Safety and Efficacy of Remimazolam Besylate in Patients Undergoing Continuous Mechanical Ventilation

WANG Wenjing; TANG Yong; HU Bin; CHEN Gang; SHEN Jianhua; NIE Zhusheng; XU Jijian; ZHU Min; CHENG Chuji

doi:10.3639/j.issn.2095-3097.2026.02.025

Abstract：Objective To explore the efficacy and safety of remimazolam besylate for continuous mechanical ventilation in intensive care unit(ICU)patients.Methods Fifty critically ill patients who required continuous mechanical ventilation and were admitted to Anqing Municipal Hospital from May 2021 to June 2022 were selected.They were divided into a remimazolam group and a midazolam group using a random number table,with 25 cases in each group.Sedation dose was titrated based on the Richmond Agitation-Sedation Scale and the Bispectral Index.The time to achieve satisfactory sedation,the time from discontinuation of sedation to full alertness,adverse reactions during sedation,delirium,and sedation failure events were recorded.Results The drug infusion dose for maintaining light sedation was(0.22±0.07)mg/(kg·h)in the remimazolam group and(0.06±0.01)mg/(kg·h)in the midazolam group.The time to achieve satisfactory sedation was significantly shorter in the remimazolam group than in the midazolam group[8.00(7.00,11.00)min vs 16.00(10.50,19.00)min,P<0.001].The time to regain full alertness after discontinuation of sedation was significantly shorter in the remimazolam group than in the midazolam group[18.00(14.25,21.00)min vs 32.00(27.00,43.00)min,P<0.001].In the remimazolam group,there was 1 case of sedation failure,2 cases of hypotension,and 1 case of delirium.In the midazolam group,all cases achieved successful sedation,with 4 cases of hypotension and 6 cases of delirium.The differences were not statistically significant(P>0.05).Conclusion Remimazolam besylate can be safely and effectively used for continuous mechanical ventilation in ICU patients.