三例使用瑞马唑仑后难以实现确切意识丧失的病例。
Three cases of difficulty in achieving definitive loss of consciousness with remimazolam.
作者信息
Miyanishi Mao, Yaguramaki Toru, Maehara Yasuhiro, Nagata Osamu
机构信息
Department of Anesthesiology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Orthopaedic Surgery, JR Tokyo General Hospital, 2-1-3, Yoyogi, Shibuya-ku, Tokyo, 151-8528, Japan.
出版信息
JA Clin Rep. 2022 Jan 11;8(1):4. doi: 10.1186/s40981-021-00485-1.
BACKGROUND
Remimazolam is a novel, ultra-short-acting benzodiazepine used for general anesthesia. Because remimazolam is an emerging drug, the tolerance to remimazolam in benzodiazepine-taking patients has been unclear. Also, the efficacy of remimazolam in different races is not fully elucidated so far.
CASE PRESENTATION
Here we experienced three cases in which high dose of remimazolam was needed for attempting to achieve appropriate anesthetic depth. Two of the three cases were of preoperatively benzodiazepine-taking patients. The other was a case of a Chinese patient. In all three cases, conversion to general anesthesia with propofol was necessitated.
CONCLUSIONS
When signs of inadequate sedative effect of remimazolam are observed in patients of benzodiazepine users or of different races, conversion to another sedative agent such as propofol should be considered.
背景
瑞马唑仑是一种用于全身麻醉的新型超短效苯二氮䓬类药物。由于瑞马唑仑是一种新药，服用苯二氮䓬类药物的患者对瑞马唑仑的耐受性尚不清楚。此外，瑞马唑仑在不同种族中的疗效目前尚未完全阐明。
病例报告
我们在此报告三例为达到适当麻醉深度而需要高剂量瑞马唑仑的病例。三例中有两例是术前服用苯二氮䓬类药物的患者。另一例是一名中国患者。在所有三例中，均需要改用丙泊酚进行全身麻醉。
结论
当在服用苯二氮䓬类药物的患者或不同种族的患者中观察到瑞马唑仑镇静效果不足的迹象时，应考虑改用另一种镇静剂，如丙泊酚。
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