Sagawa Tomoki, Ishida Yusuke, Sasaki Tomomi, Hosokawa Maiko, Bito Kiyoko, Oe Katsunori
Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan.
SAGE Open Med Case Rep. 2024 Dec 25;12:2050313X241310640. doi: 10.1177/2050313X241310640. eCollection 2024.
Remimazolam, a short-acting benzodiazepine approved for use in general anesthesia in Japan in 2020, has cardiovascular stability superior to conventional anesthetics. Anesthesia management using remimazolam of a patient with impaired cardiac function and several complications is reported. A man in his 50s with hypertension, diabetes mellitus, and chronic kidney disease (G 5) on dialysis came to our hospital with a chief complaint of exertional dyspnea and chest tightness, and a close examination showed stenoses of three coronary arteries. The patient was managed under anesthesia using remimazolam as a sedative because anesthetics could easily induce circulatory failure. Cardiopulmonary bypass was initiated without causing any circulatory failure, and coronary artery bypass grafting and aortic valve replacement were performed. The patient was successfully weaned with a small dose of catecholamine. Remimazolam was selected for this patient because of its minimal effect on cardiac rhythm, and the anesthesia was safely administered.
瑞马唑仑是一种短效苯二氮䓬类药物，于2020年在日本被批准用于全身麻醉，其心血管稳定性优于传统麻醉剂。本文报道了使用瑞马唑仑对一名心功能受损且伴有多种并发症的患者进行麻醉管理的情况。一名50多岁的男性，患有高血压、糖尿病和慢性肾脏病（G5期）且正在接受透析治疗，因劳力性呼吸困难和胸闷为主诉前来我院就诊，详细检查显示三支冠状动脉狭窄。由于麻醉剂容易诱发循环衰竭，该患者在麻醉下使用瑞马唑仑作为镇静剂进行管理。体外循环启动时未引起任何循环衰竭，并进行了冠状动脉旁路移植术和主动脉瓣置换术。患者使用小剂量儿茶酚胺成功脱机。选择瑞马唑仑用于该患者是因为其对心律的影响最小，并且麻醉过程安全实施。
