Cardiothoracic & vascular anesthesia
Changes in Free and Total Remimazolam Concentrations During Cardiopulmonary Bypass: A Randomized Dose-Comparison Trial
Authors' conclusion
During CPB, free remimazolam concentrations increased over time under constant infusion without corresponding changes in bispectral index values, whereas reducing the infusion rate to 70% at CPB initiation maintained free remimazolam concentrations within a stable range.
Study context
- Population
- Adults undergoing cardiac surgery with cardiopulmonary bypass (CPB), university hospital
- Participants
- 36 adults
- Comparison
- Remimazolam low dose vs normal dose
- Primary endpoint
- Free remimazolam concentration
Methodological detailsparallel-group, single-centre
- Parallel-group
- Single-centre
Primary result
As reported in the abstract
Free remimazolam concentration (baseline-adjusted)
- Time-by-group interaction: free remimazolam increasing over time in normal-dose, stable in low-dose
- pinteraction = 0.001
- Largest adjusted between-group mean difference, 30 minutes after CPB termination
- 89 ng/mL (95% CI 58-120 ng/mL; p < 0.001)
Secondary outcomes
Association between bispectral index values and free or total remimazolam concentrations
- No linear association observed
Original publication
Changes in Free and Total Remimazolam Concentrations During Cardiopulmonary Bypass: A Randomized Dose-Comparison Trial. J Cardiothorac Vasc Anesth. Published 30 June 2026. doi:10.
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