A favorable event comparison can coexist with important baseline imbalance.
The retrospective remimazolam–etomidate analysis reported no EEG suppression events in the remimazolam group versus about 29% with etomidate. Intubation-related hypertension also differed. The remimazolam group contained a much higher proportion of ASA III patients.
Nonrandomized treatment selection and unequal physical-status distributions complicate interpretation. The absence of events in this sample does not establish that remimazolam cannot produce suppression under other exposures or clinical conditions.
Keep anesthetic phase, dose strategy and population with the EEG finding. Do not turn a group zero into a universal drug property. An individual opinion needs the raw EEG, administration timeline, brain condition and co-medications rather than inference from one retrospective comparison.
Source: PMC12415106, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Remimazolam Produced Burst Suppression in a Neurosurgical Case.