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Remimazolam for procedural sedation: a future sedative potential in the emergency department?
  1. A van der Have1,
  2. B L ten Harmsen1,2,
  3. B W Storm van Leeuwen1,
  4. J Stollman1,
  5. G Alexandridis2
  1. 1Emergency Department, Radboudumc, Nijmegen, The Netherlands
  2. 2Emergency Department, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
  1. Correspondence to B L ten Harmsen, Emergency Department, Radboudumc, Nijmegen, The Netherlands; bibettenharmsen{at}

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Procedural sedation (PS) is a frequently performed clinical practice in the ED1 aiming to facilitate a state that allows patients to tolerate uncomfortable procedures.2 The ideal agent for PS in the ED should provide anxiolysis, analgesia and amnesia in a rapid and predictable manner, with minimal adverse events and a rapid recovery phase.3 Remimazolam (RMZ) is a novel benzodiazepine with rapid conversion into an inactive metabolite, making it ultra-short acting. Compared with other intravenous sedative agents, it is less likely to cause cardiovascular or respiratory depression and in case of an adverse event, it can be antagonised using flumazenil.4 This beneficial risk profile suggests safe use of RMZ in the ED. Previous studies have described the success of RMZ for PS during endoscopic procedures5; however, there is no literature on the use of RMZ in the ED.

The aim of the current study …

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  • Handling editor Gene Yong-Kwang Ong

  • Contributors AvdH, BWSvL, JS and GA conceived of the presented idea. AvdH, BWSvL, JS and GA contributed to sample preparation. AvdH and GA verified the analytical methods and performed the analytical calculations. BtH took the lead in writing the manuscript and the revision. GA helped supervise the project. AvdH, BtH, BWSvL, JS and GA provided critical feedback and helped shape the research, analysis and the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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