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.
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。
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