Procedural sedation (PS) is a frequently performed clinical practice in the ED1 aiming to facilitate a state that allows patients to tolerate uncomfortable procedures.2 The ideal agent for PS in the ED should provide anxiolysis, analgesia and amnesia in a rapid and predictable manner, with minimal adverse events and a rapid recovery phase.3 Remimazolam (RMZ) is a novel benzodiazepine with rapid conversion into an inactive metabolite, making it ultra-short acting. Compared with other intravenous sedative agents, it is less likely to cause cardiovascular or respiratory depression and in case of an adverse event, it can be antagonised using flumazenil.4 This beneficial risk profile suggests safe use of RMZ in the ED. Previous studies have described the success of RMZ for PS during endoscopic procedures5; however, there is no literature on the use of RMZ in the ED.

The aim of the current study …