Gastroscopy Dose-Finding Still Required Propofol Rescue in Four of Twenty-Two Patients

The need for rescue treatment belongs in the interpretation of a successful sedation study.

Study findings

Twenty-two adults entered the remimazolam dose-finding study. Eighteen completed anesthesia with remimazolam alone; four required propofol. The estimated ED50 was 0.362 mg/kg and ED95 0.464 mg/kg, with the ED95 confidence interval extending from 0.403 to 2.242 mg/kg. These are study estimates rather than dosing instructions.

What limits the conclusion

The very wide upper-response interval shows considerable uncertainty. An acceptable vital-sign record in this small sample cannot exclude uncommon harm. Recovery measurements after rescue reflect a changed drug sequence, not necessarily the isolated effect of the initial agent.

Implications for case review

Report the observed rescue frequency alongside modeled dose estimates. A final successful examination does not establish that the initial dose was sufficient throughout. Actual medication timestamps and responses are necessary before using the study to explain an individual’s movement, recovery or exposure.

Source and related reading

Source: PMC11001170, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.

Related: Remimazolam Endoscopy Success Included Rescue and Supplemental-Dose Rules.