Department of Anesthesiology and Pain Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu 42601, Republic of Korea.
Medicina (Kaunas). 2023 Jul 5;59(7):1247. doi: 10.3390/medicina59071247.
: With the rising prevalence of obesity, anesthesiologists are expected to increasingly encounter patients with obesity, which poses challenges for anesthetic management. The use of remimazolam, an intravenous anesthetic agent approved in 2020, may be beneficial in these patients. However, its use in patients with super-super obesity remains underexplored. : A 55-year-old woman with a body mass index (BMI) of 60.6 kg/m and moderate obstructive sleep apnea (OSA) underwent laparoscopic sleeve gastrectomy under general anesthesia. The transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) technique was used along with the administration of remimazolam at a rate of 6 mg/kg/h based on the total body weight. The patient was sedated within 125 s without any signs of hemodynamic instability, and the surgery was completed successfully. : This case study demonstrates the potential effectiveness of remimazolam infusion for inducing general anesthesia in patients with super-super obesity. The infusion rate, derived from the total body weight, yielded an outcome comparable with that observed in individuals without obesity. Further studies with larger cohorts are required to confirm these findings.
: 随着肥胖症的患病率不断上升，预计麻醉师将越来越多地遇到肥胖症患者，这给麻醉管理带来了挑战。在这些患者中，使用 2020 年批准的静脉麻醉剂瑞马唑仑可能是有益的。然而，其在超级肥胖症患者中的应用仍未得到充分探索。 : 一名 55 岁女性，体重指数（BMI）为 60.6 kg/m，患有中度阻塞性睡眠呼吸暂停（OSA），在全身麻醉下接受腹腔镜袖状胃切除术。该患者使用经鼻湿化快速充气换气（THRIVE）技术，并根据总体重以 6mg/kg/h 的速度给予瑞马唑仑。患者在 125 秒内被镇静，没有出现任何血流动力学不稳定的迹象，手术成功完成。 : 这项病例研究表明，瑞马唑仑输注在诱导超级肥胖症患者全身麻醉方面具有潜在的有效性。输注率来自于总体重，产生的结果与非肥胖患者观察到的结果相当。需要进一步进行更大样本量的研究来证实这些发现。
