Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report

JA Clinical Reports

Case Report

Kazuyoshi Hirota¹  Satoshi Uchida¹  Daiki Takekawa¹  Reiko Kudo¹  Eiji Hashiba² 

[1] Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562, Hirosaki, Japan;Division of Intensive Care, Hirosaki University Hospital, 53 Hon-cho, 036-8562, Hirosaki, Japan;

关键词: Remimazolam;    Flumazenil;    Liver cirrhosis;    Child-Pugh score;   

DOI  :  10.1186/s40981-022-00590-9

 received in 2022-11-20, accepted in 2022-12-13,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRemimazolam is a new ultra-short-acting benzodiazepine, and its sedative effect is prolonged in patients with hepatic impairment. This is the first report of remimazolam anesthesia in a patient with Child-Pugh C liver cirrhosis.Case presentationA 52-year-old female was diagnosed with tongue cancer and scheduled for partial glossectomy. Preoperative examinations revealed Child-Pugh C liver cirrhosis, but the pathogenesis was unknown. We scheduled remimazolam anesthesia because it would stabilize her intraoperative circulation. We managed with a much lower-than-normal dose of remimazolam; even so, the patient required flumazenil to regain consciousness. She was admitted to the intensive care unit, but her consciousness remained clear even after the effect of flumazenil had worn off.ConclusionWe experienced anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis. Even conservative use of remimazolam in patients with severe hepatic dysfunction may result in emergence times that are delayed longer than expected.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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