What question did this study set out to answer?

The research aims to assess how remimazolam affects perioperative shivering and clinical outcomes during cesarean sections under neuraxial anesthesia.

March 31, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Effects of remimazolam on postanesthetic shivering and related clinical responses in patients undergoing cesarean section

ZZZiyi ZhangBengbu Medical College MLMengyang LiuTianjin University of Traditional Chinese Medicine QZQiang ZhangBengbu Medical College

Key Points

The research aims to assess how remimazolam affects perioperative shivering and clinical outcomes during cesarean sections under neuraxial anesthesia.
120 patients undergoing cesarean section were randomly assigned to three groups: remimazolam (R), remimazolam plus flumazenil (RF), or normal saline (C).
Remimazolam was administered intravenously post-delivery, followed by infusion until surgery ended.
Effects on shivering incidence, body temperature, traction response scores, and adverse events were measured and compared among groups.
Incidence of shivering was significantly lower in the R (17.5%) and RF (30.0%) groups compared to the C group (52.5%; p < 0.05).
Body temperatures were higher in the R group than in the C group (p < 0.05).
Lower traction response scores were observed in the R and RF groups during uterine manipulation than in the C group (p < 0.05).
Postoperative nausea and vomiting occurred less frequently in the R and RF groups compared to the C group (p < 0.05).

Abstract

Purpose This study aimed to evaluate the association between remimazolam administration and perioperative shivering as well as related clinical outcomes in patients undergoing cesarean section under neuraxial anesthesia. Methods A total of 120 patients undergoing cesarean section under neuraxial anesthesia were randomly allocated to a remimazolam group (R), a remimazolam plus flumazenil group (RF), or a normal saline group (C) ( n = 40 each). In the R group, remimazolam was administered intravenously at 0.1 mg/kg after fetal delivery, followed by continuous infusion at 0.2 mg/kg/h until the end of surgery. In the RF group, flumazenil was administered at the end of surgery to reverse sedation. The C group received an equivalent volume of normal saline. The incidence and severity of perioperative shivering, changes in perioperative body temperature, intraoperative traction response scores, and perioperative adverse events were compared among the three groups. Results The incidence of perioperative shivering was 17.5% in the R group and 30.0% in the RF group, both of which were significantly lower than that in the C group (52.5%; p 0.05). Intraoperative and postoperative body temperatures were higher in the R group than in the C group ( p 0.05). During uterine cavity manipulation, traction response scores were lower in the R and RF groups than in the C group ( p 0.05). The incidence of postoperative nausea and vomiting was lower in the R and RF groups than in the C group ( p 0.05). Conclusion In patients undergoing cesarean section under neuraxial anesthesia, remimazolam administration after fetal delivery was associated with a lower incidence of perioperative shivering, higher perioperative body temperature, and reduced intraoperative traction responses. Differences in perioperative adverse events were observed among the groups. The reduction in perioperative shivering was partially preserved after reversal with flumazenil.

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