Evidence map›Paper›PMID 41247517›Full record

Trial reportJournal of gastroenterology2026

Efficacy and recovery of remimazolam versus midazolam in sedated upper gastrointestinal endoscopy: a multicenter randomized controlled trial in Japan (RECOVER Study).

Daisuke Yamaguchi, Ryoji Ichijima, Hisatomo Ikehara, Yosuke Minoda, Mitsuru Esaki, Ayako Takamori, Akiyoshi Yoh, Moeko Shirouzu, Kento Sadashima, Yutaro Fujimura and 9 more

Abstract readMulticenter StudyRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Efficacy and Recovery of Remimazolam Versus Midazolam in Sedated Colonoscopy: A Multicenter Randomized Controlled Trial in Japan.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Trial
  2. Trial
  3. Trial
  4. Review
  5. Upper Gastrointestinal Endoscopy in Elderly Patients: An Individualized Decision-Making Approach for Screening and Surveillance.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Review
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Daisuke YamaguchiDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan. daisukehawks@gmail.com.ORCID 0000-0001-9782-9998
Ryoji IchijimaDepartment of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan.
Hisatomo IkeharaDepartment of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Yosuke MinodaDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Mitsuru EsakiDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ayako TakamoriClinical Research Center, Saga University Hospital, Saga, Japan.
Akiyoshi YohDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Moeko ShirouzuDepartment of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
Kento SadashimaDepartment of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
Yutaro FujimuraDepartment of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
Takuya ShimamuraDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Hironobu TakedomiDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Takashi AkutagawaDepartment of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
Nanae TsuruokaDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Yasuhisa SakataDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Takuya WadaDepartment of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Chika KusanoDepartment of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Ryo ShimodaDepartment of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
Motohiro EsakiDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSedation is increasingly essential for gastrointestinal endoscopy. Remimazolam, an ultra-short-acting benzodiazepine, has a shorter pharmacokinetic half-life than midazolam. The aim of this study was to determine whether remimazolam provides superior procedural sedation in Japanese patients.

methodsThe cohort of this prospective, multicenter, randomized, single-blind controlled trial comprised adults (18-80 years) scheduled for sedated upper gastrointestinal endoscopy. Participants were randomized to remimazolam and midazolam groups. The primary outcome was the proportion of ambulatory patients 5 min after endoscopy. Secondary outcomes were successful pre-procedure sedation (Modified Observer's Assessment of Alertness/Sedation ≤ 4), dose of sedative to achieve sedation, time to ambulation, and adverse events.

resultsFrom October 2024 to January 2025, 40 patients were enrolled. After excluding two outliers 38 were analyzed (remimazolam, n = 20; midazolam, n = 18). Ambulation at 5 min occurred in 85.0% (17/20) of the remimazolam versus 0.0% (0/18) of the midazolam group (p < 0.0001). Mean time from procedure end to walking was 4.25 min (range 0.0-10.0) for remimazolam and 35.56 min (10.0-60.0) for midazolam (p < 0.0001). Pre-procedure sedation was successful (MOAA/S ≤ 4) in 100% of both groups. Mean doses to achieve sedation were 4.30 mg (3.0-7.0) for remimazolam and 3.11 mg (2.0-5.0) for midazolam (p = 0.003). Hypoxemia occurred in 5.0% of the remimazolam and 33.3% of the midazolam group (p = 0.038).

conclusionsIn upper gastrointestinal endoscopy, remimazolam achieved markedly faster recovery and a lower incidence of hypoxemia than midazolam. Rates of achieving target sedation were equivalent. These findings indicate remimazolam is an effective and potentially safer sedative option for Japanese patients undergoing endoscopy.

trial registrationThis research was registered with the Japan Registry of Clinical Trials (trial number jRCTs071240062) on September 26, 2024.

Indexed as

BenzodiazepinesEndoscopy, GastrointestinalHypnotics and SedativesMidazolamProcedural SedationAdolescentAdultAgedAged, 80 and overAnesthesia Recovery PeriodFemaleHumansJapanMaleMiddle AgedProspective StudiesBenzodiazepinesHypnotics and SedativesMidazolamremimazolamMidazolamMOAA/S scoreRemimazolamSedationUpper gastrointestinal endoscopy

Identifiers

PMID41247517
PMCPMC12987776

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.