瑞米唑仑用于1型强直性肌营养不良患者全身麻醉下行内镜逆行胰胆管造影术：一例报告
Remimazolam for a patient with myotonic dystrophy type 1 who underwent endoscopic retrograde cholangiopancreatography under general anesthesia: a case report.
作者信息
Fukuda Masakazu, Tachibana Shunsuke, Nishihara Noriaki, Yamakage Michiaki
机构信息
Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
出版信息
JA Clin Rep. 2021 Feb 24;7(1):17. doi: 10.1186/s40981-021-00422-2.
BACKGROUND
Remimazolam is a benzodiazepine receptor agonist with an ultra-short-acting anesthetic effect. We used remimazolam for anesthesia in a patient with myotonic dystrophy type 1 who underwent endoscopic retrograde cholangiopancreatography (ERCP).
CASE PRESENTATION
A 58-year-old woman received ERCP under general anesthesia. She had impaired respiratory function due to myotonic dystrophy type I and was at a risk of respiratory complications after anesthesia. General anesthesia was induced with remimazolam 12 mg/kg/h, remifentanil 0.1 μg/kg/min and rocuronium 15 mg, followed by tracheal intubation and maintained with remimazolam 0.8-1.0 mg/kg/h. At the end of anesthesia, we injected sugammadex 150 mg and flumazenil 0.2 mg, allowing smooth and clear emergence from anesthesia. She was discharged from the hospital without any respiratory problems on postoperative day 5.
CONCLUSIONS
Remimazolam was safe to use for general anesthesia in a patient with myotonic dystrophy type 1 undergoing ERCP.
背景
瑞米唑仑是一种具有超短效麻醉作用的苯二氮䓬受体激动剂。我们在一名接受内镜逆行胰胆管造影术（ERCP）的1型强直性肌营养不良患者中使用瑞米唑仑进行麻醉。
病例介绍
一名58岁女性在全身麻醉下接受ERCP。她因1型强直性肌营养不良导致呼吸功能受损，麻醉后有发生呼吸并发症的风险。以12mg/kg/h的瑞米唑仑、0.1μg/kg/min的瑞芬太尼和15mg的罗库溴铵诱导全身麻醉，随后进行气管插管，并以0.8 - 1.0mg/kg/h的瑞米唑仑维持麻醉。麻醉结束时，我们注射了150mg的舒更葡糖和0.2mg的氟马西尼，使患者顺利且清醒地从麻醉中苏醒。她在术后第5天出院，没有任何呼吸问题。
结论
瑞米唑仑用于一名接受ERCP的1型强直性肌营养不良患者的全身麻醉是安全的。
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