Choi Soron, Lee Ganghyun, Jung Jiwook, Lee Taeyoung, Park Sangyoong
Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of Korea.
J Clin Med. 2023 May 19;12(10):3558. doi: 10.3390/jcm12103558.
Remimazolam is a benzodiazepine with rapid onset and recovery time. Ketamine provides analgesia and sedation without compromising hemodynamics. Combining both agents may provide good anesthesia and analgesia with fewer complications. We report four cases of monitored anesthesia care with a combination of remimazolam and ketamine for brief gynecological surgeries. We applied 0.5 mg/kg bolus ketamine and infused patients with remimazolam at 6 mg/kg/h for induction and 1 mg/kg/h for maintenance. Then, 25 µg of fentanyl was administered for analgesia 4 min before the procedure, and additional fentanyl was administered as needed. Remimazolam was discontinued shortly after surgery. We conducted satisfactory monitored anesthesia care with a combination of remimazolam and ketamine in all four cases.
瑞米唑仑是一种起效迅速且恢复时间短的苯二氮䓬类药物。氯胺酮可提供镇痛和镇静作用，同时不影响血流动力学。联合使用这两种药物可能会提供良好的麻醉和镇痛效果，且并发症较少。我们报告了4例在简短妇科手术中使用瑞米唑仑和氯胺酮联合进行麻醉监测的病例。我们给予0.5mg/kg的氯胺酮静脉推注，并以6mg/kg/h的速度静脉输注瑞米唑仑用于诱导，以1mg/kg/h的速度用于维持。然后，在手术前4分钟给予25μg芬太尼用于镇痛，并根据需要追加芬太尼。术后不久停用瑞米唑仑。我们在所有4例病例中使用瑞米唑仑和氯胺酮联合进行了令人满意的麻醉监测。
