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Remimazolam in pediatric ambulatory anesthesia: a critical review and clinical perspective

Yi Zhang1, Hongchen Liu2, Linyun Wang3

  • 1Department of Anesthesiology, Maternal and Child Health Hospital of Wanzhou District, Chongqing, China.

Frontiers in Medicine
|December 31, 2025
PubMed

Insights

Remimazolam shows promise for pediatric anesthesia due to its rapid action and recovery. However, more research, especially in infants and on long-term effects, is needed before widespread use.

Area of Science:

  • Anesthesiology
  • Pediatric Pharmacology

Background:

  • Pediatric anesthesia requires agents with rapid onset, precise control, and predictable recovery.
  • Remimazolam, an ultrashort-acting benzodiazepine, theoretically fits these requirements due to its unique metabolism.

Purpose of the Study:

  • To evaluate the current evidence for remimazolam in pediatric day surgery.
  • To identify gaps in knowledge regarding its use in young children and long-term outcomes.

Main Methods:

  • Review of existing pediatric studies on remimazolam.
  • Analysis of limitations in current evidence, including study size and design.

Main Results:

  • Current pediatric evidence for remimazolam is limited, primarily from small observational studies.
  • Significant data gaps exist for infants under two years and for long-term neurodevelopmental effects.

Conclusions:

  • Remimazolam presents a potential option for pediatric anesthesia.
  • Cautious use in selected cases is advised pending robust randomized controlled trials and further safety data.

Keywords:
anesthesiacritical appraisalfuture perspectivespediatric day surgerypharmacodynamicspharmacokineticsremimazolamsafety

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