Remimazolam in pediatric anesthesia: a systematic review for clinical decision-making.

ABSTRACT:

Background

Remimazolam's role in pediatric anesthesia is evolving. We systematically reviewed 2024-2025 evidence to establish a clinical decision-making framework for its use.

Methods

Following PRISMA guidelines, a systematic search identified 23 studies (15 RCTs) involving 2,847 pediatric patients for narrative synthesis.

Results

Remimazolam demonstrated superior hemodynamic stability vs. propofol (cardiovascular complications: RR 0.30, 95% CI 0.20-0.46) and reduced emergence delirium by 61% (RR 0.39, 95% CI 0.21-0.70). The CES1 G143E polymorphism was identified as a genetic basis for prolonged sedation, reducing drug clearance >90%. Critical limitations include a 15% re-sedation rate post-flumazenil, a complete lack of data in infants <1 year, and unknown long-term

SUBMITTER: Zhang Y 

PROVIDER: S-EPMC12500429 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature