Related Experiment Video

Updated: Mar 3, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Comparative Efficacy and Safety of Remimazolam Versus Propofol for Sedation in Gastrointestinal Endoscopy: A

Wentao Su1, Yanqing Sun2, Airong Xu3

  • 1Gastroenterology, Binzhou People's Hospital, Binzhou, CHN.

Cureus
|March 2, 2026
PubMed

Insights

Remimazolam, a new sedative, significantly reduces cardiorespiratory events during GI endoscopy compared to propofol. It offers a safer sedation option while maintaining comparable efficacy for these procedures.

Area of Science:

  • Anesthesiology and Pharmacology
  • Gastroenterology
  • Clinical Trials and Meta-Analysis

Background:

  • Propofol is a common sedative for GI endoscopy but carries risks of cardiorespiratory depression.
  • Remimazolam, a novel benzodiazepine, presents a potentially safer alternative due to its rapid action and specific antagonist.

Purpose of the Study:

  • To compare the efficacy and safety of remimazolam versus propofol for sedation in adult patients undergoing GI endoscopic procedures.
  • To evaluate cardiorespiratory adverse events, sedation success, recovery times, and satisfaction levels.

Main Methods:

  • Systematic literature search of major databases (PubMed, Web of Science, EMBASE, Cochrane Library) up to January 2026.
  • Inclusion of 14 randomized controlled trials (RCTs) involving 2,883 patients comparing intravenous remimazolam and propofol.
  • Meta-analysis using random-effects model to assess the primary outcome (composite cardiorespiratory events) and secondary outcomes, with risk of bias assessment.

Main Results:

  • Remimazolam significantly lowered the risk of composite cardiorespiratory adverse events compared to propofol (RR = 0.34, 95% CI: 0.27-0.44).
  • Sedation success rates were comparable between remimazolam and propofol.
  • Remimazolam showed similar or favorable recovery profiles, reduced injection pain, and higher patient satisfaction in some studies.

Conclusions:

  • Remimazolam demonstrates a superior safety profile concerning cardiorespiratory stability for GI endoscopy sedation compared to propofol.
  • Efficacy of remimazolam is non-inferior to propofol, supporting its use as a valuable alternative, particularly for high-risk patients.
Keywords:
adverse eventsefficacygastrointestinal endoscopymeta-analysispropofolremimazolamsafetysedation

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