Title: Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single
center observational study
Version: 3 Date: 04 Nov 2024
Reviewer:  Hisatomo Ikehara
Reviewer's report:
This study by Conigliaro et al. demonstrated the utility of remimazolam in sedation for EGD
and lower endoscopy. As a recent ultrashort-acting sedative in the field of gastrointestinal
endoscopy, remimazolam’s effects were examined in Italy. To enhance scientific robustness,
revisions are recommended based on the following comments:
Comment 1
Please clarify whether this study employed a prospective or retrospective design. Additionally,
specify the study period, recruitment process for the 73 participants, and if any participants
dropped out.
Comment 2
Although the target number of cases was set at 100, only 73 were enrolled. Please provide the
statistical rationale for the analysis with 73 cases.
Comment 3
The initial and total doses of remimazolam differed between EGD and lower endoscopy, with
three cases requiring propofol as a rescue sedative during EGD. Given the expectation of shorter
duration for upper endoscopy, the total dose of remimazolam was high. Add statistical analysis
and discussion on this point.
Comment 4
Confirm whether fentanyl was administered to study participants and, if so, indicate the dosage.
Title: Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single
center observational study
Version: 3 Date: 04 Nov 2024
Reviewer:  Hisatomo Ikehara
Reviewer's report:
This study by Conigliaro et al. demonstrated the utility of remimazolam in sedation for EGD
and lower endoscopy. As a recent ultrashort-acting sedative in the field of gastrointestinal
endoscopy, remimazolam’s effects were examined in Italy. To enhance scientific robustness,
revisions are recommended based on the following comments:
Comment 1
Please clarify whether this study employed a prospective or retrospective design. Additionally,
specify the study period, recruitment process for the 73 participants, and if any participants
dropped out.
Comment 2
Although the target number of cases was set at 100, only 73 were enrolled. Please provide the
statistical rationale for the analysis with 73 cases.
Comment 3
The initial and total doses of remimazolam differed between EGD and lower endoscopy, with
three cases requiring propofol as a rescue sedative during EGD. Given the expectation of shorter
duration for upper endoscopy, the total dose of remimazolam was high. Add statistical analysis
and discussion on this point.
Comment 4
Confirm whether fentanyl was administered to study participants and, if so, indicate the dosage.
Please review this paper.
user
Title: Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single
center observational study
Version: 3 Date: 04 Nov 2024
Reviewer:  Hisatomo Ikehara
Reviewer's report:
This study by Conigliaro et al. demonstrated the utility of remimazolam in sedation for EGD
and lower endoscopy. As a recent ultrashort-acting sedative in the field of gastrointestinal
endoscopy, remimazolam’s effects were examined in Italy. To enhance scientific robustness,
revisions are recommended based on the following comments:
Comment 1
Please clarify whether this study employed a prospective or retrospective design. Additionally,
specify the study period, recruitment process for the 73 participants, and if any participants
dropped out.
Comment 2
Although the target number of cases was set at 100, only 73 were enrolled. Please provide the
statistical rationale for the analysis with 73 cases.
Comment 3
The initial and total doses of remimazolam differed between EGD and lower endoscopy, with
three cases requiring propofol as a rescue sedative during EGD. Given the expectation of shorter
duration for upper endoscopy, the total dose of remimazolam was high. Add statistical analysis
and discussion on this point.
Comment 4
Confirm whether fentanyl was administered to study participants and, if so, indicate the dosage.
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