Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report
Abstract Background Remimazolam 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 presentation A 52-year-old female was diagnose...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-12-01
|
| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40981-022-00590-9 |
| _version_ | 1797973679239331840 |
|---|---|
| author | Satoshi Uchida Daiki Takekawa Eiji Hashiba Reiko Kudo Kazuyoshi Hirota |
| author_facet | Satoshi Uchida Daiki Takekawa Eiji Hashiba Reiko Kudo Kazuyoshi Hirota |
| author_sort | Satoshi Uchida |
| collection | DOAJ |
| description | Abstract Background Remimazolam 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 presentation A 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. Conclusion We 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. |
| first_indexed | 2024-04-11T04:08:08Z |
| format | Article |
| id | doaj.art-0c9231ee925644c3a8d83d56d490315b |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-04-11T04:08:08Z |
| publishDate | 2022-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-0c9231ee925644c3a8d83d56d490315b2023-01-01T12:14:49ZengSpringerOpenJA Clinical Reports2363-90242022-12-01811410.1186/s40981-022-00590-9Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case reportSatoshi Uchida0Daiki Takekawa1Eiji Hashiba2Reiko Kudo3Kazuyoshi Hirota4Department of Anesthesiology, Hirosaki University Graduate School of MedicineDepartment of Anesthesiology, Hirosaki University Graduate School of MedicineDivision of Intensive Care, Hirosaki University HospitalDepartment of Anesthesiology, Hirosaki University Graduate School of MedicineDepartment of Anesthesiology, Hirosaki University Graduate School of MedicineAbstract Background Remimazolam 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 presentation A 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. Conclusion We 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.https://doi.org/10.1186/s40981-022-00590-9RemimazolamFlumazenilLiver cirrhosisChild-Pugh score |
| spellingShingle | Satoshi Uchida Daiki Takekawa Eiji Hashiba Reiko Kudo Kazuyoshi Hirota Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report JA Clinical Reports Remimazolam Flumazenil Liver cirrhosis Child-Pugh score |
| title | Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report |
| title_full | Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report |
| title_fullStr | Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report |
| title_full_unstemmed | Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report |
| title_short | Anesthetic management with remimazolam in a patient with Child-Pugh C liver cirrhosis: a case report |
| title_sort | anesthetic management with remimazolam in a patient with child pugh c liver cirrhosis a case report |
| topic | Remimazolam Flumazenil Liver cirrhosis Child-Pugh score |
| url | https://doi.org/10.1186/s40981-022-00590-9 |
| work_keys_str_mv | AT satoshiuchida anestheticmanagementwithremimazolaminapatientwithchildpughclivercirrhosisacasereport AT daikitakekawa anestheticmanagementwithremimazolaminapatientwithchildpughclivercirrhosisacasereport AT eijihashiba anestheticmanagementwithremimazolaminapatientwithchildpughclivercirrhosisacasereport AT reikokudo anestheticmanagementwithremimazolaminapatientwithchildpughclivercirrhosisacasereport AT kazuyoshihirota anestheticmanagementwithremimazolaminapatientwithchildpughclivercirrhosisacasereport |