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A case of pediatric Perthes' disease with unexplained hyperlactatemia at the time of initial surgery and anesthetic management with remimazolam for the subsequent surgery.1例小儿佩特兹病患者,初次手术时出现不明原因的高乳酸血症,后续手术采用瑞米唑仑进行麻醉管理。
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本文引用的文献

1
Remimazolam anesthesia for transcatheter mitral valve repair in a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome: a case report.咪达唑仑麻醉用于线粒体肌病、脑病、乳酸性酸中毒和卒中样发作(MELAS)综合征患者的经导管二尖瓣修复术:一例报告
JA Clin Rep. 2022 Jun 1;8(1):38. doi: 10.1186/s40981-022-00528-1.
2
General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report.咪达唑仑用于线粒体脑肌病患者的全身麻醉:一例报告
JA Clin Rep. 2021 Jun 23;7(1):51. doi: 10.1186/s40981-021-00454-8.
3
Pediatric sedation using dexmedetomidine and remimazolam for magnetic resonance imaging.使用右美托咪定和瑞马唑仑进行小儿镇静用于磁共振成像
J Anesth. 2022 Feb;36(1):1-4. doi: 10.1007/s00540-021-02957-1. Epub 2021 Jun 5.
4
A mechanism of re-sedation caused by remimazolam.瑞米唑仑引起再镇静的机制。
J Anesth. 2021 Jun;35(3):467-468. doi: 10.1007/s00540-021-02930-y. Epub 2021 Apr 6.
5
What are mechanisms of re-sedation caused by remimazolam?瑞米唑仑引起再镇静的机制是什么?
J Anesth. 2021 Jun;35(3):466. doi: 10.1007/s00540-021-02926-8. Epub 2021 Mar 22.
6
Re-sleeping after reversal of remimazolam by flumazenil.氟马西尼逆转瑞米唑仑作用后再次入睡。
J Anesth. 2021 Apr;35(2):322. doi: 10.1007/s00540-021-02915-x. Epub 2021 Mar 9.
7
Ringer's acetate solution-induced precipitation of remimazolam.乳酸林格氏液诱导瑞米唑仑沉淀。
Br J Anaesth. 2021 Mar;126(3):e87-e89. doi: 10.1016/j.bja.2020.11.021. Epub 2021 Jan 6.
8
Remimazolam for anaesthesia or sedation.瑞马唑仑用于麻醉或镇静。
Curr Opin Anaesthesiol. 2020 Aug;33(4):506-511. doi: 10.1097/ACO.0000000000000877.
9
Anesthetic Management of Two Pediatric Patients With Concurrent Diagnoses of Mitochondrial Disease and Malignant Hyperthermia Susceptibility: A Case Report.两名同时诊断为线粒体疾病和恶性高热易感性的儿科患者的麻醉管理:病例报告
A A Case Rep. 2017 Oct 1;9(7):204-206. doi: 10.1213/XAA.0000000000000565.
10
CARE guidelines for case reports: explanation and elaboration document.病例报告的CARE指南:解释与阐述文件。
J Clin Epidemiol. 2017 Sep;89:218-235. doi: 10.1016/j.jclinepi.2017.04.026. Epub 2017 May 18.

咪达唑仑用于患有线粒体脑肌病伴乳酸血症和卒中样发作(MELAS)及复发性癫痫的儿科患者的全身麻醉:一例报告

General anesthesia with remimazolam for a pediatric patient with MELAS and recurrent epilepsy: a case report.

作者信息

Yamadori Yusuke, Yamagami Yuki, Matsumoto Yukihisa, Koizumi Mari, Nakamura Akiyo, Mizuta Daiskuke, Yasuda Kyoko, Shirakami Gotaro

机构信息

Department of Anesthesiology, Takamatsu Red Cross Hospital, 4-1-3 Bancho, Takamatsu City, Kagawa, 760-0017, Japan.

Department of Anesthesia and Pain Medicine, Kagawa University Hospital, 1750-1 Ikenobe, Miki-cho, Kagawa, 761-0793, Japan.

出版信息

JA Clin Rep. 2022 Sep 16;8(1):75. doi: 10.1186/s40981-022-00564-x.

DOI:10.1186/s40981-022-00564-x
PMID:36112237
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9481841/
Abstract

BACKGROUND

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a mitochondrial disease. We report here the safe use of remimazolam in a pediatric MELAS patient.

CASE PRESENTATION

A 10-year-old girl (118 cm, 16 kg) was scheduled for an open gastrostomy to improve nutrition and epileptic seizure control. We induced and maintained general anesthesia with remimazolam, remifentanil, fentanyl, and rocuronium. We also performed a bilateral subcostal transversus abdominis plane block before the surgery. The surgery finished uneventfully. After we discontinued remimazolam administration, the patient woke up immediately but calmly without flumazenil. Epileptic seizures did not occur during intra- and early post-operative periods.

CONCLUSION

Remimazolam enabled us to provide a pediatric MELAS patient with general anesthesia without causing delayed emergence or epileptic seizures.

摘要

背景

线粒体脑肌病伴乳酸血症和卒中样发作(MELAS)是一种线粒体疾病。我们在此报告瑞米唑仑在一名儿科MELAS患者中的安全使用情况。

病例介绍

一名10岁女孩(身高118厘米,体重16千克)计划进行开放性胃造口术以改善营养状况并控制癫痫发作。我们使用瑞米唑仑、瑞芬太尼、芬太尼和罗库溴铵诱导并维持全身麻醉。我们还在手术前进行了双侧肋下腹横肌平面阻滞。手术顺利完成。停用瑞米唑仑后,患者未使用氟马西尼即立即平静苏醒。术中和术后早期均未发生癫痫发作。

结论

瑞米唑仑使我们能够为一名儿科MELAS患者提供全身麻醉,而不会导致苏醒延迟或癫痫发作。