Using Remimazolam to Generate Hemodynamically Stable Burst Suppression: A Case Report and Literature Review

Remimazolam is a short-acting benzodiazepine that was approved by the United States Food and Drug Administration (FDA) in 2020 for the induction and maintenance of procedural sedation in adults undergoing procedures lasting 30 min or less. Given its recent introduction, the use of remimazolam for general anesthesia and monitored anesthesia care (MAC) remains an area of ongoing investigation. In this report, we present the first documented case demonstrating that remimazolam can achieve hemodynamic stable burst suppression in a critically ill patient undergoing emergent craniectomy and aneurysm clipping. Additionally, this manuscript reviews the reported off-label applications of remimazolam in both the operating room and the intensive care unit (ICU) settings.