A comparison with no remimazolam is not necessarily a comparison with one standardized alternative.
The retrospective study included 405 older hip-fracture patients under subarachnoid block. Continuous remimazolam use was associated with lower delirium and anxiety measures. The authors acknowledged substantial differences in the control group’s treatment and sedation regimens.
Those differences complicate attribution to a single medicine. Retrospective selection and one-center practice also limit causal inference. Lower anxiety scores do not establish that anxiety reduction mediated any delirium association.
Describe what the control group actually received before assigning the observed difference to remimazolam. The study cannot establish that a particular delirium episode was preventable by substituting one drug. Individual analysis requires the full perioperative regimen, baseline cognition, pain control and subsequent clinical events.
Source: PMC12464516, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Neonatal Seizure Control Was Assessed Clinically Without EEG in a Midazolam Comparison.