Safety of Remimazolam in Vulnerable Populations

Vulnerable populations require careful consideration in drug selection due to their unique physiological conditions. Remimazolam, an innovative ultra-short-acting benzodiazepine, presents several advantages, including rapid onset, brief duration of action, and high predictability. Despite the extensive literature on remimazolam, few studies have specifically evaluated its safety in vulnerable patient populations. This review offers a comprehensive analysis of the safety profile of remimazolam in vulnerable populations, including cardiovascular diseases, neurological disorders, hepatic and renal dysfunction, respiratory conditions, metabolic disorders, rare diseases, and special groups such as the elderly and pediatric patients. It assesses recovery outcomes, hemodynamic stability, and adverse events such as respiratory depression and delirium. In our view, the prophylactic potential of remimazolam in these aspects may not be inferior to traditional anesthetic drugs (propofol, sevoflurane, etomidate, etc). and shows a trend of surpassing them in some aspects.