# Review of clinical advances in the procedural sedation application of remimazolam

**Authors:** Qiwei Wang, Shuancheng Bai

PMC · DOI: 10.3389/fphar.2026.1740897 · Frontiers in Pharmacology · 2026-02-23

## TL;DR

This paper reviews remimazolam, a new benzodiazepine, for procedural sedation, highlighting its fast action, safety, and effectiveness in clinical settings.

## Contribution

The paper systematically analyzes remimazolam's pharmacological and clinical advantages over traditional sedatives.

## Key findings

- Remimazolam has rapid onset and short duration of action, making it suitable for procedural sedation.
- It shows high safety and low adverse reactions, improving patient experience and procedural efficiency.
- The drug is a promising alternative to traditional sedatives in palliative care and other clinical settings.

## Abstract

With the ongoing advancement of comfort-oriented healthcare, procedural sedation is increasingly applied in clinical practice. As a novel benzodiazepine derivative, remimazolam offers distinct advantages in procedural sedation. This paper aims to thoroughly examine its pharmacological properties and key clinical applications, providing systematic guidance for rational clinical use while promoting further adoption and development of this medication in relevant fields.

Conduct a systematic analysis and summary by examining the pharmacological characteristics of remimazolam, including its mechanism of action and pharmacokinetic properties, and integrating its application scenarios, dosing regimens, and comparative efficacy data across various clinical sedation procedures.

Remimazolam, with its unique pharmacological advantages—such as rapid onset, short duration of action, inactive metabolites, and high safety profile—demonstrated excellent sedative efficacy and tolerability in clinical procedural sedation. It effectively meets sedation requirements across diverse procedural settings while exhibiting a low incidence of adverse reactions, thereby offering significant clinical value.

As a novel benzodiazepine derivative, remimazolam overcomes the limitations of traditional sedatives, offering a new option for procedural sedation in palliative care. Its unique pharmacologic properties ensure rapid onset, controllable duration of action, and high safety, thereby enhancing clinical procedural efficiency and patient experience. This systematic review of its clinical applications provides scientific evidence for the rational and standardized use of remimazolam in clinical practice. Future research should focus on expanding its application in more complex clinical scenarios and conducting long-term safety and efficacy studies to further promote the widespread use of remimazolam in procedural sedation.

## Linked entities

- **Chemicals:** remimazolam (PubChem CID 9867812), benzodiazepine (PubChem CID 134664)

## Full-text entities

- **Genes:** ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CES1 (carboxylesterase 1) [NCBI Gene 1066] {aka ACAT, CE-1, CEH, CES2, HMSE, HMSE1}
- **Diseases:** abdominal distension (MESH:D000007), IONV (MESH:D020250), Allergic reactions (MESH:D004342), peripheral nerve block (MESH:D010523), tooth extraction (MESH:D014076), hip fracture (MESH:D006620), abdominal tumor (MESH:D000008), dizziness (MESH:D004244), respiratory adverse events (MESH:D064420), nausea (MESH:D009325), obese (MESH:D009765), tachycardia (MESH:D013610), rash (MESH:D005076), respiratory and circulatory depression (MESH:D012131), hypotension (MESH:D007022), bradycardia (MESH:D001919), anaphylactic shock (MESH:D000707), hypoxemia (MESH:D000860), hand trauma (MESH:D014947), hepatic impairment (MESH:D008107), skin reactions (MESH:D012871), pain (MESH:D010146), brachial plexus (MESH:D020516), allergic symptoms (MESH:D063926), asthma (MESH:D001249), anxiety (MESH:D001007), cardiac arrest (MESH:D006323)
- **Chemicals:** Remimazolam (MESH:C522201), CNS7054 (-), benzodiazepine (MESH:D001569), alfentanil (MESH:D015760), dexmedetomidine (MESH:D020927), acetone (MESH:D000096), zolpidem (MESH:D000077334), propofol (MESH:D015742), Chloride (MESH:D002712), ibuprofen (MESH:D007052), midazolam (MESH:D008874), carboxylic acid (MESH:D002264), epinephrine (MESH:D004837), ester (MESH:D004952), flumazenil (MESH:D005442)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12968273/full.md

## References

49 references — full list in the complete paper: https://tomesphere.com/paper/PMC12968273/full.md

---
Source: https://tomesphere.com/paper/PMC12968273