使用瑞米唑仑对肝移植受者进行麻醉管理。
Anesthesia Management of a Liver Transplant Recipient with Remimazolam.
作者信息
Kawasaki Takashi, Oyoshi Takafumi, Hirata Naoyuki
机构信息
Department of Anesthesiology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-Ku, Kumamoto 860-8556, Japan.
出版信息
Case Rep Anesthesiol. 2023 Jan 12;2023:5935657. doi: 10.1155/2023/5935657. eCollection 2023.
BACKGROUND
Intraoperative anesthetic requirements might be altered due to the modulated metabolic function in living donor liver transplant recipients. Remimazolam may provide appropriate anesthesia in patients with cirrhosis. However, the efficacy and safety of remimazolam in liver transplant recipients have not been reported. We present the successful anesthesia management of a liver transplant recipient using remimazolam. . A 54-year-old woman who was diagnosed with Child-Pugh C cirrhosis of unknown etiology was scheduled for living donor liver transplantation. Remimazolam was used for anesthesia management under electroencephalogram monitoring, including bispectral index (BIS) and patient state index (PSI) values. Despite the prolonged surgical time (1,037 min) and massive blood loss (22,500 mL), BIS and PSI values were maintained within acceptable ranges intraoperatively. There was no intraoperative awareness/recall or adverse events associated with remimazolam administered perioperatively.
CONCLUSIONS
We safely managed general anesthesia for living donor liver transplantation with remimazolam using electroencephalogram monitoring.
背景
由于活体肝移植受者代谢功能的调节，术中麻醉需求可能会发生改变。瑞米唑仑可能为肝硬化患者提供合适的麻醉。然而，瑞米唑仑在肝移植受者中的疗效和安全性尚未见报道。我们介绍了一例使用瑞米唑仑成功进行麻醉管理的肝移植受者病例。一名54岁女性，诊断为病因不明的Child-Pugh C级肝硬化，计划进行活体肝移植。在脑电图监测下，包括脑电双频指数（BIS）和患者状态指数（PSI）值，使用瑞米唑仑进行麻醉管理。尽管手术时间延长（1037分钟）且失血量大（22500毫升），术中BIS和PSI值仍维持在可接受范围内。围手术期使用瑞米唑仑未发生术中知晓/回忆或不良事件。
结论
我们通过脑电图监测，使用瑞米唑仑安全地管理了活体肝移植的全身麻醉。
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