Trial reportBMC anesthesiology2026
Optimal remimazolam dosage for pediatric painless gastrointestinal endoscopy: a randomized controlled trial comparing efficacy and safety of three doses combined with sufentanil and propofol.
Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07083440 (A Clinical Investigation of Varied Remimazolam Dosages With Sufentanil and Propofol for Painless Pediatric Gastrointestinal Endoscopy), which is not on this map. Cited by 2 papers.
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.
A Clinical Investigation of Varied Remimazolam Dosages With Sufentanil and Propofol for Painless Pediatric Gastrointestinal Endoscopy
Who cites it
2 citing papers in PubMed.
- Remimazolam-Propofol and Propofol Induction Regimens for Pediatric Bidirectional Endoscopy: A Three-Arm Randomized Trial.Children (Basel, Switzerland) · 2026Article
- The 90% effective dose of remimazolam in combination with sufentanil for sedation in patients undergoing gastroscopy.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRemimazolam is a novel sedative with potential benefits for pediatric procedural sedation, but its optimal dose in combination regimens is unknown. This study aimed to compare the efficacy and safety of three different remimazolam doses combined with sufentanil and propofol for pediatric gastroscopy.
methodsThis prospective, randomized, single-center study enrolled 180 ASA physical status I-II pediatric patients (aged 3 to < 18 years) undergoing gastroscopy. Patients were randomized to receive 0.2 mg/kg (R2 group), 0.3 mg/kg (R3 group), or 0.4 mg/kg (R4 group) remimazolam, all with 0.1 µg/kg sufentanil. Anesthesia was induced with remimazolam followed by titrated propofol to achieve a Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score ≤ 2. The primary outcome was total propofol consumption.
resultsSedation success was 100%. The R3 group required significantly less propofol (42.5 ± 8.1 mg; 1.2 ± 0.2 mg/kg) than the R2 group (58.8 ± 9.9 mg; 1.7 ± 0.3 mg/kg; mean difference − 0.5 mg/kg, 95% CI [-0.6, -0.4]; P < 0.001) and the R4 group (50.2 ± 7.5 mg; 1.4 ± 0.2 mg/kg; P < 0.001), with fewer supplemental doses (1.67%) versus the R2 group (16.67%; P = 0.003). The R4 group had the most pronounced decreases in blood pressure, with a higher incidence of hypotension requiring intervention (23.33%) compared to the R2 group (8.33%; P = 0.026). Respiratory depression was significantly less frequent in R3 (5.00%) compared to R2 (16.67%; P = 0.031). Injection pain was absent in the R3 and R4 groups versus 6.67% in the R2 group (P = 0.017). Awakening and recovery times were comparable across groups.
conclusionFor pediatric gastroscopy, a 0.3 mg/kg dose of remimazolam combined with sufentanil and propofol provides an optimal balance of efficacy and safety, significantly reducing propofol requirements and associated respiratory depression compared to a 0.2 mg/kg dose, while causing less hypotension than a 0.4 mg/kg dose. Limitations of this single-center study include the lack of a non-remimazolam comparator group and the inability to blind the anesthesiologist administering the sedative agents.
trial registrationClinicalTrials.gov, NCT07083440. Retrospectively registered on July 16, 2025. The first patient was enrolled on June 1, 2023.
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