Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea.
Medicina (Kaunas). 2022 Sep 29;58(10):1372. doi: 10.3390/medicina58101372.
High-risk surgeries for patients with severe aortic stenosis (AS) are challenging for anesthesiologists and can result in hemodynamic deterioration and even mortality. We describe a case in which remimazolam was used to induce and maintain general anesthesia for a high-risk, noncardiac surgery accompanied by ongoing bleeding. An 86-year-old man with severe AS was scheduled to undergo proximal gastrectomy due to ongoing gastrointestinal bleeding and severe anemia. Remimazolam, a novel, ultra-short-acting benzodiazepine, was administered along with remifentanil for the induction and maintenance of general anesthesia. Throughout the anesthetic process, the patient's cardiac index and systemic vascular resistance were well preserved without any vasopressor support. Remimazolam seems to have possible effectiveness as a relatively safe agent for the induction and maintenance of general anesthesia in patients with severe AS who are undergoing high-risk, noncardiac surgery with bleeding.
对于严重主动脉瓣狭窄（AS）患者的高危手术，麻醉医师面临挑战，可能导致血流动力学恶化，甚至死亡。我们描述了一例瑞马唑仑用于伴有持续出血的高危非心脏手术的全麻诱导和维持的病例。一位 86 岁男性因持续胃肠道出血和严重贫血，拟行近端胃切除术。瑞马唑仑是一种新型的超短效苯二氮䓬类药物，与瑞芬太尼联合用于全麻的诱导和维持。在整个麻醉过程中，患者的心指数和全身血管阻力得到很好的维持，无需血管加压支持。瑞马唑仑似乎可作为一种相对安全的药物，用于伴有出血的高危非心脏手术的严重 AS 患者全麻的诱导和维持。
