Effectiveness and safety of remimazolam sedation in the emergency department.

INTRODUCTION

The demand for procedural sedation in the emergency department (ED) has risen. This study aims to 1) investigate the safety of remimazolam as analgosedation, 2) evaluate amnesia and the quality of sedation and 3) determine whether the sedation was successful and effectively managed pain for procedures in the ED.

METHODS

This prospective clinical cohort study was performed by registered nurse anaesthetists in the ED at Aalborg University Hospital from February to May 2024. Outcome measures were 1) adverse effects of remimazolam, proportion of patients reporting 2) adequate sedation or amnesia post-procedure and 3) adequate pain or anxiety relief.

RESULTS

A total of 68 patients (median age 59, 58% female) were sedated by remimazolam with a median dose of 7.5 mg. Most patients (97% (n = 66)) had no or mild respiratory problems during sedation. Two patients had transient severe respiratory problems following sedation. Both patients had received large doses of opioids before remimazolam sedation. Patient satisfaction was 97% based on reports of procedural amnesia or satisfaction with sedation and pain control. Almost all (89%) joint reductions were successfully performed. In over half of patients who would have otherwise required general anaesthesia in an operating room (57%, n = 20/35), sedation with remimazolam was sufficient to perform the procedure in the ED.

CONCLUSIONS

The use of remimazolam in the ED was a safe and effective sedative treatment with high patient satisfaction levels.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.