麻醉中的疗效良好，具有良好的安全性，心血管和呼吸抑制的风险极小。与丙泊酚等传统麻醉剂相比，瑞马唑仑具有明显的优势，包括可预测的药代动力学、降低长时间镇静的风险以及可靠的安全边际。这些特性使瑞马唑仑成为各种临床环境下有前途的药物。本综述的目的是综合目前关于瑞马唑仑的证据，并讨论其在麻醉实践中改善临床结局的潜力。
