Effects of remimazolam on hemodynamics in children with congenital heart disease

Abstract Maintaining hemodynamic stability during anesthesia is crucial for patients with congenital heart disease. Remimazolam, a novel benzodiazepine, offers advantages, such as rapid onset, quick recovery, stable hemodynamics, and mild respiratory depression. We aimed to assess the effects of a single intravenous dose of remimazolam on hemodynamics in children with congenital heart disease. Between June and September 2024, 40 children undergoing elective cardiac catheterization and transcatheter closure at Shanghai Children's Hospital were included. Non-invasive (heart rate, blood pressure, oxygen saturation) and invasive hemodynamic parameters (cardiac output, cardiac index, vena cava pressure, right atrial pressure, right ventricular pressure, pulmonary artery pressure) were measured before and after intravenous administration of 0.3 mg/kg remimazolam. Hemodynamic changes were compared pre- and post-treatment. Five patients were excluded due to incomplete data, leaving 35 for analysis (sex, 11 male, 24 female; median age, 6.67 [interquartile range: 4–11.5 years]). No significant changes in non-invasive or invasive hemodynamic parameters were observed after remimazolam administration. Additionally, no adverse effects, such as bradycardia, hypotension, or hypertension, occurred. A single intravenous dose of 0.3 mg/kg remimazolam did not affect hemodynamic parameters in children with congenital heart disease, providing stable hemodynamics with minimal circulatory fluctuations.