Remimazolam as a Novel Anesthetic in Pediatric Procedural Sedation and Anesthesia: A Narrative Review.

As an ultra-short-acting benzodiazepine, remimazolam demonstrates rapid onset, quick offset, and a short half-life. Current evidence suggests that its metabolism is not dependent on hepatic or renal function, and its effects can be reversed by flumazenil, a benzodiazepine antagonist. Ever since its approval for procedural sedation and general anesthesia, it has gained popularity due to its minimal impact on circulation and respiration and reduced incidence of adverse reactions. While the clinical application of remimazolam in adult and elderly patients has been studied and reported extensively, its safety and efficacy in pediatric patients remain unclear. Current evidence suggests its potential clinical value and application prospects in children. This review outlines the pharmacokinetics and pharmacodynamics of remimazolam and summarizes the latest research progress regarding its use in pediatric patients for procedural sedation and anesthetic induction and maintenance. We conducted a literature search using PubMed and the China National Knowledge Infrastructure (CNKI), specifically targeting clinical studies and case reports that evaluated the use of remimazolam for procedural sedation and general anesthesia in pediatric patients. The search strategy incorporated the following keyword combinations: "remimazolam and pediatric anesthesia", "remimazolam and pediatric sedation", "remimazolam and children", and "remimazolam and pediatric patients". In summary, we synthesized existing clinical studies and case reports to provide guidance and insights into the use and research of remimazolam in pediatric patients.