Using Remimazolam And The Correct Dosage
Remimazolam is a pharmacological innovation in anesthesia. This innovation combines the properties of two drugs that are already in use – Midazolam and Remifentanil. In the following, we will discuss the use of Remimazolam and the correct dosage.
Although anesthesiology as a specialty has evolved a lot, the search for an ideal anesthetic continues. The goal is to discover drugs that have as few side effects as possible. Because of this, researchers are still studying drugs for anesthesia.
What is Remimazolam and how does it work?
This medicine works similarly to Midazolam and is metabolised in the same way as Remifentanil. It can also be used as a sedative in the intensive care unit and as a sedative medicine in some procedures.
It is different from other fast-acting intravenous sedatives. Remimazolam does not cause apnea. In other words, Remimazolam is a derivative of Midazolam that has properties similar to those of Remifentanil.
Use Remimazolam and the correct dosage
Used as a premedication or pre-induction sedative, Remimazolam is no better than Midazolam. However, its effects last longer, which can be beneficial if the patient is anxious while waiting for induction. The specialist should also offer the patient treatment for anxiety just before entering the operating room.
In addition, Remimazolam has the advantage of being able to be used in patients who need short-term sedation. It is also useful in cases where the use of stronger sedatives can be dangerous.
Many procedures, such as gastrointestinal endoscopies, can use a short-acting benzodiazepine, along with a short-acting opioid, such as Fentanyl.
The effect of Remimazolam occurs after 1 to 3 minutes. Although it seems like a short time, it is actually slow. This is a disadvantage when speed is important for the process, as most gastroduodenoscopies take about 2-3 minutes.
Although the action of Remimazolam can be accelerated by using higher doses or combining it with Fentanyl, this is not a good idea. In addition, this combination can lead to respiratory problems.
Many anesthesia specialists use and teach their students to use a combination that involves a benzodiazepine, an opioid inhalation agent, and a muscle relaxant.
Remimazolam produces dose-dependent hypnosis. The drug does not accumulate in the body. In addition, if necessary, its effect can be reversed with Flumazenil.
Often, patients with critical illness have liver or kidney failure. Currently, most sedatives are metabolized by the liver or kidneys. The whole process is a problem, even if the sedation stops. In addition, most drugs have a significantly longer half-life.
The ideal drug for these cases is one that has a short action and a metabolism that does not involve the liver or kidneys. Remimazolam meets these requirements, being the drug in these critically ill patients.
Use and future of Remimazolam
Remimazolam is probably the sedative of the future. There are high expectations about the results of tests being conducted around the world. In addition, it may be ideal for patients with liver or kidney problems.
