Remimazolam besylate; overview of a novel benzodiazepine for general anesthesia

Abstract

Remimazolam, a novel, ultra-short-acting intravenous anesthetics, belongs to the benzodiazepine class of drugs and was approved for as a general anesthetic. Its pharmacological action is similar to that of midazolam. However, the differences in the metabolic pathway and pharmacokinetic profiles of its metabolites contribute to the faster offset of the action of remimazolam than midazolam. The context-sensitive half time (CSHT) is as short as 6.8 ± 2.4 min. An advantage of remimazolam over other intravenous anesthetics, such as propofol, is the presence of antagonists. Remimazolam-induced sedation is reversed by flumazenil, a benzodiazepine antagonist. Moreover, lower prevalence of injection site pain and less reduction in blood pressure in the are the advantages of remimazolam over propofol. Although our knowledge is limited at present, remimazolam may be useful for general anesthesia. We look forward to the future possibilities of this new anesthetic agent.