Trial reportScientific reports2025
The 50% effective dose of remimazolam combined with different doses of esketamine for painless gastroscopy.
Trial report in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative safety of esketamine in procedural sedation and analgesia: a systematic review and network meta-analysis.BMC anesthesiology · 2026Pooled it
- Remimazolam in pediatric anesthesia: a systematic review for clinical decision-making.Frontiers in pediatrics · 2025Pooled it
- Comparison of the EDDrug design, development and therapy · 2026Trial
- Determination of the 90% effective dose of propofol combined with oliceridine or fentanyl for inhibiting the insertion response in upper gastrointestinal endoscopy: a dose-finding trial.Frontiers in medicine · 2026Trial
- Efficacy of Different Doses of Remimazolam Tosilate Combined with Esketamine in Painless Abortion Patients: A Prospective, Double-Blind, Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Update on Sedation for Upper Gastrointestinal Endoscopy in Japan: Current Evidence on Remimazolam.DEN open · 2027Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveRemimazolam is a novel benzodiazepine sedative that provides effective sedation, stable haemodynamics, and minimal adverse effects during intravenous general anaesthesia. The aim of this study was to determine the 50% effective dose (ED50) of remimazolam combined with different doses of esketamine for painless gastroscopy and to evaluate the efficacy and safety of this combination.
methodsThis was a randomised, double-blind, up-and-down sequential allocation study. Patients undergoing painless gastroscopy who met all the inclusion criteria and did not meet any of the exclusion criteria were randomised in a 1:1:1 ratio into the ES0 group (0 mg/kg of esketamine), ES1 group (0.2 mg/kg of esketamine), and ES2 group (0.4 mg/kg of esketamine). The initial dose of remimazolam was 0.3 mg/kg in each group, with the dose increased or decreased by 0.05 mg/kg for the subsequent patient based on the success or failure of sedation in the previous patient. The trial was concluded when seven successful failure crossovers were achieved. The ED50 and 95% confidence intervals (CI) of remimazolam were calculated using Probit regression. Haemodynamic parameters, time to induction of anaesthesia, time to gastroscopy, time to awakening from anaesthesia, and adverse events were recorded.
resultsA total of 59 patients were included in the final analysis: 19 in the ES0 group, 23 in the ES1 group, and 17 in the ES2 group. The ED50 (95% CI) of remimazolam in the ES0, ES1, and ES2 groups was 0.344 (0.302-0.389) mg/kg, 0.289 (0.249-0.328) mg/kg, and 0.193 (0.145-0.239) mg/kg, respectively. Additionally, the ES1 and ES2 groups exhibited more stable haemodynamics compared to the ES0 group. However, the ES1 and ES2 groups had significantly longer recovery times than the ES0 group. The incidence of hypotension was higher in the ES0 group compared to the ES1 and ES2 groups.
conclusionThe ED50 of remimazolam combined with 0 mg/kg, 0.2 mg/kg, and 0.4 mg/kg of esketamine for induction of anaesthesia during painless gastroscopy was 0.344 mg/kg, 0.289 mg/kg, and 0.193 mg/kg, respectively. Combining esketamine with remimazolam for induction of anaesthesia during painless gastroscopy offers advantages in terms of haemodynamic stability and reduced adverse effects.
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