Can someone wake up from remimazolam anesthesia before new memories reliably stick?

Wakefulness and recall have separate clocks

A single-center randomized trial enrolled 44 patients undergoing breast surgery under remimazolam anesthesia. Researchers compared patients assigned to flumazenil with patients assigned to recovery without it. After consciousness returned, the team used an illustrated poster to assess whether patients retained newly presented material.

What the patients remembered

At the one-hour assessment, 21 of 22 patients in the flumazenil group recalled the poster, compared with 9 of 22 in the group without flumazenil. All patients could recall the poster within two hours. The result describes memory performance on the study’s task after a particular anesthetic regimen in an open-label trial.

What the chart can establish

A timestamp for eye opening, command following or extubation documents a specific event. If a dispute concerns whether someone later remembered a conversation, identify when the conversation occurred, how the person responded and whether anyone checked delayed recall. The trial did not test comprehension, decision-making capacity or recall of a particular clinical conversation.

Source paper

Nobukuni et al., JA Clinical Reports (2025) · Full text