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Related Concept Videos

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Related Experiment Video

Updated: Apr 1, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Comparative Safety of Intravenous Sedatives for Bronchoscopy: A Bayesian Network Meta-Analysis.

Jonghoo Lee1, Jae-Uk Song2

  • 1Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. lovlet@jejunu.ac.kr.

Yonsei Medical Journal
|March 31, 2026
PubMed
Summary

Remimazolam is the safest sedative for bronchoscopy, significantly reducing hypoxemia risk compared to midazolam and propofol. This intravenous agent offers superior safety in airway procedures.

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Bronchoscopyconscious sedationhypoxianetwork meta-analysis

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Area of Science:

  • Anesthesiology
  • Pulmonology
  • Pharmacology

Background:

  • Sedation choices for flexible bronchoscopy are debated.
  • Optimizing patient safety during procedural sedation is crucial.

Purpose of the Study:

  • To evaluate the safety of intravenous midazolam, propofol, dexmedetomidine, and remimazolam during flexible bronchoscopy.
  • To compare the incidence of hypoxemia across different sedative agents.

Main Methods:

  • A Bayesian network meta-analysis (NMA) was performed using data from PubMed, Embase, and Cochrane.
  • Twenty-four randomized controlled trials (4010 patients) were included.
  • Hypoxemia rate was the primary outcome, analyzed using odds ratios and SUCRA plots.

Main Results:

  • Remimazolam showed a significantly lower hypoxemia rate versus midazolam (OR 0.36) and propofol (OR 0.33).
  • The safety ranking from most to least favorable was remimazolam, dexmedetomidine, midazolam, and propofol.
  • Midazolam had the lowest hypotension risk, while propofol had the lowest bradycardia risk.

Conclusions:

  • Intravenous remimazolam is suggested as the safest sedative agent for bronchoscopy, primarily due to reduced hypoxemia risk.
  • Remimazolam demonstrated a 93.4% probability of being the most effective treatment for safety.