Efficacy of remimazolam versus dexmedetomidine for procedural sedation: a systematic review and meta-analysis

Dexmedetomidine is a widely used sedative agent, owing to its stable hemodynamic profiles and minimal respiratory depression.Recently, remimazolam was approved for procedural sedation.Its pharmacokinetic properties may provide more controllable sedation with fewer adverse effects.This systematic review aims to evaluate the relative efficacy of remimazolam versus dexmedetomidine during procedural sedation.A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials comparing remimazolam with dexmedetomidine for procedural sedation.Of 515 studies identified, nine met the inclusion criteria and were included in the final analysis.Compared to dexmedetomidine, remimazolam was associated with a significant shorter induction time (mean difference [MD] -3.78 min; 95% confidence interval [CI] -5.88 to -1.68; p=0.0004;I 2 =98%) and a reduced recovery time (MD -3.89 min; 95% CI -5.67 to -2.11; p