Remimazolam in children: a comprehensive narrative review

Abstract Remimazolam is a novel ultra-short-acting benzodiazepine gaining attention for its rapid onset, predictable pharmacokinetics, and favorable safety profile in adult procedural sedation and anesthesia. Early pediatric data suggest it may offer significant advantages over traditional sedatives...

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Main Authors: Tom G. Hansen, Thomas Engelhardt
Format: Article
Language:English
Published: Springer 2025-02-01
Series:Anesthesiology and Perioperative Science
Subjects:
Online Access:https://doi.org/10.1007/s44254-025-00090-w
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author Tom G. Hansen
Thomas Engelhardt
author_facet Tom G. Hansen
Thomas Engelhardt
author_sort Tom G. Hansen
collection DOAJ
description Abstract Remimazolam is a novel ultra-short-acting benzodiazepine gaining attention for its rapid onset, predictable pharmacokinetics, and favorable safety profile in adult procedural sedation and anesthesia. Early pediatric data suggest it may offer significant advantages over traditional sedatives, including enhanced predictability, improved safety, and faster recovery times. Despite these promising attributes, its routine use in pediatric populations remains underexplored and unestablished. This narrative review examines remimazolam’s pharmacological properties, including its mechanism of action, metabolism, and elimination, and evaluates its safety and efficacy in pediatric sedation. Potential clinical applications are highlighted, such as procedural sedation, intensive care, and anesthesia induction, with comparisons to conventional agents. While initial studies suggest benefits, critical gaps remain in understanding its use in children. These include age-specific dosing strategies, long-term safety considerations, and its efficacy in children with comorbid conditions or undergoing complex procedures. Addressing these gaps will require robust clinical trials and large-scale observational studies. This review synthesizes current evidence and explores the potential of remimazolam to enhance pediatric sedation and anesthesia practices. By identifying key knowledge gaps and proposing future research directions, it aims to inform clinicians and researchers about the role of remimazolam in improving safety and outcomes in pediatric anesthesia.
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spelling doaj-art-a38df81aa0fc4fa8868864ca541f3d892025-08-20T03:41:40ZengSpringerAnesthesiology and Perioperative Science2731-83892025-02-01311710.1007/s44254-025-00090-wRemimazolam in children: a comprehensive narrative reviewTom G. Hansen0Thomas Engelhardt1Department of Anaesthesiology & Intensive Care Medicine, Akershus University HospitalDepartment of Pediatric Anesthesia, Montreal Children’s HospitalAbstract Remimazolam is a novel ultra-short-acting benzodiazepine gaining attention for its rapid onset, predictable pharmacokinetics, and favorable safety profile in adult procedural sedation and anesthesia. Early pediatric data suggest it may offer significant advantages over traditional sedatives, including enhanced predictability, improved safety, and faster recovery times. Despite these promising attributes, its routine use in pediatric populations remains underexplored and unestablished. This narrative review examines remimazolam’s pharmacological properties, including its mechanism of action, metabolism, and elimination, and evaluates its safety and efficacy in pediatric sedation. Potential clinical applications are highlighted, such as procedural sedation, intensive care, and anesthesia induction, with comparisons to conventional agents. While initial studies suggest benefits, critical gaps remain in understanding its use in children. These include age-specific dosing strategies, long-term safety considerations, and its efficacy in children with comorbid conditions or undergoing complex procedures. Addressing these gaps will require robust clinical trials and large-scale observational studies. This review synthesizes current evidence and explores the potential of remimazolam to enhance pediatric sedation and anesthesia practices. By identifying key knowledge gaps and proposing future research directions, it aims to inform clinicians and researchers about the role of remimazolam in improving safety and outcomes in pediatric anesthesia.https://doi.org/10.1007/s44254-025-00090-wAnesthesiaSedationRemimazolamChildren
spellingShingle Tom G. Hansen
Thomas Engelhardt
Remimazolam in children: a comprehensive narrative review
Anesthesiology and Perioperative Science
Anesthesia
Sedation
Remimazolam
Children
title Remimazolam in children: a comprehensive narrative review
title_full Remimazolam in children: a comprehensive narrative review
title_fullStr Remimazolam in children: a comprehensive narrative review
title_full_unstemmed Remimazolam in children: a comprehensive narrative review
title_short Remimazolam in children: a comprehensive narrative review
title_sort remimazolam in children a comprehensive narrative review
topic Anesthesia
Sedation
Remimazolam
Children
url https://doi.org/10.1007/s44254-025-00090-w
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