The goal of this clinical trial is to compare two sedation regimens-remimazolam and midazolam-for colonoscopy in adult patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis.

The main questions it aims to answer are:

• Does remimazolam provide patient satisfaction that is non-inferior to midazolam during colonoscopy?
• Does remimazolam allow faster recovery and discharge readiness compared to midazolam?

Researchers will compare sedation with remimazolam plus fentanyl to sedation with midazolam plus fentanyl to see if remimazolam improves patient experience and procedural efficiency.

Participants will:

• Receive either remimazolam or midazolam, each combined with fentanyl, during their scheduled colonoscopy
• Complete a short questionnaire to rate their satisfaction after the procedure
• Be assessed for recovery using a standardized discharge score at 10 and 20 minutes after the procedure

• Inclusion Criteria

  • Age ≥18 years
  • Diagnosis of IBD (CD or UC) for ≥6 months
  • Scheduled colonoscopy for clinical or surveillance purposes
  • Ability to provide informed consent

• Exclusion Criteria

  • ASA class IV
  • Allergy to benzodiazepines, opioids, flumazenil, or naloxone
  • Severe COPD
  • Obstructive sleep apnea
  • BMI >35
  • Pregnancy or lactation
  • Prior multiple ileocolonic resections or subtotal colectomy
  • Inability to complete questionnaires

De-identified individual participant data (IPD) related to primary and secondary outcomes may be shared with qualified researchers upon reasonable request and subject to institutional and ethical approval. Data will be available after publication and will include demographic data, sedation details, outcome measures, and adverse events. Access will require a data-sharing agreement.

IPD will be made available within 6 months after publication of the main results and will remain available for up to 1 year thereafter.

Qualified researchers affiliated with academic institutions, healthcare organizations, or regulatory agencies will be able to request access to the de-identified individual participant data (IPD), including demographic variables, treatment allocation, sedation response, recovery scores, adverse events, and primary/secondary outcomes. Supporting documents such as the study protocol and statistical analysis plan (SAP) will also be available.

Access will be granted upon submission and approval of a written data request, which must include a brief research proposal and data use rationale. A data-sharing agreement must be signed prior to access. Data will be shared securely via encrypted files or institutional data-sharing platforms approved by the sponsor institution.