The Medical Letter TML n. 4 / 2022
Nr. 04 del 21/02/2022
TML n. 4 / 2022 REMIMAZOLAM PER LA SEDAZIONE PROCEDURALE BREVE
La Food and Drug Administration (FDA) ha approvato il remimazolam (Byfavo-Paion Netherlands in USA; autorizzato per l’uso in Europa a marzo 2021; non disponibile in commercio in Italia), una benzodiazepina EV ad azione ultra-breve, per l’induzione e il mantenimento della sedazione negli adulti sottoposti a procedure chirurgiche della durata massima di 30 minuti.
TRATTAMENTO STANDARD – Per la sedazione procedurale breve vengono comunemente utilizzati la benzodiazepina midazolam e il farmaco sedativo-ipnotico propofol. A seconda della profondità della sedazione desiderata e della necessità di analgesia prevista, possono essere impiegati singolarmente, insieme o con un altro farmaco come l’oppioide fentanil.
IL NUOVO FARMACO – Come nel remifentanil, derivato del fentanil ad azione ultra-breve, la struttura chimica del remimazolam ha un estere carbossilico che viene rapidamente scisso dalle carbossilesterasi dei tessuti per formare un metabolita inattivo, con conseguente durata d’azione molto breve.
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