Evidence map›Paper›PMID 42597464›Full record

ReviewDEN open2027

Update on Sedation for Upper Gastrointestinal Endoscopy in Japan: Current Evidence on Remimazolam.

Ryoji Ichijima, Masahiro Toyama, Taiki Shishido, Yuki Koyo, Takehiro Yoshii, Reona Kawamura, Tsubasa Ishikawa, Yasuhiko Mizuguchi, Naoya Toyoshima, Hiroyuki Takamaru and 4 more

Abstract readReview
In one paragraph

Review in DEN open, 2027. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Ryoji IchijimaEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Masahiro ToyamaEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Taiki ShishidoEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Yuki KoyoEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Takehiro YoshiiEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Reona KawamuraEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Tsubasa IshikawaEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Yasuhiko MizuguchiEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Naoya ToyoshimaEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Hiroyuki TakamaruEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Masayoshi YamadaEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Masau SekiguchiEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Seiichiro AbeEndoscopy Division National Cancer Center Hospital Tokyo Japan.
Yutaka SaitoEndoscopy Division National Cancer Center Hospital Tokyo Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sedation is an essential component of upper gastrointestinal endoscopy because it reduces patient discomfort and anxiety while improving patient acceptance and procedural quality. In Japan, benzodiazepines such as midazolam and opioid analgesics have long been widely used in routine clinical practice; however, many of these agents historically lacked formal insurance approval for sedation during gastrointestinal endoscopy. Propofol is also a useful sedative because of its rapid onset and recovery, but its use in Japan has been limited because of concerns regarding respiratory and cardiovascular depression and the need for management by anesthesia-trained personnel. Against this background, the approval of remimazolam for sedation during gastrointestinal endoscopy in June 2025 represented a major turning point in Japanese endoscopic sedation practice. Remimazolam is an ultra-short-acting benzodiazepine rapidly metabolized by carboxylesterases and reversible with flumazenil. Japanese phase III trials demonstrated high sedation success rates and rapid recovery during upper gastrointestinal endoscopy, including in elderly patients. Compared with midazolam, remimazolam shortened awakening and ambulation times, whereas compared with propofol, it may cause fewer respiratory and cardiovascular adverse events. This review summarizes the current status of upper gastrointestinal endoscopic sedation in Japan, focusing on the clinical evidence and positioning of the newly approved ultra-short-acting benzodiazepine, remimazolam.

Indexed as

elderlyrecoveryremimazolamsedationupper gastrointestinal endoscopy

Identifiers

PMID42597464
PMCPMC13469318

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.