Related Experiment Video

Updated: Jun 11, 2026

Application of Dixon's Up-and-Down Design to Estimate the Minimum Alveolar Concentration of Sevoflurane in Rats with Refined Movement Classification
03:02

Application of Dixon's Up-and-Down Design to Estimate the Minimum Alveolar Concentration of Sevoflurane in Rats with Refined Movement Classification

Published on: July 25, 2025

Determination of the ED90 of Remimazolam Bolus Dose for Preventing Emergence Delirium in Children with Sevoflurane

Bin Xue1, Lu Wang1,2, Chenchen Li3

  • 1Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.

Drug Design, Development and Therapy
|June 10, 2026
PubMed

Insights

The 90% effective dose (ED90) of single-bolus remimazolam for preventing emergence delirium in pediatric patients is 0.114 mg/kg. This dose is safe and effective for children undergoing sevoflurane anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Emergence delirium (ED) is common in children under sevoflurane anesthesia.
  • Single-bolus remimazolam can reduce ED, but the optimal dose is unknown.

Purpose of the Study:

  • To determine the 90% effective dose (ED90) of single-bolus remimazolam for preventing ED in pediatric patients.
  • To establish an optimal dose for preventing emergence delirium in children.

Main Methods:

  • A biased-coin design up-and-down sequential method was used to determine the ED90.
  • 59 children (aged 2-12 years) undergoing laparoscopic inguinal hernia repair were included.
  • The starting dose was 0.1 mg/kg, with 0.02 mg/kg intervals.

Main Results:

  • The estimated ED90 of remimazolam was 0.114 mg/kg (95% CI, 0.098-0.128 mg/kg).
  • The overall incidence of ED was 14.3%.
  • No adverse events were observed within the tested dose range.

Conclusions:

  • The ED90 of single-bolus remimazolam for preventing ED in pediatric patients is 0.114 mg/kg.
  • This finding provides crucial clinical evidence for pediatric anesthesia practices.
  • The study offers a methodological reference for future dose-finding research.
Abstract

Keywords:
childrendose-finding studypediatric anesthesiapsychomotor agitationultra-short-acting benzodiazepine

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