Remimazolam: a short-acting benzodiazepine for procedural sedation.

The ultra-short-acting opioid analgesic remifentanil provided the approach that was used in the synthesis of remimazolam. A carboxylic ester was incorporated into the benzodiazepine structure providing a resultant compound that is rapidly broken down in the body into a breakdown product that is inactive, thus ensuring a very short-acting benzodiazepine. Remimazolam is highly selective in its action, only having activity at the GABAA receptor. It has been shown to be highly effective in providing sedation for bronchoscopy and colonoscopy without having a prolonged duration of action, therefore having a short effect until patients are fully awake and ready for discharge.