【摘要】 瑞马唑仑（CNS 7056）是一种新型镇静剂，是基于酯基的、具有非常短效药效作用的、可静脉注射的苯二氮?类药物，主要用于手术室、ICU、内镜室等科室的多种检查和手术患者的程序镇静和全身麻醉，具有起效快、代谢快、作用持续时间短、无蓄积、不经肝肾代谢、可被氟马西尼快速拮抗、呼吸和循环抑制作用低等特点，比现有传统苯二氮?类镇静药物（如丙泊酚、咪达唑仑、阿普唑仑、奥沙西泮等）镇静效果更优。理论上，瑞马唑仑可安全用于ICU短时操作及长时镇静治疗，是危重患者用于镇静的最佳选择，但其临床应用方法和潜在的不良反应仍有待于进一步研究。为进一步为临床研究提供参考，本研究在梳理瑞马唑仑研发背景、临床应用以及药理作用机制的基础上，重点阐述瑞马唑仑在ICU中（包括在纤维支气管镜检查和治疗、在有创机械通气患者镇静治疗、在肝肾功能障碍患者的镇静治疗中）的临床应用，综合分析药品不良反应，并做以讨论和展望，认为瑞马唑仑是ICU中理想的镇静药物，是危重患者镇静的良好选择，在老年重症患者中极具镇静优势，有潜力成为首选镇静药物。更多还原

【Abstract】 Remimazolam(CNS 7056) is a novel sedative, classified as an ester-based, ultra-short-acting, intravenous benzodiazepine. It is primarily utilized for procedural sedation and general anesthesia across various settings such as the operating room, intensive care unit(ICU), and endoscopy suite. Remimazolam boasts several advantages, including rapid onset, quick metabolism, short duration of action, lack of accumulation, non-hepatic and non-renal metabolism, swift reversal by flumazenil, and minimal respiratory and circulatory depression. These features render it superior to traditional benzodiazepine sedatives(eg, propofol, midazolam, alprazolam, and oxazepam) in terms of sedation efficacy. Theoretically, remimazolam can be safely administered for short-term procedures and longterm sedation therapy in the ICU, making it an optimal choice for critically ill patients. However, further research is necessary to explore its clinical application methods and potential adverse effects. To provide a comprehensive reference for clinical research, this study reviews the development background, clinical applications, and pharmacological mechanisms of remimazolam. It mainly focuses on its clinical application in the ICU, including during fiberoptic bronchoscopy, sedation for patients on invasive mechanical ventilation, and sedation in patients with hepatic and renal dysfunction. Additionally, this study analyzes adverse drug reactions, discusses future prospects, and concludes that remimazolam is an ideal sedative in the ICU, especially for elderly critically ill patients, and holds the potential to become the preferred first-line choice sedative.更多还原