Usefulness and safety of remimazolam in upper gastrointestinal endoscopy: A comparative study between elderly and non-elderly patients

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY DEN open Pub Date : 2025-01-16 DOI:10.1002/deo2.70057

Ryoji Ichijima, Hisatomo Ikehara, Daisuke Yamaguchi, Yasuhiko Nagata, Kanako Ogura, Mitsuru Esaki, Yosuke Minoda, Hiroyuki Ono, Yuki Maeda, Shinsuke Kiriyama, Tetsuya Sumiyoshi, Yuichi Kanmura

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Abstract

Objectives

In gastroenterology, sedation demand is increasing, although elderly patients are more prone to experiencing adverse events. Remimazolam, a novel ultra-short-acting benzodiazepine, may reduce recovery time after endoscopic procedures.

Methods

This study was a secondary analysis of the investigator-initiated trial, which investigated the efficacy and safety of remimazolam in gastrointestinal endoscopy (REM-IICT JP01). Remimazolam sedation was administered during upper gastrointestinal endoscopy. Patients were divided into two groups: 45 non-elderly and 11 elderly patients (aged ≥65 years). The primary outcome was sedation success. Secondary outcomes included the dose required for sedation, time to awakening, time to regain the ability to walk, and occurrence of adverse events.

Results

Endoscopic sedation was successful in 95.6% of the non-elderly group and 100% of the elderly group. The total dose of remimazolam was significantly higher in the non-elderly group (4.0 [3.0–8.0] mg) than in the elderly group (3.0 [2.0–3.0] mg; p < 0.01). The time to awakening was 0.0 (0.0–10.0) min in the non-elderly group compared to 0.0 (0.0–30.0) min (p = 0.98) in the elderly group. The time to regain the ability to walk was significantly longer in the elderly group (5.0 [0.0–60.0] min) than in the non-elderly group (5.0 [0.0–30.0] min; p = 0.03). During the procedure, adverse events included hypotension in two cases (4.4%) in the non-elderly group and hypoxemia in one case (9.0%) in the elderly group.

Conclusions

Upper gastrointestinal endoscopy with remimazolam was effective and safe, regardless of age.

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雷马唑仑用于上消化道内镜检查的有效性和安全性：老年和非老年患者的比较研究。

目的：在胃肠病学，镇静的需求正在增加，尽管老年患者更容易出现不良事件。雷马唑仑是一种新型超短效苯二氮卓类药物，可以缩短内镜手术后的恢复时间。方法：本研究是对研究者发起的一项试验的二次分析，该试验研究了雷马唑仑在胃肠内镜检查中的有效性和安全性（REM-IICT JP01）。上消化道内窥镜检查时给予雷马唑仑镇静。患者分为两组：非老年患者45例，老年患者11例（年龄≥65岁）。主要结果是镇静成功。次要结局包括镇静所需剂量、苏醒时间、恢复行走能力的时间和不良事件的发生。结果：非老年组镇静成功率95.6%，老年组镇静成功率100%。非老年组雷马唑仑总剂量（4.0 [3.0-8.0]mg）显著高于老年组（3.0 [2.0-3.0]mg）；P = 0.98)。老年组恢复行走能力的时间（5.0 [0.0-60.0]min）明显长于非老年组（5.0 [0.0-30.0]min）；p = 0.03)。在手术过程中，不良事件包括非老年组2例低血压（4.4%）和老年组1例低氧血症（9.0%）。结论：不论年龄大小，雷马唑仑上消化道内镜检查是有效且安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

DEN open

CiteScore

1.30

自引率

0.00%

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