Cardiothoracic & vascular anesthesia
Alterations in Total and Unbound Remimazolam Concentrations During Cardiac Surgery Requiring Cardiopulmonary Bypass: A Single-center Observational Study
Authors' conclusion
An increase in unbound concentration and a transient decrease in total concentration occurred at CPB initiation. Under the present dosing protocol, unbound remimazolam concentrations remained elevated throughout surgery.
Study context
- Population
- Adults aged ≥20 years, weighing ≤90 kg, undergoing elective cardiac surgery with cardiopulmonary bypass (CPB), receiving remimazolam 12 mg·kg⁻¹·h⁻¹ until loss of responsiveness then 1 mg·kg⁻¹·h⁻¹
- Exposure
- T1 vs T3
- Outcome
- Total and unbound remimazolam concentrations
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Total concentration T1 vs T3: median 761 vs 560 ng·mL⁻¹ (significantly lower at T3)
- p < 0.001
- Unbound concentration T1 vs T3: median 7.1 vs 23.5 ng·mL⁻¹ (significantly higher at T3)
- p < 0.001
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Alterations in Total and Unbound Remimazolam Concentrations During Cardiac Surgery Requiring Cardiopulmonary Bypass: A Single-center Observational Study. J Cardiothorac Vasc Anesth. Published 26 December 2025. doi:10.
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