Related Experiment Video
Updated: Jan 10, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Remimazolam Besylate Versus Propofol for Procedural Sedation in Patients Undergoing Electrical Cardioversion: A
Jacopo D'Andria Ursoleo1, Alice Bottussi1, Viviana Teresa Agosta1
1Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Objective:
Remimazolam besylate is a novel, short-acting benzodiazepine with a more favorable hemodynamic and respiratory profile than traditional anesthetics and may be suitable for procedural sedation. The objective of this study was to assess the safety, feasibility, and clinical advantages of remimazolam compared to propofol for procedural sedation during electrical cardioversion.
Design:
A prospective observational study.
Setting:
The Electrophysiology Department of a tertiary referral center university hospital.
Participants:
Sixty consecutive adult patients undergoing procedural sedation during electrical cardioversion for atrial fibrillation.
Intervention:
Patients receiving remimazolam (n = 30) were compared to those receiving propofol (n = 30) for procedural sedation.
Measurements And Main Results:
The primary outcome of time to loss of consciousness was evaluated in a prespecified noninferiority analysis. Other outcomes included adequacy of sedation, the time course of hemodynamics, time to recovery of consciousness, and adverse drug events. The achievement of satisfactory sedation was similar between the remimazolam (n = 29, 97%) and propofol (n = 30, 100%) groups. The mean difference in time to loss of consciousness between the groups was within the margin of noninferiority (0.41 minutes; 95% confidence interval, -0.38 to 1.20 minutes). In the linear mixed-effects model, remimazolam produced significantly more favorable blood pressure indexes but similar oxygen saturations compared to propofol over the course of the procedure. Three patients in the propofol group required rescue ventilation.
Conclusions:
Remimazolam was associated with similar sedation adequacy but more favorable hemodynamics over time compared to propofol when used for procedural sedation in adults undergoing electrical cardioversion for atrial arrhythmias.
More Related Videos
Related Concept Videos
Parenteral Anesthetics: Overview
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Depolarizing Blockers: Pharmocokinetics

