Impact of CES1 Genotype on Remimazolam

Remimazolam is a newer sedative/anesthetic drug used during surgery. Like many drugs, it is broken down in the body by specific enzymes — in this case, an enzyme called CES1 (carboxylesterase 1). The gene controlling CES1 varies between individuals, meaning some people metabolize remimazolam faster or slower than others, which could affect how deeply they are sedated and how quickly they wake up. This study investigates whether CES1 genetic variation (genotype) affects how remimazolam behaves during anesthesia. Participants are adults aged 19 to 70 who are scheduled for elective (non-emergency) surgery under general anesthesia. People with serious liver, kidney, lung, or heart conditions, those with uncontrolled diabetes, or those taking benzodiazepine medications are excluded. Understanding how genetics affect drug metabolism is the foundation of precision medicine — the idea that treatments can be tailored to individuals based on their genetic makeup. If CES1 genotype significantly influences remimazolam metabolism, anesthesiologists could potentially use a patient's genetic profile to choose the right dose, resulting in safer, more predictable anesthesia.