Bui Anastasia, Serafin Joanna, Shah Suken, Barnett Kara M
From the SUNY Downstate College of Medicine, Brooklyn, New York.
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
A A Pract. 2024 Dec 10;18(12):e01879. doi: 10.1213/XAA.0000000000001879. eCollection 2024 Dec 1.
Patients with aortic stenosis (AS) and other significant cardiopulmonary comorbidities are vulnerable to hemodynamic instability during anesthesia. This case report compares the use of remimazolam and midazolam in a 71-year-old man with symptomatic AS, chronic kidney disease, and ischemic cardiomyopathy. The patient underwent multiple short ambulatory interventional radiology procedures. While moderate sedation with midazolam resulted in significant hypotension, use of remimazolam in subsequent procedures demonstrated a stable hemodynamic profile despite increased disease burden. This report highlights the potential advantages of remimazolam compared to midazolam in high-risk patients undergoing interventional radiology procedures.
患有主动脉瓣狭窄(AS)及其他严重心肺合并症的患者在麻醉期间易出现血流动力学不稳定。本病例报告比较了瑞米唑仑和咪达唑仑在一名71岁有症状AS、慢性肾病和缺血性心肌病男性患者中的应用情况。该患者接受了多次门诊短期介入放射学检查。使用咪达唑仑进行中度镇静导致显著低血压,而在随后的检查中使用瑞米唑仑,尽管疾病负担增加,但血流动力学表现稳定。本报告强调了在接受介入放射学检查的高危患者中,瑞米唑仑相对于咪达唑仑的潜在优势。