Saito Kota, Ohno Sho, Maeda Makishi, Hirata Naoyuki, Yamakage Michiaki
Department of Anesthesiology, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
JA Clin Rep. 2021 Mar 6;7(1):21. doi: 10.1186/s40981-021-00424-0.
Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB.
A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6-1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period.
Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.
在非心脏手术患者中，瑞马唑仑的心血管抑制作用比丙泊酚小。然而，瑞马唑仑在体外循环（CPB）心脏手术中的有效性和安全性尚未见报道。我们报告一例在CPB心脏手术中成功使用瑞马唑仑进行麻醉管理的病例。
一名76岁女性计划进行二尖瓣修复、三尖瓣环成形术、迷宫手术和左心耳闭合术。我们在全身麻醉诱导（6.0mg/kg/h）和维持（0.6 - 1.0mg/kg/h）过程中使用瑞马唑仑，包括CPB期间，脑电双频指数值维持在36至48范围内。血流动力学、混合静脉血氧饱和度和双侧局部脑血氧饱和度维持在可接受范围内。围手术期全程未出现与瑞马唑仑相关的术中知晓/回忆或严重并发症。
在CPB心脏手术中，瑞马唑仑可与其他现有麻醉剂一样使用。
