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Background <p>High-quality neonatal imaging often necessitates sedation or anesthesia to minimize motion artifacts. However, procedural sedation for non-painful pediatric examinations outside the operating room presents unique challenges due to their distinct cardiopulmonary physiology and drug metabolism. Although remimazolam is associated with minimal hemodynamic and respiratory effects in adults, evidence supporting its use in neonatal MRI remains limited.</p> Case description <p>We report the first successful application of remimazolam for MRI sedation in an early-term neonate (37 ⁴⁄₇ weeks’ gestational age, 2.9&#xa0;kg). After unsuccessful non-pharmacologic measures and intranasal dexmedetomidine, intravenous remimazolam (0.1&#xa0;mg/kg) produced adequate sedation within 1&#xa0;min, allowing completion of a 17-minute MRI examination while preserving hemodynamic and respiratory stability.</p> Conclusions <p>This case highlights potential utility of remimazolam s a rescue sedative for neonatal MRI sedation. Comprehensive multicenter studies are warranted to evaluate its safety, efficacy, and role in clinical practice.</p>

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Feasibility of remimazolam rescue sedation for neonatal MRI: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Di Wu,
  • Lin Chen,
  • Jing Cheng,
  • Cheng Jing Yue,
  • Yingyao Quan

摘要

Background

High-quality neonatal imaging often necessitates sedation or anesthesia to minimize motion artifacts. However, procedural sedation for non-painful pediatric examinations outside the operating room presents unique challenges due to their distinct cardiopulmonary physiology and drug metabolism. Although remimazolam is associated with minimal hemodynamic and respiratory effects in adults, evidence supporting its use in neonatal MRI remains limited.

Case description

We report the first successful application of remimazolam for MRI sedation in an early-term neonate (37 ⁴⁄₇ weeks’ gestational age, 2.9 kg). After unsuccessful non-pharmacologic measures and intranasal dexmedetomidine, intravenous remimazolam (0.1 mg/kg) produced adequate sedation within 1 min, allowing completion of a 17-minute MRI examination while preserving hemodynamic and respiratory stability.

Conclusions

This case highlights potential utility of remimazolam s a rescue sedative for neonatal MRI sedation. Comprehensive multicenter studies are warranted to evaluate its safety, efficacy, and role in clinical practice.