Bispectral index during remimazolam versus propofol sedation at matched depths: a randomized, double-blind crossover trial in healthy volunteers.
Ann MedSep 25, 2026 (epub)
Clinical ResearchAnesthesiology
Senlin Cai, Xiaofen Hu, Yuqian Wei et al.
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In 30 seconds
This randomized, double-blind crossover trial evaluated the bispectral index (BIS) during remimazolam versus propofol sedation in 16 healthy volunteers. At deep sedation, remimazolam resulted in a mean BIS of 57.6 compared to 46.5 for propofol, with an adjusted difference of 11.1 units (95% CI, 7.3 to 14.8; p < 0.001).
Key findings
- Mean BIS at deep sedation was 57.6 for remimazolam versus 46.5 for propofol.
- BIS was also higher with remimazolam at moderate sedation and loss of eyelash reflex.
- Processing speed and executive function recovered faster after remimazolam at 30 minutes.
- Emergence time did not differ significantly between the two agents.
Why it matters
Understanding the differences in BIS values between sedative agents is crucial for clinicians to ensure appropriate sedation depth and patient safety. This study highlights the need for agent-specific reference values for remimazolam.