ArticleJournal of anesthesia2026
Clinical utility of effect-site concentration simulation during remimazolam general anesthesia.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
3 authors.
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Abstract
purposeThis prospective observational study evaluated the clinical utility of effect-site concentration (Ce) simulation during remimazolam anesthesia.
methodsFifty ASA I-II adult patients undergoing orthopedic surgery were enrolled, with two excluded due to undisclosed benzodiazepine use. Remimazolam was infused at 3 mg/kg/h for induction, and Ce was simulated. Loss and recovery of responsiveness were assessed by verbal stimulation every 30 s, and EEG-derived parameters including BIS and BSR were recorded.
resultsThe mean remimazolam Ces at loss and recovery of responsiveness were 0.35 ± 0.08 µg/mL and 0.36 ± 0.07 µg/mL, with no significant difference (p = 0.68). A positive correlation was observed (r = 0.76). The relationship between remimazolam Ce and BIS was weak, and BSR remained 0 in 98% of data points, indicating minimal EEG suppression even at higher concentrations.
conclusionsEffect-site concentration simulation is useful for estimating adequate anesthetic depth and predicting emergence during remimazolam anesthesia. EEG-derived indices, particularly BIS, have limited reliability. Further studies using TCI systems and higher concentration ranges are needed to refine dosing strategies and fully characterize EEG-drug interactions.
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