In-Silico Molecular Interaction and Pharmacokinetic Evaluation of Remimazolam and Major Intravenous Anesthetics Targeting GABAA Receptors

This study investigates the molecular interactions and pharmacokinetic properties of five intravenous anaesthetics Remimazolam, Midazolam, Propofol, Thiopental, and Etomidate with the -Aminobutyric acid type A (GABAA) receptor, a key mediator of inhibitory neurotransmission in the central nervous system.Using molecular docking analysis, we evaluated the binding affinities of these drugs to the GABAA neurotransmitter receptor.Remimazolam emerged as a promising candidate with a docking score of -6.9 kcal/mol, demonstrating strong and stable interactions with critical receptor residues such as THR96 and GLN65.Although Midazolam exhibited a slightly superior docking score of -7.1 kcal/mol, Remimazolam's pharmacokinetic profile offers distinct advantages, including rapid onset, short duration of action, and a favourable safety profile with minimal risk of hepatotoxicity and skin sensitization.In comparison, Propofol, Thiopental, and Etomidate showed weaker binding affinities and raised safety concerns.These findings suggest that Remimazolam is a competitive and safer alternative to existing intravenous anaesthetics, particularly in outpatient settings and procedures requiring efficient anaesthetic management.This study contributes valuable insights into the clinical application of Remimazolam, reinforcing its potential as an effective choice in the realm of intravenous anaesthesia.