Supplemental Material for: Sedation Data of Remimazolam for Gastrointestinal Endoscopy: A Retrospective Cohort of over 3,500 Procedures in Japan

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IntroductionSedation during endoscopy iswidely practiced,however, adverse events and prolonged recovery room stayremain important concerns. Previous small-scale studieshave suggested that remimazolam, a novel benzodiazepine sedative,may be advantageous owing to its short half-life. This study aimed to consider the safety profiles of remimazolam during endoscopy and elucidate their characteristics.MethodsWe conducted a retrospective observational study of outpatients aged 20 years or older who underwent upper or lower gastrointestinal routine endoscopy between January 2025 and June 2025. Remimazolamwas introduced into clinical practice at our institution inNovember 2022. In January 2025, sedation with remimazolam was adopted for routine endoscopic sedation.The outcomes were incidence of adverse events and duration of recovery room stay. Logistic regression analysis was used to identify risk factors for cardiorespiratory depression and prolonged recovery room stay.ResultsA total of 3,797 patients were included. The median total dosewas 3 mg (IQR, 3–5). The incidence of cardiorespiratory depression was 4.9%. 55.5% of patients were discharged from the recovery unit within 30 minutes. Older age and female sex were identified as risk factors for cardiorespiratory depression, and female sex was additionally associated with prolonged recovery room stay.ConclusionRemimazolam may be a feasible sedative option for routine gastrointestinal endoscopy, although careful monitoring is warranted in elderly and female patients.

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