Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases
Abstract Background Remimazolam is a short-acting benzodiazepine with small circulatory depression. We used remimazolam for general anesthesia management in two very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation (TAVI) plus off-pump coronary artery bypass graf...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-10-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-023-00662-4 |
| _version_ | 1797577485073776640 |
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| author | Takafumi Oyoshi Yuki Mitsuta Yumiko Uemura Koichiro Tajima Naoyuki Hirata |
| author_facet | Takafumi Oyoshi Yuki Mitsuta Yumiko Uemura Koichiro Tajima Naoyuki Hirata |
| author_sort | Takafumi Oyoshi |
| collection | DOAJ |
| description | Abstract Background Remimazolam is a short-acting benzodiazepine with small circulatory depression. We used remimazolam for general anesthesia management in two very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation (TAVI) plus off-pump coronary artery bypass grafting (OPCABG). Case presentation A 96-year-old man (case 1) and a 92-year-old woman (case 2) had complex coronary artery disease (CAD) and severe aortic stenosis (AS) and were scheduled for TAVI plus OPCAB. Anesthesia in both patients was induced with 6 mg/kg/h remimazolam and fentanyl and maintained with 0.3 mg/kg/h and 0.5 mg/kg/h remimazolam and fentanyl, respectively. Although catecholamines were required, we successfully maintained circulation during the induction of anesthesia and the procedures of OPCAB and TAVI. Both patients were discharged without complications. Conclusion Remimazolam can be a useful option for safe general anesthesia in very elderly patients when performing hybrid surgery. |
| first_indexed | 2024-03-10T22:09:57Z |
| format | Article |
| id | doaj.art-05f7b84fc58d446faefd5836d659318e |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-03-10T22:09:57Z |
| publishDate | 2023-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-05f7b84fc58d446faefd5836d659318e2023-11-19T12:38:21ZengSpringerOpenJA Clinical Reports2363-90242023-10-01911610.1186/s40981-023-00662-4Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two casesTakafumi Oyoshi0Yuki Mitsuta1Yumiko Uemura2Koichiro Tajima3Naoyuki Hirata4Department of Anesthesiology, Kumamoto University, Graduate School of Medical SciencesDepartment of Anesthesiology, Japanese Red Cross Kumamoto HospitalDepartment of Anesthesiology, Minamata City General Hospital and Medical CenterDepartment of Anesthesiology, Kumamoto University, Graduate School of Medical SciencesDepartment of Anesthesiology, Kumamoto University, Graduate School of Medical SciencesAbstract Background Remimazolam is a short-acting benzodiazepine with small circulatory depression. We used remimazolam for general anesthesia management in two very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation (TAVI) plus off-pump coronary artery bypass grafting (OPCABG). Case presentation A 96-year-old man (case 1) and a 92-year-old woman (case 2) had complex coronary artery disease (CAD) and severe aortic stenosis (AS) and were scheduled for TAVI plus OPCAB. Anesthesia in both patients was induced with 6 mg/kg/h remimazolam and fentanyl and maintained with 0.3 mg/kg/h and 0.5 mg/kg/h remimazolam and fentanyl, respectively. Although catecholamines were required, we successfully maintained circulation during the induction of anesthesia and the procedures of OPCAB and TAVI. Both patients were discharged without complications. Conclusion Remimazolam can be a useful option for safe general anesthesia in very elderly patients when performing hybrid surgery.https://doi.org/10.1186/s40981-023-00662-4RemimazolamAortic stenosisElderlyHemodynamicsHybrid surgeryTranscatheter aortic valve implantation |
| spellingShingle | Takafumi Oyoshi Yuki Mitsuta Yumiko Uemura Koichiro Tajima Naoyuki Hirata Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases JA Clinical Reports Remimazolam Aortic stenosis Elderly Hemodynamics Hybrid surgery Transcatheter aortic valve implantation |
| title | Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases |
| title_full | Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases |
| title_fullStr | Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases |
| title_full_unstemmed | Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases |
| title_short | Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases |
| title_sort | anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off pump coronary artery bypass grafting report of two cases |
| topic | Remimazolam Aortic stenosis Elderly Hemodynamics Hybrid surgery Transcatheter aortic valve implantation |
| url | https://doi.org/10.1186/s40981-023-00662-4 |
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